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1.
PLoS One ; 15(9): e0239759, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32970759

RESUMEN

OBJECTIVE: The purpose of this study was to evaluate the effects of miniscrew insertion angle and vertical facial type on the interradicular miniscrew-root distance available for molar distalization. MATERIALS AND METHODS: Cone-beam computed tomography images of 60 adults with skeletal Class I occlusion exhibiting hyperdivergent (n = 20), normodivergent (n = 20), and hypodivergent (n = 20) facial types were used. Placement of a 6-mm long, 1.5-mm diameter, tapered miniscrew was simulated at a site 4 mm apical to the cementoenamel junction, with insertion angles of 0°, 30°, 45°, and 60° relative to the transverse occlusal plane. The shortest linear distance between the miniscrew and anterior root at four interradicular sites was measured: maxillary second premolar and first molar (Mx 5-6), maxillary first and second molars (Mx 6-7), mandibular second premolar and first molar (Mn 5-6), and mandibular first and second molars (Mn 6-7). RESULTS: Miniscrew-root distance significantly increased as the insertion angle increased from 0° to 60°. In the mandible, the distances significantly differed among vertical facial types, increasing in the following order: hyperdivergent, normodivergent, and hypodivergent. The minimum mean distance was found in the Mx 6-7 (30°; 0.86±0.35 mm), and the maximum mean distance was found in the Mn 5-6 (60°; 2.64±0.56 mm). The rates of miniscrews located buccally outside the root distalization path were up to 70% and 55% when the miniscrews were placed at 60° insertion angles in the Mx 5-6 and Mn 5-6 regions, respectively. CONCLUSIONS: Miniscrew-root distance increased significantly with the increased insertion angle, and the amount of increase was affected by the miniscrew placement site and vertical facial type. To ensure adequate distalization of the posterior segment, the miniscrew should be inserted at an angle in the interradicular area between the second premolar and first molar.


Asunto(s)
Tornillos Óseos , Simulación por Computador , Tomografía Computarizada de Haz Cónico/métodos , Diente Molar/diagnóstico por imagen , Métodos de Anclaje en Ortodoncia/métodos , Técnicas de Movimiento Dental/métodos , Raíz del Diente/diagnóstico por imagen , Adulto , Femenino , Humanos , Masculino , Métodos de Anclaje en Ortodoncia/instrumentación , Técnicas de Movimiento Dental/instrumentación
2.
BMC Oral Health ; 20(1): 114, 2020 04 16.
Artículo en Inglés | MEDLINE | ID: mdl-32299416

RESUMEN

BACKGROUND: Increased tooth mobility persists after fixed orthodontic appliance removal, which is therapeutically utilized for post-treatment finishing with positioners. As such a fine adjustment is only required for selected teeth, the aim of this pilot study was to investigate tooth mobility in vivo on corrected and uncorrected subgroups under positioner therapy. METHODS: Mobility was measured on upper teeth of 10 patients (mean age 16.8) by applying loadings for 0.1, 1.0 and 10.0 s with a novel device directly after multibracket appliance debonding as much as 2d, 1, 2 and 6 weeks later. Positioners were inserted at day 2. Specimens were divided into Group C (teeth corrected via positioner), Group N (uncorrected teeth adjacent to teeth from group C), and Group U (uncorrected teeth in an anchorage block). Untreated individuals served as controls (n = 10, mean age 22.4). Statistics were performed via Kolmogorov-Smirnov test and Welch's unequal variances t-test for comparisons between groups. P < 0.05 was considered statistically significant. RESULTS: After 1 week, tooth mobility in Group U almost resembled controls (13.0-15.7 N), and reached physiological values after 6 weeks (17.4 N vs. 17.3 N in controls). Group C (9.0-13.4 N) and Group N (9.2-14.7 N) maintained increased mobility after 6 weeks. Tooth mobility was generally higher by reason of long loading durations (10.0 s). CONCLUSIONS: Positioner therapy can selectively utilized increased tooth mobility upon orthodontic fixed appliance treatment for case refinements. Here, uncorrected teeth in anchorage blocks are not entailed by unwanted side effects and recover after 6 weeks post treatment. Corrected teeth and their neighbors exhibit enhanced mobility even after 6 weeks, which represents a necessity for the proper correction of tooth position, and concurrently arouses the requirement for an adequate retention protocol.


Asunto(s)
Métodos de Anclaje en Ortodoncia/instrumentación , Aparatos Ortodóncicos Fijos , Movilidad Dentaria/diagnóstico , Técnicas de Movimiento Dental/instrumentación , Adulto , Humanos , Lactante , Proyectos Piloto , Diente , Adulto Joven
3.
J Appl Oral Sci ; 28: e20190364, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32348442

