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1.
Am J Orthod Dentofacial Orthop ; 156(4): 512-521.e6, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582123

RESUMEN

INTRODUCTION: This prospective cohort study aimed to evaluate canine substitution supported by skeletal anchorage as a viable treatment protocol for patients with maxillary lateral incisor agenesis (MLIA) and skeletal Class I or Class III. METHODS: Patients (n = 30) who met the following criteria were recruited: (1) bilateral MLIA or unilateral MLIA with a riziform contralateral incisor with a planned extraction; (2) skeletal Class I or Class III; and (3) dentoalveolar discrepancy in the mandible <5 mm. The archwire sequence routine was administered, combined with a rapid palatal expander, temporary intraoral skeletal anchorage device, and intermaxillary traction with Class III elastics. The results of the cephalometric analyses, peer assessment rating indexes, and the patient's smile self-evaluation using the visual analog scale were compared between initial and final treatments. RESULTS: This study indicated that closing the space in patients with Class I or Class III malocclusion by using temporary intraoral skeletal anchorage devices in the mandible, along with Class III elastics, yielded satisfactory outcomes. Proper occlusion was established by mesialization of the maxillary teeth and correction of the intermaxillary discrepancy, thereby yielding beneficial and significant cephalometric changes after the treatment. The soft tissue profile was maintained when it was harmonious before the treatment and improved posttreatment in patients in whom the profile was initially inharmonious. All occlusions improved, as evidenced by the peer assessment rating index. Smile esthetics were also enhanced after orthodontic treatment for all patients. CONCLUSIONS: Canine substitution may be safely offered to patients with Class I and Class III skeletal pattern and MLIA.


Asunto(s)
Anodoncia/terapia , Diente Canino , Maloclusión de Angle Clase III/terapia , Maloclusión Clase I de Angle/terapia , Métodos de Anclaje en Ortodoncia/métodos , Técnicas de Movimiento Dental/métodos , Adolescente , Cefalometría , Niño , Terapia Combinada , Estética Dental , Aparatos de Tracción Extraoral , Femenino , Humanos , Masculino , Técnica de Expansión Palatina , Estudios Prospectivos , Resultado del Tratamiento , Escala Visual Analógica , Adulto Joven
2.
Int Orthod ; 17(4): 817-825, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31481304

RESUMEN

This case report shows the orthodontic treatment of four first premolar extractions of a 14-year-old teenager presenting a dental Class I malocclusion with a severe retrognathic mandible. It reflects conflicting views on objectives between the orthodontist who takes into account the facial balance and the patient who only desires a tooth alignment.


Asunto(s)
Diente Premolar/cirugía , Maloclusión Clase II de Angle/terapia , Maloclusión Clase I de Angle/terapia , Extracción Dental , Técnicas de Movimiento Dental/métodos , Adolescente , Puntos Anatómicos de Referencia , Cefalometría , Modelos Dentales , Mentoplastia , Humanos , Masculino , Maloclusión Clase I de Angle/diagnóstico por imagen , Maloclusión Clase II de Angle/diagnóstico por imagen , Aparatos Ortodóncicos Fijos , Alambres para Ortodoncia , Osteotomía , Técnicas de Movimiento Dental/instrumentación , Resultado del Tratamiento
3.
Am J Orthod Dentofacial Orthop ; 156(2): 275-282, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375238

RESUMEN

This case report describes the interdisciplinary treatment of an ectopic horizontally placed maxillary right central incisor with severe root dilaceration. The root was distally angulated and entrapped by the root of the maxillary right lateral incisor. The initial force system was aimed at an occlusal displacement and applied to the crown. During the second phase, a button was cemented onto the apex of the impacted tooth. A force from the apex to a temporary anchorage device in the palate moved the root toward the midline. Finally, a root canal and an apectomy were performed and the central incisor could be moved to its ideal position. The treatment generated a normal height of the alveolar bone and an ideal occlusion with a healthy periodontium.