RESUMEN

Objective Maxillary molar distalization with intraoral distalizer appliances is a non-extraction orthodontic treatment used to correct molar relationship in patients with Class II malocclusion presenting maxillary dentoalveolar protrusion and minor skeletal discrepancies. This study compares the changes caused by three distalizers with different force systems. Methodology 71 patients, divided into three groups, were included. The Jones jig group (JJG, n=30; 16 male, 14 female, 13.17 years mean age) was treated with the Jones jig for 0.8 years. The Distal jet group (DJG, n=25; 8 male, 17 female, 12.57 years mean age) was treated with the Distal jet for 1.06 years. The First Class group (FCG, n=16; 6 male, 10 female, 12.84 years mean age) was treated with the First Class for 0.69 years. Intergroup treatment changes were compared using one-way ANOVA, followed by post-hoc Tukey's tests. Results Intergroup comparisons showed significantly greater maxillary incisor protrusion in DJG than in FCG (2.56±2.24 mm vs. 0.74±1.39mm, p=0.015). The maxillary first premolars showed progressive and significantly smaller mesial angulation in JJG, FCG and DJG, respectively (14.65±6.31º, 8.43±3.99º, 0.97±3.16º; p<0.001). They also showed greater mesialization in JJG than FCG (3.76±1.46 mm vs. 2.27±1.47 mm, p=0.010), and greater extrusion in DJG compared to JJG (0.90±0.77 mm vs 0.11±0.60 mm, p=0.004). The maxillary second premolars showed progressive and significantly smaller mesial angulation and mesialization in JJG, FCG and DJG, respectively (12.77±5.78º, 3.20±3.94º, -2.12±3.71º and 3.87±1.34 mm, 2.25±1.40 mm, 1.24±1.26 mm, respectively; p<0.001). DJG showed smaller distal angulation of maxillary first molars (-2.14±5.09º vs. -7.73±4.28º and -6.05±3.76º, for the JJG and FCG, respectively; p<0.001) and greater maxillary second molars extrusion (1.17±1.41 mm vs -0.02±1.16 mm and 0.16±1.40 mm, for the JJG and FCG, respectively; p=0.003). Overjet change was significantly larger in DJG compared to FCG (1.79±1.67 mm vs 0.68±0.84; p=0.046). Treatment time was smaller in FCG (0.69±0.22 years vs 0.81±0.33 years and 1.06±0.42 years, comparing it with the JJG and DJG, respectively; p=0.005). Conclusion The three appliances corrected the Class II molar relationship by dentoalveolar changes. The Distal jet produced smaller molar distal angulation than the Jones jig and First Class. The First Class appliance showed less anchorage loss, greater percentage of distalization and shorter treatment time than the Jones jig and Distal jet.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Diente Molar/fisiopatología , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos Fijos , Técnicas de Movimiento Dental/instrumentación , Adolescente , Análisis de Varianza , Cefalometría , Niño , Femenino , Humanos , Masculino , Maloclusión de Angle Clase II/fisiopatología , Métodos de Anclaje en Ortodoncia/instrumentación , Valores de Referencia , Reproducibilidad de los Resultados , Estudios Retrospectivos , Resultado del Tratamiento
4.
Sci Rep ; 10(1): 5848, 2020 04 03.
Artículo en Inglés | MEDLINE | ID: mdl-32246125

RESUMEN

The reason of the biological stability loss of mini-implants is still a matter of discussion between dentistry professionals. The main objective of this systematic literature review and meta-analysis was to analyze the risk factors that prejudice this loss. A search was made in the electronic databases Pubmed, Scopus, Embase and Cochrane, in addition a manual search was made too in Grey Literature (Opengrey). No limits were set on the year of publication or language. The inclusion criteria were: studies in humans treated with fixed appliances with mini-implants, where the risk factors for secondary stability were evaluated for a minimum of 8 weeks. After eliminating duplicate studies and assessing which ones achieve the inclusion criteria, a total of 26 studies were selected for the qualitative synthesis, 18 of them were included in the quantitative synthesis. Common risk variables were compared in all of them. Analyzing the forest and funnel plots, statistically significant differences were obtained only for location, the upper maxilla having lower risk than the mandible with an odds ratio of 0.56 and confidence interval of 0.39 to 0.80. Prospective studies under controlled conditions should be required in order to obtain a correct assessment of the variables analyzed.


Asunto(s)
Implantes Dentales/efectos adversos , Métodos de Anclaje en Ortodoncia/efectos adversos , Fracaso de la Restauración Dental , Humanos , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Factores de Riesgo
5.
Oral Maxillofac Surg Clin North Am ; 32(1): 83-88, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31685346

RESUMEN

Patients and orthodontists seek to reduce treatment time in braces. Rapid canine retraction through dentoalveolar distraction osteogenesis is one of several treatment approaches to reduce treatment in braces. This article provides an overview of technique of dentoalveolar distraction osteogenesis to accomplish rapid canine retraction and associated outcomes. When this treatment protocol is implemented well, rapid canine retraction is achieved predictably with minimal side effects. Although current evidence suggests that adverse sequelae, such as root resorptions and pulp devitalization, are rare, prospective clinical studies that are adequately powered and documenting long-term follow-up of these outcomes are lacking.


Asunto(s)
Procedimientos Quirúrgicos Orales/métodos , Métodos de Anclaje en Ortodoncia , Diseño de Aparato Ortodóncico , Osteogénesis por Distracción/métodos , Osteotomía/métodos , Técnicas de Movimiento Dental/métodos , Humanos , Maxilar , Métodos de Anclaje en Ortodoncia/efectos adversos , Métodos de Anclaje en Ortodoncia/instrumentación , Aparatos Ortodóncicos , Procedimientos Quirúrgicos Ortognáticos , Estudios Prospectivos , Resultado del Tratamiento
6.
J. appl. oral sci ; 28: e20190364, 2020. tab, graf
Artículo en Inglés | LILACS, BBO - Odontología | ID: biblio-1101252

RESUMEN

Abstract Objective Maxillary molar distalization with intraoral distalizer appliances is a non-extraction orthodontic treatment used to correct molar relationship in patients with Class II malocclusion presenting maxillary dentoalveolar protrusion and minor skeletal discrepancies. This study compares the changes caused by three distalizers with different force systems. Methodology 71 patients, divided into three groups, were included. The Jones jig group (JJG, n=30; 16 male, 14 female, 13.17 years mean age) was treated with the Jones jig for 0.8 years. The Distal jet group (DJG, n=25; 8 male, 17 female, 12.57 years mean age) was treated with the Distal jet for 1.06 years. The First Class group (FCG, n=16; 6 male, 10 female, 12.84 years mean age) was treated with the First Class for 0.69 years. Intergroup treatment changes were compared using one-way ANOVA, followed by post-hoc Tukey's tests. Results Intergroup comparisons showed significantly greater maxillary incisor protrusion in DJG than in FCG (2.56±2.24 mm vs. 0.74±1.39mm, p=0.015). The maxillary first premolars showed progressive and significantly smaller mesial angulation in JJG, FCG and DJG, respectively (14.65±6.31º, 8.43±3.99º, 0.97±3.16º; p<0.001). They also showed greater mesialization in JJG than FCG (3.76±1.46 mm vs. 2.27±1.47 mm, p=0.010), and greater extrusion in DJG compared to JJG (0.90±0.77 mm vs 0.11±0.60 mm, p=0.004). The maxillary second premolars showed progressive and significantly smaller mesial angulation and mesialization in JJG, FCG and DJG, respectively (12.77±5.78º, 3.20±3.94º, -2.12±3.71º and 3.87±1.34 mm, 2.25±1.40 mm, 1.24±1.26 mm, respectively; p<0.001). DJG showed smaller distal angulation of maxillary first molars (-2.14±5.09º vs. -7.73±4.28º and -6.05±3.76º, for the JJG and FCG, respectively; p<0.001) and greater maxillary second molars extrusion (1.17±1.41 mm vs -0.02±1.16 mm and 0.16±1.40 mm, for the JJG and FCG, respectively; p=0.003). Overjet change was significantly larger in DJG compared to FCG (1.79±1.67 mm vs 0.68±0.84; p=0.046). Treatment time was smaller in FCG (0.69±0.22 years vs 0.81±0.33 years and 1.06±0.42 years, comparing it with the JJG and DJG, respectively; p=0.005). Conclusion The three appliances corrected the Class II molar relationship by dentoalveolar changes. The Distal jet produced smaller molar distal angulation than the Jones jig and First Class. The First Class appliance showed less anchorage loss, greater percentage of distalization and shorter treatment time than the Jones jig and Distal jet.


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Técnicas de Movimiento Dental/instrumentación , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos Fijos , Maloclusión de Angle Clase II/terapia , Diente Molar/fisiopatología , Valores de Referencia , Cefalometría , Reproducibilidad de los Resultados , Estudios Retrospectivos , Análisis de Varianza , Resultado del Tratamiento , Métodos de Anclaje en Ortodoncia/instrumentación , Maloclusión de Angle Clase II/fisiopatología
7.
Artículo en Inglés | LILACS-Express | LILACS, BBO - Odontología | ID: biblio-1101287

RESUMEN

Abstract Objective: To evaluate the rate of tooth movement and the pain perception via self-ligating (SL) and conventional elastomeric ligation brackets (CB) system. Material and Methods: This study has been conducted at the Orthodontic Department of Baqai Dental College, Baqai Medical University. The sample size of this study comprised 40 patients, falling between the age of 12-30 years without any sex discrimination. Shapiro-Wilk was used to check the distribution of data. Non-parametric Mann Whitney U test was applied to evaluate the pain associated with SL and CB brackets system. To analysis the canine retraction Wilcoxon test was applied for the comparison of CB and SL brackets system. For all statistical analyses, the p-value of <0.05 was considered significant. Results: Pain level associated with retraction via CB and SL shows significant differences. However, the rate of canine retraction via CB and SL shows no significant differences at stages T0-T1 and T1-T2. However, stage T2-T3 shows a significant difference. Conclusion: As pain during orthodontic treatment is mostly associated with the level of compression of the periodontal ligament, it may be hypothesized that lower frictional forces generate less compression of the periodontal ligament and blood vessels, and so alter the type of pain experienced.