Asunto(s)
Incisivo/cirugía , Técnicas de Movimiento Dental/métodos , Raíz del Diente/cirugía , Diente Impactado/cirugía , Diente Impactado/terapia , Fenómenos Biomecánicos , Niño , Tomografía Computarizada de Haz Cónico/métodos , Cavidad Pulpar , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Imagenología Tridimensional , Maloclusión Clase I de Angle/terapia , Maxilar/anatomía & histología , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Aparatos Ortodóncicos Fijos , Extrusión Ortodóncica/métodos , Planificación de Atención al Paciente , Tratamiento del Conducto Radicular , Corona del Diente , Diente Impactado/diagnóstico por imagen , Resultado del Tratamiento
4.
Int Orthod ; 17(3): 513-518, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31326368

RESUMEN

OBJECTIVES: To determine the effects of Invisalign® aligners on patients' abilities to articulate consonants. MATERIALS AND METHODS: Thirty patients undergoing active two-arch Invisalign® treatment were examined. Patients were recorded reading the rainbow passage (a passage with every phoneme represented), once with the trays inserted and once with the trays removed. The recordings were analysed by a speech pathologist for misarticulation of consonant phonemes. RESULTS: Misarticulation of consonants was significantly associated with the Invisalign® aligners inserted as based on the McNemar's statistical test (P=0.008). The fricative alveolar consonant /z/ was found to be the most impacted by the trays, followed by the consonant /s/ (P=0.016). The consonant /sh/ was not shown to be affected by the Invisalign® aligners. CONCLUSIONS: Invisalign® aligners do have an impact on the articulation of consonants. Fricative alveolar consonants were the primary phonemes impacted. Due to the fact that the efficacy of Invisalign® treatment is based primarily on compliance and that speech impairment may interfere with compliance, the information presented in this study should be conveyed to the patient before the initiation of Invisalign® treatment.


Asunto(s)
Aparatos Ortodóncicos Removibles/efectos adversos , Inteligibilidad del Habla , Habla/fisiología , Adolescente , Adulto , Femenino , Humanos , Masculino , Maloclusión Clase I de Angle/terapia , Maloclusión Clase II de Angle/terapia , Persona de Mediana Edad , Ortodoncia Correctiva , Cooperación del Paciente/estadística & datos numéricos , Adulto Joven
5.
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 Clase II de Angle/terapia , Maloclusión Clase I de Angle/terapia , Ortodoncia Correctiva/métodos , Adulto , Cefalometría/métodos , Modelos Dentales , Femenino , Humanos , Maloclusión Clase I de Angle/diagnóstico por imagen , Maloclusión Clase I de Angle/cirugía , Maloclusión Clase II de Angle/diagnóstico por imagen , Maloclusión Clase II de Angle/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
6.
Niger J Clin Pract ; 22(6): 872-876, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31187776

RESUMEN

Papillon-Léage-Psaume Syndrome, also known as oral-facial-digital syndrome (OFDS) type I, describes a group of neurodevelopmental disorders that are characterized by anomalies of the oral cavity, facial features, and the digits. Central nervous system (CNS) anomalies and visceral organ abnormalities such as kidney, pancreas, and ovarian cysts can also be seen in these patients. Among 13 potential types, female-inherited OFDS type I is the most common and it has been reported to be lethal in males. After the identification of the genetic relation of OFDS in 2001, it is now known that, except X-linked OFDS Type I and VIII, generally all types of OFDSs are autosomal recessive. The dentist's knowledge about the syndrome can reduce the development of physical and dental anomalies by facilitating early diagnosis. This article presents a patient with Papillon-Léage-Psaume Syndrome (Oral-Facial-Digital Syndrome Type I).


Asunto(s)
Maloclusión Clase I de Angle/terapia , Maxilar/cirugía , Síndromes Orofaciodigitales/complicaciones , Técnicas de Movimiento Dental , Anomalías Múltiples/terapia , Adolescente , Fisura del Paladar/complicaciones , Femenino , Humanos , Maloclusión Clase I de Angle/etiología , Diente Impactado/etiología
7.
Int Orthod ; 17(3): 478-487, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31231000

RESUMEN

INTRODUCTION: The mouth plays an important role in the overall aesthetic appearance of the face. The aims of this study were to determine the optimal antero-posterior (AP) lip position relative to various rotations of the nasal tip and assess the impact of the nasolabial angle on facial aesthetics. MATERIAL AND METHODS: Three-dimensional facial volumes, in motion, of one Caucasian male and one Caucasian female with a Class I malocclusion and an orthognathic profile were modified to alter the nasal tip rotation (3 rotations) and the AP lips position (6 positions). 72 generated models were created in two and three-dimensions. Generated models were rated online by 60 dentists, 60 orthodontists and 60 laypeople, using a Visual Analogue Scale. Scores were analysed according to lip position, rater's profession and gender. RESULTS: General agreement was found between all groups on the most and least preferred lip positions. No differences between male and female raters were found. All raters were more influenced by the 3-dimensional rotating facial volume than by 2-dimensional angles. Similar angular values for the nasolabial angles were found in the most and least preferred profiles, showing that the most influential factor in facial aesthetics was the lip position, and stressing the need to evaluate each component of the nasolabial angle independently. CONCLUSION: The lip position was the determinant factor in facial aesthetics with little influence of the nose tip rotation. Three-dimensional evaluation of the nose and lip were needed to establish a soft tissue-based treatment plan.


Asunto(s)
Cara/anatomía & histología , Labio/anatomía & histología , Maloclusión Clase I de Angle/diagnóstico por imagen , Nariz/anatomía & histología , Adulto , Mentón/anatomía & histología , Estética Dental , Cara/diagnóstico por imagen , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Imagenología Tridimensional/métodos , Labio/diagnóstico por imagen , Masculino , Maloclusión Clase I de Angle/terapia , Nariz/diagnóstico por imagen , Fotograbar , Factores Sexuales , Encuestas y Cuestionarios , Escala Visual Analógica
8.
Clin Exp Dent Res ; 5(3): 199-204, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31249699

RESUMEN

This study aims to evaluate the prevalence of occlusal traits and to assess parents'/caregivers' satisfaction with child's dental appearance and perception of orthodontic treatment need in 4-5-year-old Estonians. Clinical records and plaster casts of 390 children (190 girls and 200 boys, mean age 4.7 years, range 4 - 5 years) were analyzed. Assessed occlusal traits included deciduous canine and second molar sagittal relationship, overjet, overbite, crowding, midline diastema, crossbite, and scissor bite. Parents'/caregivers' opinions regarding their child's teeth were determined with a questionnaire. The most prevalent occlusal traits were symmetrical sagittal relationship in deciduous canines (78.2%) and molars (75.1%), Class I sagittal relationship in deciduous canines (69.7%) and midline diastema (67.7%). Asymmetrical sagittal canine relationship was registered in 21.8% deciduous canines and in 24.9% second deciduous molars. Parents'/caregivers' perceived orthodontic treatment need was related to Class III sagittal relationship in canines, increased overjet and overbite, negative overbite, and crossbite. Prevalence of most occlusal traits in Estonian children were in line with those reported in neighboring countries. Parents/caregivers were well able to observe occlusal traits that deviated from acceptable occlusion.


Asunto(s)
Maloclusión/fisiopatología , Ortodoncia Correctiva , Padres , Satisfacción Personal , Apariencia Física , Preescolar , Estonia , Femenino , Humanos , Indice de Necesidad de Tratamiento Ortodóncico , Masculino , Maloclusión/terapia , Maloclusión Clase I de Angle/fisiopatología , Maloclusión Clase I de Angle/terapia , Maloclusión Clase II de Angle/fisiopatología , Maloclusión Clase II de Angle/terapia , Maloclusión de Angle Clase III/fisiopatología , Maloclusión de Angle Clase III/terapia , Evaluación de Necesidades , Sobremordida/fisiopatología , Sobremordida/terapia
9.
Am J Orthod Dentofacial Orthop ; 155(4): 523-528, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30935607

RESUMEN

OBJECTIVE: To compare the clinical bracket failure rate and bonding time differences between Adhesive Precoated Flash-Free (APCF) and Adhesive Precoated Plus (APCP) bracket systems. METHODS: Thirty-three patients (7 male and 26 female) with a mean age of 17.2 ± 3.6 years and permanent dentition were included in the study. Total of 660 brackets were bonded by 1 operator with the use of a split-mouth design, and bracket failure rates were observed over 6 months. Bracket bonding time of each group was also evaluated. Bracket failure rates were evaluated by means of chi-square test. One-way analysis of variance (ANOVA) and Tukey honestly significant difference tests were used to evaluate the bonding time differences between groups. RESULTS: The overall, APCF, and APCP bracket failure rates were 1.21%, 1.81%, and 1.51%, respectively. Chi-square test revealed significant differences (P <0.01) between groups in bracket failure rates. The upper left APCP group showed significantly (P <0.05) more failure than the other groups. One-way ANOVA test (P <0.001) showed statistically significant bonding time differences between groups. Bonding time of APCF brackets was significantly shorter than the bonding time of APCP brackets for the same quadrants. Chi-square test did not reveal significant differences (P >0.05) between groups according to adhesive remnant index scores. CONCLUSIONS: Compared with APCP brackets, APCF brackets can reduce the bonding time without increasing bracket failure rate.