Asunto(s)
Humanos , Masculino , Femenino , Niño , Adolescente , Adulto , Ligamento Periodontal , Técnicas de Movimiento Dental/instrumentación , Métodos de Anclaje en Ortodoncia/instrumentación , Percepción del Dolor , Fricción Ortodóntica , Estadísticas no Paramétricas , Malasia
8.
Int Orthod ; 17(4): 806-816, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31477527

RESUMEN

The treatment of skeletal deep bite does not remain stable. The patient was a Japanese woman aged 16 years and 10 months. Her chief complaint was maxillary protrusion. The degree of overjet was + 10.5 mm and overbite was + 5.0 mm; the intermolar relationship was Angle Class II. An excessive curve of Spee was observed in the mandibular arch. A hypodivergent skeletal pattern was indicated by a small mandibular plane angle and gonial angle. The maxillary incisors were proclined and the mandibular incisors were retroclined. Based on the above findings, the patient was diagnosed with Angle Class II maxillary protrusion and deep bite with hypodivergency. Both maxillary first premolars were extracted and orthodontic treatment was performed using multi-bracket appliances. A proper overbite was achieved by 5.0 mm intrusion of the mandibular incisors. The maxillary incisors were retracted by 11.2 mm and a proper overjet was achieved. Good treatment results were obtained without apical root resorption. After 2 years of retention, the occlusion has been well maintained. This report may constitute a remarkable suggestion for treatment of an unstable deep bite.


Asunto(s)
Incisivo , Maloclusión de Angle Clase II/terapia , Maxilar , Métodos de Anclaje en Ortodoncia/métodos , Sobremordida/terapia , Técnicas de Movimiento Dental/métodos , Adolescente , Diente Premolar , Cefalometría , Modelos Dentales , Oclusión Dental , Femenino , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Mandíbula , Métodos de Anclaje en Ortodoncia/instrumentación , Soportes Ortodóncicos , Alambres para Ortodoncia , Sobremordida/diagnóstico por imagen , Técnicas de Movimiento Dental/instrumentación , Resultado del Tratamiento
9.
Am J Orthod Dentofacial Orthop ; 156(3): 326-336, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474262

RESUMEN

INTRODUCTION: Orthodontic mini-implants aid in the correction of distocclusions via direct anchorage (pull from mini-implant to teeth) and indirect anchorage (teeth pulled against other teeth anchored by the mini-implant). The aim of this study was to compare stress levels on the periodontal ligament (PDL) of maxillary buccal teeth in direct and indirect distalization against orthodontic mini-implants and accounting for individual variation in maxillary anatomy and biomechanical characteristics of the compact bone. METHODS: A 3D model of the maxilla containing the different components (teeth, PDL, trabecular and cortical bones) was generated from a computed tomographic scan. Cortical bone was divided into several areas according to previously defined zones. Bone stiffness and thickness data, obtained from 11 and 12 cadavers, respectively, were incorporated into the initial model to simulate the individual cortical bone variation at the different locations. Subsequently, a finite element analysis was used to simulate the distalization modalities. RESULTS: Stresses at the buccal, palatal, mesial, and distal surfaces were significantly different between adjacent teeth under stiffness but not thickness variation. In both distalization modalities, low or no significant correlations were found between stress values and corresponding cortical bone thicknesses. High significant and inverted correlations were observed at the first molar between stress amounts and cortical bone stiffness (direct modality: -0.68 < r < -0.72; indirect modality: -0.80 < r < -0.82; P <0.05). CONCLUSIONS: With the use of a novel finite element approach that integrated human data on variations in bone properties, findings suggested that cortical bone stiffness may influence tooth movement more than bone thickness. Significant clinical implications could be related to these findings.


Asunto(s)
Análisis del Estrés Dental/métodos , Análisis de Elementos Finitos , Técnicas de Movimiento Dental/métodos , Fenómenos Biomecánicos , Tornillos Óseos , Simulación por Computador , Implantes Dentales , Humanos , Imagenología Tridimensional/métodos , Maxilar/anatomía & histología , Maxilar/diagnóstico por imagen , Modelos Anatómicos , Diente Molar , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Diseño de Aparato Ortodóncico , Ligamento Periodontal , Estrés Mecánico , Técnicas de Movimiento Dental/instrumentación , Torsión Mecánica
10.
Am J Orthod Dentofacial Orthop ; 156(3): 345-354, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474264

RESUMEN

INTRODUCTION: Orthodontic mini-implants are frequently used to provide additional anchorage for orthodontic appliances. The anterior palate is frequently used owing to sufficient bone quality and low risk of iatrogenic trauma to adjacent anatomical structures. Even though the success rates in this site are high, failure of an implant will result in anchorage loss. Therefore, implants should be placed in areas with sufficient bone quality. The aim of the present study was to identify an optimal insertion angle and position for orthodontic mini-implants in the anterior palate. METHODS: Maxillary cone-beam computed tomographic (CBCT) scans from 30 patients (8 male, 22 female, age 18.6 ± 12.0 years) were analyzed. To assess the maximum possible length of an implant, a 25-reference-point grid was defined: 5 sagittal slices were extracted along the median plane and bilaterally at 3 mm and 6 mm distances, respectively. Within each slice, 5 dental reference points were projected to the palatal curvature at the contact point between the cuspid (C) and first bicuspid (PM1), midpoint of PM1, between PM1 and PM2, midpoint of PM2, and between PM2 and the first molar (M1). Measurements were conducted at -30°, -20°, -10°, 0°, 10°, 20°, and 30° to a vector placed perpendicular to the local palatal curvature. Statistical analysis was conducted with the use of R using a random-effects mixed linear model and a Tukey post hoc test with Holm correction. RESULTS: High interindividual variability was detected. Maximum effective bone heights were detected within a T-shaped area at the midpoint of PM1 and contact point PM1-PM2 (P < 0.01). Within the anterior region a posterior tipping was advantageous, whereas in the posterior regions an anterior tipping was beneficial (P < 0.01). In the middle of the median plane, tipping did not reveal a significant influence. No gender- or age-related differences were observed. CONCLUSIONS: Within the limitations of this study, optimal insertion positions were found within a T-shaped area at the height of PM1-PM2 in the anterior palate. In general, a posterior tipping was beneficial at anterior positions, and an anterior tipping appeared beneficial at posterior positions. High interindividual variation was found and should be carefully considered by the clinician.