Asunto(s)
Recubrimiento Dental Adhesivo , Cementos Dentales/uso terapéutico , Soportes Ortodóncicos , Recubrimiento Dental Adhesivo/efectos adversos , Recubrimiento Dental Adhesivo/métodos , Cementos Dentales/efectos adversos , Femenino , Humanos , Masculino , Maloclusión Clase I de Angle/terapia , Maloclusión Clase II de Angle/terapia , Soportes Ortodóncicos/efectos adversos , Insuficiencia del Tratamiento , Adulto Joven
10.
Int Orthod ; 17(1): 170-180, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30772353

RESUMEN

Date of birth: 4/02/97; gender: female. PRE-TREATMENT DOCUMENTS: 13.7 years old; 09/2010. DIAGNOSIS: Angle's class: class II subdivision. Missing teeth before treatment: none. TREATMENT PLANNING: Extractions of four first premolars 14, 24, 34, 44. Class II molar and discrepancy correction. Intercuspidation, finishing. Bimaxillary multi-bracket. Beginning of treatment: 12 years old; 10/2010. POST-TREATMENT DOCUMENTS: 15.6 years old; 8/2012. Treatment duration: 17 months. POST-RETENTION DOCUMENTS (MINIMUM 1 YEAR): 06/2016; 19.4 years old. Retention period: unlimited. Maxilla: bonded wire from 12 to 22, vacuum-formed retainer (night-only). Mandible: bonded wire from 33 to 43, vacuum-formed retainer (night-only).


Asunto(s)
Maloclusión Clase II de Angle/terapia , Maloclusión Clase I de Angle/terapia , Ortodoncia Correctiva/métodos , Adolescente , Puntos Anatómicos de Referencia , Diente Premolar , Niño , Modelos Dentales , Femenino , Humanos , Maloclusión Clase I de Angle/diagnóstico por imagen , Maloclusión Clase II de Angle/diagnóstico por imagen , Mandíbula , Soportes Ortodóncicos , Alambres para Ortodoncia , Planificación de Atención al Paciente , Adulto Joven
11.
Int Orthod ; 17(1): 181-191, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30777735

RESUMEN

Date of birth: 17/11/1998; gender: female. A. PRE-TREATMENT DOCUMENTS: 11 years old; 02/2010. DIAGNOSIS: Angle's class: class II division 2. Missing teeth before treatment: none. TREATMENT PLANNING: Without extractions. Alignment, levelling and arch coordination with intermaxillary class II alastics. Intercuspidation, finishing. Damon's bimaxillary multi-bracket. Beginning of treatment: 12 years old; 10/2010. B. POST-TREATMENT DOCUMENTS: 14 years old; 11/2012. Treatment duration: 25 months. C. POST-RETENTION DOCUMENTS (MINIMUM 1 YEAR): 09/2016; 18 years old. Retention period: unlimited. Maxilla: vacuum-formed retainer (night-only). Mandible: bonded wire from 33 to 43.


Asunto(s)
Maloclusión Clase II de Angle/terapia , Maloclusión Clase I de Angle/terapia , Ortodoncia Correctiva/métodos , Adolescente , Cefalometría , Niño , Modelos Dentales , Femenino , Humanos , Maloclusión Clase I de Angle/diagnóstico por imagen , Maloclusión Clase II de Angle/diagnóstico por imagen , Mandíbula/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Soportes Ortodóncicos , Retenedores Ortodóncicos , Alambres para Ortodoncia , Planificación de Atención al Paciente , Radiografía Panorámica
12.
J Orofac Orthop ; 80(2): 79-87, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30673806

RESUMEN

PURPOSE: The aims of the study were (1) to evaluate the fitting of three different aligners (Invisalign [Align Technology, Santa Clara, CA, USA], CA Clear Aligner [Scheu-Dental, Iserlohn, Germany] and F22 [Sweden&Martina, Due Carrare, Italy]) on anchorage attachments using scanning electron microscopy (SEM), and (2) to analyze the influence of 2 different types of resin used to build attachments on aligner fitting. METHODS: Using STL files of a patient, six resin casts were obtained and rectangular attachments were bonded on them. Conventional bulk-fill resin was used to build upper attachments while a flowable resin was used to build the lower ones. Passive aligners were adapted on each cast and then sectioned buccolingually. Microphotographs of the obtained sections were performed using a SEM and then micrometric measurements of aligner fitting on anchorage attachments were recorded. RESULTS: Analyzing the overall fitting of upper arch aligners, Invisalign provided a significantly better fitting with respect to F22 (P = 0.009); differences were not significant when comparing Invisalign with CA Clear Aligner, and CA Clear Aligner with F22. Analyzing the overall fitting of lower arch aligners, F22 provided a significantly better fitting with respect to CA Clear Aligner (P = 0.008) and Invisalign (P = 0.011). The analysis showed a significantly better fitting on upper attachments, built using conventional bulk-fill resin (P = 0.034). CONCLUSIONS: Invisalign, CA Clear Aligner and F22 have comparable performance in terms of fitting on anchorage attachments. Conventional bulk-fill resin provides the best fitting on anchorage attachments.


Asunto(s)
Métodos de Anclaje en Ortodoncia , Aparatos Ortodóncicos Removibles , Técnica de Colado Dental , Humanos , Maloclusión Clase I de Angle/terapia , Microscopía Electrónica de Rastreo , Resinas Sintéticas/uso terapéutico , Técnicas de Movimiento Dental/instrumentación , Técnicas de Movimiento Dental/métodos
13.
Angle Orthod ; 89(4): 661-671, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-30141695

RESUMEN

This case report describes orthodontic space closure for managing an avulsed maxillary central incisor and a lateral incisor in a growing girl with a Class I deep bite malocclusion with moderate lower and mild upper crowding. The treatment approach moved a central incisor across the midline and substituted a lateral incisor for a central incisor, in combination with canine substitution. Veneers on all maxillary anterior teeth attained acceptable esthetics. The right central incisor was moved to serve as the avulsed left central incisor. The right lateral incisor was moved to the position of the right central incisor and restored. The canines on both sides were substituted as lateral incisors; the posterior occlusion was left in Class II. Mesialization of central and lateral incisors with prosthetic rehabilitation is an acceptable treatment option.


Asunto(s)
Incisivo , Maloclusión Clase I de Angle , Maloclusión , Avulsión de Diente , Estética Dental , Femenino , Humanos , Incisivo/lesiones , Maloclusión Clase I de Angle/terapia , Maxilar , Avulsión de Diente/terapia
14.
Am J Orthod Dentofacial Orthop ; 154(6): 803-808, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30477778

RESUMEN

INTRODUCTION: Our objective was to assess the levels of bisphenol A (BPA) released from light-cured and chemically cured resins used for orthodontic bracket bonding in 1 month. METHODS: Saliva specimens were obtained at 5 time periods from 40 healthy patients treated with orthodontic mechanotherapeutics. The periods of collections were just before bonding orthodontic brackets, followed by 30 minutes, 1 day, 1 week, and 1 month after orthodontic bonding. The specimens were analyzed with the high-performance liquid chromatography/mass spectrometry method for quantitative evaluation of BPA levels. RESULTS: We observed a large increase in BPA levels 30 minutes after orthodontic bonding in the 2 groups. Thereafter, there was sudden decline in BPA levels as time passed, and the levels reached a statistically significant level at 1 month after orthodontic bonding. Interestingly, the amount of BPA released from chemically cured resin was much higher; this was also significant statistically compared with light-cured resins. CONCLUSIONS: The results of this in-vivo approach with high-performance liquid chromatography on salivary specimens confirmed continued release of BPA after bonding brackets for 1 month, although in smaller quantities. The release during the initial 30 minutes is high, making it essential to introduce measures to dilute it for better patient safety.


Asunto(s)
Compuestos de Bencidrilo/análisis , Cromatografía Líquida de Alta Presión , Cementos Dentales/química , Aparatos Ortodóncicos Fijos , Fenoles/análisis , Saliva/química , Adolescente , Adulto , Femenino , Humanos , Curación por Luz de Adhesivos Dentales , Masculino , Maloclusión Clase I de Angle/terapia , Soportes Ortodóncicos
15.
Am J Orthod Dentofacial Orthop ; 154(4): 469-476, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30268257

RESUMEN

INTRODUCTION: Deepbites can be corrected by intrusion of mandibular anterior teeth. Direct anchorage with miniscrews simplifies complex tooth movements; however, few studies have reported their use for mandibular anterior intrusion. The purpose of this study was to evaluate, by means of the finite element method, initial tooth displacement and periodontal stress distribution using various mandibular anterior intrusion mechanics. Miniscrews were used as skeletal anchorage devices. METHODS: Cone-beam computed tomography scans were used for 3-dimensional reconstruction of the mandible and the mandibular anterior dentition. Models included the 4 incisors with or without the canines. After all surrounding periodontal and bony structures were determined brackets, segmental archwires, and miniscrews were added. Finite element studies were performed to assess initial tooth displacement and periodontal stress distribution with multiple intrusion force vectors. Changes in the location of the miniscrews and loading points on the archwire created 14 scenarios. RESULTS: Minimum buccolingual displacements, a uniform distribution of periodontal stress, and overall group intrusion for both 4-tooth and 6-tooth scenarios were best achieved when applying distointrusive vectors. The highest peaks of periodontal stress were observed when the force was directed at the corners of the segmental archwire. It was found that, in addition to distointrusive vectors, 4 loading points on the archwire were necessary for pure intrusion and uniform distribution of periodontal stress in the 6-tooth scenarios. CONCLUSIONS: The simulations in this study suggest that group intrusion of all 6 mandibular anterior teeth might be achieved by applying distointrusive vectors. Inserting a pair of miniscrews distal to the canine roots, 1 screw per side, and directing 4 loading points on the archwire generates uniform periodontal stress distribution and minimum buccolingual displacements. Local conditions, such as narrow bone width and attached gingiva level, play significant roles in the clinical viability of the proposed virtual scenarios.