Asunto(s)
Tomografía Computarizada de Haz Cónico/métodos , Implantes Dentales , Maxilar/anatomía & histología , Maxilar/diagnóstico por imagen , Métodos de Anclaje en Ortodoncia/métodos , Paladar (Hueso)/anatomía & histología , Paladar (Hueso)/diagnóstico por imagen , Adolescente , Adulto , Análisis de Varianza , Diente Premolar , Tornillos Óseos , Niño , Estudios Transversales , Diente Canino , Femenino , Humanos , Incisivo/anatomía & histología , Incisivo/diagnóstico por imagen , Masculino , Maxilar/cirugía , Diente Molar , Hueso Nasal/anatomía & histología , Hueso Nasal/diagnóstico por imagen , Métodos de Anclaje en Ortodoncia/instrumentación , Diseño de Aparato Ortodóncico , Paladar (Hueso)/cirugía , Adulto Joven
11.
Am J Orthod Dentofacial Orthop ; 156(3): 391-400, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474269

RESUMEN

INTRODUCTION: Orthodontic traction of a maxillary impacted canine (MIC) increases the orthodontic treatment time. Therefore, the objective of this study was to evaluate the influence of MIC characteristics and factors associated with orthodontic treatment on the duration of active orthodontic traction. METHODS: This follow-up and retrospective study included 45 MICs orthodontically tractioned into the occlusal plane with the use of a standardized protocol. MIC characteristics, including type, sector, side, location, height, and complexity of impaction, as well as α and ß angles and canine root length and area were measured. Likewise, factors associated with orthodontic treatment, including sex, age, malocclusion, premolar extractions, previous incisor root resorption, ANB, APDI, and SNA angles, and PNS-ANS distance were also evaluated. The statistical analysis included multiple linear regressions to estimate the influence of all variables on the duration of traction (α = 0.05). RESULTS: Sex had significant influence (P = 0.027) on the time of traction; in female patients, the time was 2.05 months more than in male patients. Bilateral impaction treatment increased the time by 2.74 months compared with unilateral cases (P = 0.001). Traction of bicortically centered impacted canines increased the duration of traction by 2.85 months (P = 0.001). Finally, the traction time increased in 2.35 months (P = 0.046) when the impaction sectors were 4 or 5 (close to the midline). CONCLUSIONS: The duration of active orthodontic traction of MIC is mainly influenced by sex, bilateral type, bicortically centered location, or when MIC is located in sector 4 or 5 close to midline, increasing the traction time by some months.


Asunto(s)
Diente Canino/cirugía , Maxilar/cirugía , Ortodoncia Correctiva/métodos , Diente Impactado/complicaciones , Diente Impactado/terapia , Adolescente , Diente Canino/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Incisivo , Masculino , Maloclusión/clasificación , Maloclusión/terapia , Maxilar/diagnóstico por imagen , Procedimientos Quirúrgicos Orales , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Aparatos Ortodóncicos Fijos , Ortodoncia Correctiva/instrumentación , Evaluación de Procesos y Resultados en Atención de Salud , Planificación de Atención al Paciente , Radiografía Dental , Estudios Retrospectivos , Resorción Radicular/complicaciones , Factores Sexuales , Factores de Tiempo , Erupción Dental , Raíz del Diente/anatomía & histología , Raíz del Diente/diagnóstico por imagen , Diente Impactado/diagnóstico por imagen , Diente Impactado/cirugía , Tracción , Resultado del Tratamiento
12.
Am J Orthod Dentofacial Orthop ; 156(3): 401-411, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474270

RESUMEN

A 24-year-old man presented with a severe skeletal class III malocclusion, associated with an anterior and posterior crossbite in the left side, upper and lower lip eversion, skeletal asymmetry, midline discrepancy, diastemas in the maxillary and mandibular dental arches, and agenesis of maxillary lateral incisors and canines with retained deciduous teeth. Treatment was performed with the use of the Win Lingual System. When the 0.016 × 0.022-inch NiTi archiwire was applied, the deciduous teeth were extracted and replaced with temporary crowns connected to the appliance. After the aligning, leveling, and diastema closure phases, a modified Le Fort II osteotomy, a mandibular setback with a bilateral sagittal split osteotomy and a genioplasty were performed. Implants were placed in the canine site through a flapless guided surgery, and cantilevered temporary bridges were delivered. Final prosthetic rehabilitation included veneers for the central incisors and zirconia-ceramic cantilevered bridges for the canine and lateral incisors. After 36 months of active treatment, the patient showed an Angle Class I molar and canine relationship and an ideal overbite and overjet. His profile had improved, lips were competent, and gingival levels were acceptable. The lateral radiograph and cephalometric analysis showed a good balance of the skeletal pattern, a good profile of the soft tissue, and proper inclinations of the maxillary and mandibular incisors in relation to maxilla and mandible. After 2 years of follow-up, the patient had a pleasant smile and no relapse, or joint or muscular pain.