Asunto(s)
Implantes Dentales , Análisis de Elementos Finitos , Imagenología Tridimensional/métodos , Incisivo/cirugía , Mandíbula/cirugía , Métodos de Anclaje en Ortodoncia/instrumentación , Técnicas de Movimiento Dental/instrumentación , Técnicas de Movimiento Dental/métodos , Adulto , Proceso Alveolar , Fenómenos Biomecánicos , Simulación por Computador , Tomografía Computarizada de Haz Cónico/métodos , Módulo de Elasticidad , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Incisivo/patología , Maloclusión Clase I de Angle/terapia , Mandíbula/patología , Fenómenos Mecánicos , Modelos Biológicos , Diseño de Aparato Ortodóncico , Soportes Ortodóncicos , Cierre del Espacio Ortodóncico/métodos , Alambres para Ortodoncia , Estrés Mecánico
16.
Am J Orthod Dentofacial Orthop ; 154(4): 554-569, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30268266

RESUMEN

A 33-year-old woman had a chief complaint of difficulty chewing, caused by a constricted mandibular arch and a unilateral full buccal crossbite (scissors-bite or Brodie bite). She requested minimally invasive treatment but agreed to anchorage with extra-alveolar temporary anchorage devices as needed. Her facial form was convex with protrusive but competent lips. Skeletally, the maxilla was protrusive (SNA, 86°) with an ANB angle of 5°. Amounts of crowding were 5 mm in the mandibular arch and 3 mm in the maxillary arch. The mandibular midline was deviated to the left about 2 mm, which was consistent with a medially and inferiorly displaced mandibular right condyle. Ectopic eruption of the maxillary right permanent first molar to the buccal side of the mandibular first molar cusps resulted in a 2-mm functional shift of the mandible to the left, which subsequently developed into a full buccal crossbite on the right side. Treatment was a conservative nonextraction approach with passive self-ligating brackets. Glass ionomer bite turbos were bonded on the occlusal surfaces of the maxillary left molars at 1 month into treatment. An extra-alveolar temporary anchorage device, a 2 × 12-mm OrthoBoneScrew (Newton A, HsinChu City, Taiwan), was inserted in the right mandibular buccal shelf. Elastomeric chains, anchored by the OrthoBoneScrew, extended to lingual buttons bonded on the lingually inclined mandibular right molars. Cross elastics were added as secondary uprighting mechanics. The maxillary right bite turbos were reduced at 4 months and removed 1 month later. At 11 months, bite turbos were bonded on the lingual surfaces of the maxillary central incisors, and an OrthoBoneScrew was inserted in each infrazygomatic crest. The Class II relationship was resolved with bimaxillary retraction of the maxillary arch with infrazygomatic crest anchorage and intermaxillary elastics. Interproximal reduction was performed to correct the black interdental spaces and the anterior flaring of the incisors. The scissors-bite and lingually inclined mandibular right posterior segment were sufficiently corrected after 3 months of treatment to establish adequate intermaxillary occlusion in the right posterior segments to intrude the maxillary right molars. The anterior bite turbos opened space for extrusion of the posterior teeth to level the mandibular arch, and the infrazygomatic crest bone screws anchored the retraction of the maxillary arch. In 27 months, this difficult malocclusion, with a Discrepancy Index score of 25, was treated to a Cast-Radiograph Evaluation score of 22 and a pink and white esthetic score of 3.