Asunto(s)
Anodoncia/complicaciones , Maloclusión de Angle Clase III/terapia , Diseño de Aparato Ortodóncico/instrumentación , Diseño de Aparato Ortodóncico/métodos , Aparatos Ortodóncicos , Adulto , Cefalometría , Diente Canino , Implantación Dental Endoósea , Implantes Dentales , Modelos Dentales , Diastema/cirugía , Diastema/terapia , Estética Dental , Humanos , Incisivo , Labio , Masculino , Maloclusión de Angle Clase I/complicaciones , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/rehabilitación , Maloclusión de Angle Clase III/cirugía , Mandíbula/cirugía , Maxilar/cirugía , Diente Molar , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Soportes Ortodóncicos , Alambres para Ortodoncia , Osteotomía , Sobremordida/terapia , Radiografía Panorámica , Técnicas de Movimiento Dental/instrumentación , Técnicas de Movimiento Dental/métodos , Adulto Joven
13.
Int Orthod ; 17(4): 758-768, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31494087

RESUMEN

OBJECTIVE: Initial stability of miniscrews is an important factor in their success as orthodontic anchorages. One of the factors affecting this stability is the stresses exerted to the bone by the screw. Since the distribution and extent of stresses and strains produced during insertion or removal of miniscrews had not been measured before, this study used finite element analysis (FEA) to measure these parameters in tapered versus cylindrical screws with or without pilot sockets. MATERIALS AND METHODS: An FEA model of maxilla, pilot hole, and tapered/cylindrical miniscrews were created from 875 CT scan data. The bone cortex was considered 2mm thick. The cancellous bone was reconstructed below the cortical bone. Miniscrews were modelled on the basis of commercial titanium tapered and cylindrical miniscrews (1.6mm wide, 8mm long). The diameter and length of the guiding hole were considered to be 1.1 and 1.5mm, respectively. The miniscrews were inserted (and removed) between the maxillary second premolar and first molar. Stress/strain produced in the bones or screws were measured. RESULTS: During screw insertion, in all setups, the highest stress existed within both the bone and screw, when the screw was in the cortical bone; after insertion into the cancellous bone, the stress suddenly dropped. In cylindrical screws, the highest amount of stress was distributed around the neck which was used for screw driving. In tapered screws, the stress was mostly distributed around the front one-third of the screw. During screw removal, the results of four setups were rather similar with stresses concentrated around screw necks, in the depth of the screw hole, and around the bone surface. The greatest bone stress during insertion was caused by the pilot-less tapered screw (10.18MPa) and the lowest stress was exerted by a pilot-less cylindrical screw (0.74MPa). CONCLUSION: Most of the stress and strain is tolerated by the cortical bone and not the cancellous one. Using cylindrical miniscrews might be more bone-friendly. However, all cases had stresses below tolerable thresholds, and hence are safe.


Asunto(s)
Tornillos Óseos , Análisis de Elementos Finitos , Maxilar , Estrés Mecánico , Proceso Alveolar/cirugía , Diente Premolar , Análisis del Estrés Dental , Humanos , Diente Molar , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Diseño de Aparato Ortodóncico , Titanio , Torque
14.
Am J Orthod Dentofacial Orthop ; 156(2): 210-219, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375231

RESUMEN

INTRODUCTION: More patients are choosing customized orthodontic appliances because of their excellent esthetics. It is essential that clinicians understand the biomechanics of the tooth movement tendency in customized lingual orthodontics. This study aimed to evaluate the tooth movement tendency during space closure in maxillary anterior teeth with the use of miniscrew anchorage in customized lingual orthodontics with various power arm locations. METHODS: Three-dimensional finite element models of the maxilla were created with miniscrews and power arms; the positions were varied to change the force directions. A retraction force (1.5 N) was applied from the top of the miniscrews to the selected points on the power arm, and the initial displacements of the reference nodes of the maxillary teeth were analyzed. RESULTS: After applying force in different directions, power arms located at the distal side of the canines led to larger initial lingual crown tipping and occlusal crown extrusion of the maxillary incisors compared with power arms located at the midpoint between the lateral incisors and canines, and caused a decreasing trend of the intercanine width. CONCLUSIONS: In customized lingual orthodontic treatment, power arms located at the distal side of the canines are unfavorable for anterior teeth torque control and intercanine width control. Power arms located at the midpoint between the lateral incisors and canines can get better torque control, but still cannot achieve excepted torque without extra torque control methods, no matter whether its force application point is higher than, lower than, or equal to the level of the top of the miniscrews.


Asunto(s)
Tornillos Óseos , Análisis de Elementos Finitos , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Cierre del Espacio Ortodóncico , Técnicas de Movimiento Dental/instrumentación , Técnicas de Movimiento Dental/métodos , Adulto , Fenómenos Biomecánicos , Simulación por Computador , Diente Canino/patología , Humanos , Imagenología Tridimensional/métodos , Incisivo/patología , Maxilar , Modelos Biológicos , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos , Soportes Ortodóncicos , Cierre del Espacio Ortodóncico/instrumentación , Cierre del Espacio Ortodóncico/métodos , Alambres para Ortodoncia , Planificación de Atención al Paciente , Estrés Mecánico , Corona del Diente , Torque , Resultado del Tratamiento
15.
Am J Orthod Dentofacial Orthop ; 156(2): 220-228, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375232

RESUMEN

INTRODUCTION: The primary aim of this in vitro study was to compare the insertion torque (IT) and anchorage force (AF) values of 4 different sizes of orthodontic mini-implants with 2 different angles. The second aim was to evaluate the relationship between IT and AF values under different diameter, length, and insertion angle variables. METHODS: A total of 160 mini-implants, including 20 implants in each group, with 4 different sizes (1.6 × 8 mm, 1.6 × 10 mm, 2.0 × 8 mm, and 2.0 × 10 mm) at 2 different angles (70° and 90°), were inserted into bovine iliac bone segments. The IT and AF values leading to 1.5 mm deflection were compared. The correlations between IT and AF values under different variables were also analyzed. RESULTS: The mini-implants with greater diameter and length showed greater IT and AF values (P <0.05). The IT and AF values of mini-implants inserted at 70° angle were significantly greater than those of mini-implants inserted at 90° angle (P <0.001). Significant correlations were found between IT and AF values in all variables. CONCLUSIONS: The diameter, length, and insertion angle of orthodontic mini-implants have significant effects on IT and AF values. Insertion angle and diameter of mini-implants are more effective than implant length on skeletal anchorage. Significant correlations are present between IT and AF values of mini-implants regardless of their diameters, lengths, and insertion angles.


Asunto(s)
Implantes Dentales , Métodos de Anclaje en Ortodoncia/instrumentación , Diseño de Aparato Ortodóncico/instrumentación , Animales , Tornillos Óseos , Bovinos , Implantación Dental Endoósea , Análisis del Estrés Dental , Falla de Equipo , Métodos de Anclaje en Ortodoncia/métodos , Diseño de Aparato Ortodóncico/métodos , Estrés Mecánico , Torque
16.
Int Orthod ; 17(3): 415-424, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31255550

RESUMEN

INTRODUCTION: The purpose of this study was to systematically review the evidence regarding conventional versus skeletal anchorage devices for molar distalization. METHOD: An electronic search was conducted. Hand searching was done in the reference lists of included studies and some journals. Studies comparing conventional and skeletal anchorage for molar distalization in Angle class I or II malocclusions were assessed. Presence of periodontal disease, second or third molar extraction and application of tooth accelerating methods led to exclusion of studies. Generic-inverse variance approach was used for meta-analysis by use of the mean difference and random-effect model. Risk of bias was evaluated in included studies. RESULTS: A total of 1996 articles were found; of which, 1991 were excluded. The mean amounts of molar distalization/tipping in skeletal anchorage and conventional anchorage groups were 5.35mm/8.44° and 4.25mm/8.31°, respectively, which were not significantly different. The mean amounts of premolar movement in skeletal anchorage and conventional anchorage groups were -0.96mm and +2.21mm, respectively, which was statistically significant (P=0.004). Duration of treatment in skeletal anchorage and conventional anchorage groups was 8.23 months and 7.95 months, respectively, which were significantly different (P=0.0001). Risk of bias was assessed to be high. CONCLUSION: The conventional and skeletal anchorage devices were not significantly different in terms of the amount of molar distalization/tipping. However, the anchorage loss was lower in the skeletal anchorage group. The treatment time was shorter in the conventional anchorage group. More studies with proper design are required.


Asunto(s)
Maxilar , Diente Molar , Métodos de Anclaje en Ortodoncia/instrumentación , Técnicas de Movimiento Dental/instrumentación , Diente Premolar , Bases de Datos Factuales , Arco Dental , Humanos , Maloclusión de Angle Clase I , Maloclusión de Angle Clase II , Métodos de Anclaje en Ortodoncia/métodos , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos
17.
Am J Orthod Dentofacial Orthop ; 156(1): 113-124, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256824

RESUMEN

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


Asunto(s)
Oclusión Dental , Maloclusión de Angle Clase II/terapia , Maloclusión de Angle Clase I/terapia , Ortodoncia Correctiva/métodos , Adulto , Cefalometría/métodos , Modelos Dentales , Femenino , Humanos , Maloclusión de Angle Clase I/diagnóstico por imagen , Maloclusión de Angle Clase I/cirugía , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/cirugía , Mandíbula/diagnóstico por imagen , Mandíbula/patología , Mandíbula/cirugía , Maxilar/diagnóstico por imagen , Maxilar/patología , Maxilar/cirugía , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos , Alambres para Ortodoncia , Ortodoncia Correctiva/instrumentación , Técnica de Expansión Palatina , Planificación de Atención al Paciente , Factores de Tiempo , Resultado del Tratamiento
18.
Am J Orthod Dentofacial Orthop ; 156(1): 137-147, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256827