Asunto(s)
Tornillos Óseos , Oclusión Dental , Maloclusión Clase II de Angle/diagnóstico , Maloclusión Clase I de Angle/terapia , Mandíbula/cirugía , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Sobremordida/terapia , Adulto , Cefalometría , Modelos Dentales , Femenino , Humanos , Incisivo/patología , Maloclusión Clase I de Angle/diagnóstico , Maloclusión Clase II de Angle/terapia , Mandíbula/diagnóstico por imagen , Maxilar/diagnóstico por imagen , Diente Molar/patología , Mordida Abierta/terapia , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos , Aparatos Ortodóncicos Removibles , Soportes Ortodóncicos , Alambres para Ortodoncia , Ortodoncia Correctiva , Sobremordida/complicaciones , Sobremordida/diagnóstico , Sobremordida/diagnóstico por imagen , Planificación de Atención al Paciente , Radiografía Panorámica , Técnicas de Movimiento Dental/instrumentación , Resultado del Tratamiento , Dimensión Vertical
18.
Am J Orthod Dentofacial Orthop ; 154(2): 234-237, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30075925

RESUMEN

INTRODUCTION: Orthodontic treatment planning requires skill and expertise with considerable practice variations. The aims of this study were to review retrospectively the pretreatment records of patients with Class I malocclusion and to identify variables that could play a role in the treatment decision. METHODS: From the available records of 1500 orthdontic patients, the pretreatment records of 202 patients were selected at random. Inclusion and exclusion criteria were applied, and the surviving records were divided into extraction (n = 92) and nonextraction (n = 92) treatment groups. Skeletal, dental, and soft tissue measurements were obtained from pretreatment lateral cephalograms and dental casts of subjects with bilateral Class I molar relationships. Data were statistically analyzed by binary logistic regression tests. RESULTS: The results showed that the variables of lower anterior facial height, E-plane to upper lip, and maxillary and mandibular incisor inclinations were significantly increased in the extraction group (P <0.05), whereas spacing in the mandibular arch and increased overbite were statistically significant in the nonextraction treatment group (P <0.05). According to the model, the odds of nonextraction treatment are 1.29 and 1.24 times that of extraction treatment for every 1-mm increase in overbite and spacing in the mandibular arch, respectively. CONCLUSIONS: Vertical facial pattern, overbite, mandibular tooth size-arch length discrepancy, lip position, and maxillary and mandibular incisor inclinations are a few of the important variables that should not be overlooked when planning orthodontic treatment. The findings of this study could facilitate the treatment planning process for patients with Class I malocclusion.


Asunto(s)
Toma de Decisiones Clínicas , Maloclusión Clase I de Angle/terapia , Ortodoncia Correctiva/métodos , Humanos , Estudios Retrospectivos
19.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 53(6): 398-403, 2018 Jun 09.
Artículo en Chino | MEDLINE | ID: mdl-29886634

RESUMEN

Objective: To investigate the effect of incisor retraction on three-dimensional morphology of upper airway and fluid dynamics in class Ⅰ adult patients with bimaxillary protrusion. Methods: Thirty class Ⅰ patients with bimaxillary protrusion that received fixed orthodontic treatment in Department of Stomatology, The First Affiliated Hospital of Wenzhou Medical University from January 2011 to September 2014 were selected using random number table. All the patients were treated with extraction of four first premolars and retraction of anterior teeth using implant anchorage. Cone-beam CT (CBCT) scans were performed before and after incisor retraction for all patients. The CBCT data of the upper airway were constructed using Mimics 16.0, and the flow field characteristics inside the upper airway were simulated using Ansys 14.0. The changes of volume (V), mean cross-sectional area (mCSA), maximum lateral diameters/maximum anteroposterior diameters (LP/AP) of cross section, the maximum pressure of airflow (P(max)), the minimum pressure of airflow (P(min)) and pressure drop (△P) of nasopharynx, oropharynx and hypopharynx before and after incisor retraction were measured and compared using paired t test. The correlation between the variation of △P in the most significant pharyngeal part and the morphological variables after incisor retraction was analyzed using Pearson correlation test. Results: No statistical differences were observed in the morphology and flow field in nasopharynx before and after incisor retraction (P>0.05). Before incisor retraction, the oropharyngeal volume and mCSA were (7 580±622) mm(3) and (217±40) mm(2), respectively, and the hypopharyngeal volume and mCSA were (2 564±162) mm(3), and (239±43) mm(2), respectively. After incisor retraction, the volumes of oropharynx and hypopharynx were (6 885±601) mm(3) and (2 535±156) mm(3), respectively, and mCSA of oropharynx and hypopharynx were (197±37) mm(2) and (236±42) mm(2), respectively. The volume and mCSA of oropharynx and hypopharynx were significantly decreased after incisor retraction (P<0.05). The greatest changes in pharyngeal volume and mCSA occurred in the oropharynx. In addition, the LP/AP of oropharynx after incisor retraction was changed from 1.9±0.6 to 2.1±0.7, which was significantly increased compared with the levels before incisor retraction (P<0.05). After simulation of pharyngeal airflow, the oropharyngeal P(min), hypopharyngeal P(max) and P(min) were (-13.7±4.3), (-8.3±3.8) and (-42.8±9.5) Pa, respectively, whereas the values turned to (-16.4±6.5), (-11.9±3.6) and (-46.0±11.0) Pa, respectively after incisor retraction, which was significantly reduced (P<0.05). △P of oropharynx was significantly increased from (42.7±10.1) Pa to (45.2±13.0) Pa after incisor retraction (P<0.05) and the variation of oropharyngeal △P was negatively correlated with the variation of V and mCSA in oropharynx before and after incisor retraction (r=-0.681, P=0.001; r=-0.844, P=0.000). Conclusions: The oropharynx was constricted and the pharyngeal resistance was increased after incisor retraction in adult class Ⅰ patients with bimaxillary protrusion. A comprehensive and systematic evaluation of the pharyngeal morphology and ventilatory function were very important for making a scientific and rational clinical treatment plan.