RESUMEN

A 16-year-old patient sought orthodontic correction for profile improvement and labially inclined maxillary incisors. She had Class II malocclusion, protrusive maxillary and mandibular incisors, and increased overjet and overbite with an American Board of Orthodontics discrepancy index value of 25. She was treated with maxillary premolar extractions and miniscrew-supported en masse retraction assisted with piezoincisions. Extraction spaces (7.5 mm per side) were closed with maximum anchorage in 10 months. Total treatment time was 23 months. Twenty-seven months after debonding, a pink spot was noted at the buccocervial region of the left central incisor. Radiographic evaluation on cone-beam computed tomographic scans revealed a severe case of invasive cervical resorption on both central incisors, around which the piezosurgical cuts had been made. Treatment proceeded with a nonintervention approach and the affected teeth were reinforced with a lingual retainer.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Ortodoncia Correctiva/métodos , Sobremordida/terapia , Piezocirugía/efectos adversos , Adolescente , Diente Premolar/cirugía , Tornillos Óseos , Cefalometría , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Incisivo/diagnóstico por imagen , Incisivo/patología , Incisivo/cirugía , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/cirugía , Mandíbula , Maxilar/diagnóstico por imagen , Maxilar/patología , Maxilar/cirugía , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos , Soportes Ortodóncicos , Alambres para Ortodoncia , Sobremordida/diagnóstico por imagen , Sobremordida/cirugía , Radiografía Panorámica , Resorción Radicular/etiología , Técnicas de Movimiento Dental/métodos , Resultado del Tratamiento , Dimensión Vertical
19.
Am J Orthod Dentofacial Orthop ; 156(1): 148-156, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256828

RESUMEN

This article reports on the technical aspects of using a computer-aided design-computer-aided manufacturing (CAD-CAM) insertion guide for the placement of orthodontic mini-implants used for the purpose of providing anchorage support for maxillary molar distalization. A 10-year-old girl presented with a bilateral full-step Angle Class II molar relationship in the permanent dentition, with anterior arch-length insufficiency and blocked out maxillary canine teeth. The primary treatment objective was to provide an esthetic and functional occlusal outcome, and secondarily to avoid the removal of multiple premolar teeth. The patient was initially treated with an implant-supported distalization device, and the occlusion was subsequently detailed with preadjusted fixed orthodontic appliances. The CAD-CAM procedure facilitates the safe and precise insertion of mini-implants in the anterior palate, potentially broadening the scope of use of palatal mini-implants for less experienced clinicians. The illustrated protocol allows for the insertion of mini-implants and fitting of a prefabricated appliance in a single office appointment.


Asunto(s)
Tornillos Óseos , Diseño Asistido por Computadora , Implantes Dentales , Maloclusión de Angle Clase II/terapia , Métodos de Anclaje en Ortodoncia/métodos , Diseño de Aparato Ortodóncico/métodos , Técnicas de Movimiento Dental/métodos , Diente Premolar , Cefalometría/métodos , Niño , Diente Canino , Modelos Dentales , Dentición Permanente , Estética Dental , Femenino , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/cirugía , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Diente Molar , Métodos de Anclaje en Ortodoncia/instrumentación , Diseño de Aparato Ortodóncico/instrumentación , Aparatos Ortodóncicos Fijos , Alambres para Ortodoncia , Paladar (Hueso)/diagnóstico por imagen , Paladar (Hueso)/cirugía , Planificación de Atención al Paciente , Técnicas de Movimiento Dental/instrumentación , Resultado del Tratamiento
20.
Int Orthod ; 17(3): 451-460, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31302004

RESUMEN

OBJECTIVE: To evaluate and compare the stress and displacement pattern between conventional and micro-implant supported retraction in lingual orthodontic system. MATERIALS AND METHODS: A finite element model of the maxilla, teeth, periodontal ligament, lingual-orthodontic appliance and a micro-implant complex was constructed using ANSYS 12.1 software. Two sizes of micro-implants, 6mm and 8mm, were constructed producing a simulated model of 99,190 nodes and 32,4364 elements. A retraction force of 200g was applied from an anterior retraction hook to the molar tube in the conventional model and from the micro-implants in the implant supported model. The initial displacement and stress patterns in the X-Y-Z axes were obtained using Hyper-view software. RESULTS: The maximum von Mises stresses in the 6mm, 8mm and conventional model were 22.164 Megapascals (MPa), 28.603MPa and 16.491MPa respectively. The bucco-lingual displacement of the maxillary anteriors was greater in the 8mm implant model with 23×10-3mm lingual displacement observed. The least lingual displacement of 11×10-3mm was noted for the conventional model while a slightly higher moderate reading of 15×10-3mm was seen in the 6mm micro-implant supported model. The maximum displacement of the periodontal ligament was noted in the 8mm micro-implant model. CONCLUSION: Within the limitations of this research, the 8mm micro-implant model displayed high initial stresses and greater initial displacement of the anterior teeth in the X-Y-Z coordinates in comparison to conventional retraction method.


Asunto(s)
Implantes Dentales , Dentición , Análisis de Elementos Finitos , Maxilar , Métodos de Anclaje en Ortodoncia/instrumentación , Aparatos Ortodóncicos , Estrés Mecánico , Técnicas de Movimiento Dental/métodos , Modelos Dentales , Humanos , Métodos de Anclaje en Ortodoncia/métodos , Diseño de Aparato Ortodóncico , Soportes Ortodóncicos , Alambres para Ortodoncia , Ligamento Periodontal , Acero Inoxidable , Corona del Diente , Técnicas de Movimiento Dental/instrumentación
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