Asunto(s)
Incisivo , Maloclusión Clase I de Angle/terapia , Faringe/fisiología , Técnicas de Movimiento Dental/métodos , Adulto , Diente Premolar/cirugía , Tomografía Computarizada de Haz Cónico , Humanos , Hidrodinámica , Hipofaringe/fisiología , Incisivo/diagnóstico por imagen , Maloclusión Clase I de Angle/fisiopatología , Nasofaringe/fisiología , Orofaringe/fisiología , Faringe/anatomía & histología , Extracción Dental
20.
Am J Orthod Dentofacial Orthop ; 154(1): 26-34.e1, 2018 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29957314

RESUMEN

INTRODUCTION: The objective of this 2-arm parallel trial was to compare the effects of direct and indirect bonding techniques on the orthodontic treatment process and outcomes. METHODS: Thirty patients were randomly assigned to undergo bonding of brackets indirectly (group A, n = 15) or directly (group B, n = 15). Eligibility criteria included permanent dentition with bilateral Angle Class I molar and canine relationships, no previous orthodontic treatment, no skeletal discrepancy, and mild or moderate crowding. The main outcome was the orthodontic treatment results assessed using the American Board of Orthodontics Objective Grading System; the secondary outcomes were times taken to perform the laboratory and clinical steps, total treatment duration, plaque accumulation, formation of white spot lesions, bond failures, and need for additional archwire bending and bracket repositioning. The randomization sequence was created using an online randomization software. The patients were allocated with a 1:1 ratio using a block size of 4. The sequence generator was contacted by phone for group assignment after a patient was enrolled for allocation concealment. Blinding was implemented during the dental cast and radiographic evaluations, data entry, and data analysis. Patients were evaluated before treatment, and 1, 2, and 6 months after the start of treatment, and at the end of treatment. RESULTS: All patients completed the study and were analyzed. There were no dropouts. Marginal ridge (median difference, -1.000; 95% confidence interval [CI], -2.99 to -0.001; P = 0.03) and total Objective Grading System scores (median difference, -3.999; 95% CI, -6.000 to -0.005; P = 0.03) were significantly higher in group B than in group A; other Objective Grading System categories did not differ significantly between the groups. The clinical time was significantly longer in group B than in group A (mean difference, -26.51; 95% CI, -29.57 to -23.46; P <0.001), and the total time was significantly longer in group A than in group B (mean difference, 19.03; 95% CI, 15.32 to 22.74; P <0.001). There were no significant between-group differences in treatment duration, plaque accumulation, formation of white spot lesions, bond failure, or need for additional archwire bending or bracket repositioning. No harms were encountered. CONCLUSIONS: Indirect bonding was significantly faster than direct bonding in the clinical stage and yielded better marginal ridge and total scores. Both techniques showed similar rates of plaque accumulation, formation of white spot lesions, bond failure, and additional archwire bending and bracket repositioning. REGISTRATION: The trial was not registered. PROTOCOL: The protocol was not published before trial commencement.


Asunto(s)
Recubrimiento Dental Adhesivo/métodos , Maloclusión Clase I de Angle/terapia , Ortodoncia Correctiva/efectos adversos , Ortodoncia Correctiva/métodos , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Diseño de Aparato Ortodóncico , Estudios Prospectivos , Método Simple Ciego , Resultado del Tratamiento , Adulto Joven
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