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1.
Prog Orthod ; 21(1): 6, 2020 Feb 17.
Artículo en Inglés | MEDLINE | ID: mdl-32064567

RESUMEN

BACKGROUND: The objective was to analyze clinical, microbiological, and immunological periodontal parameters in patients in corrective orthodontic treatment. MATERIALS AND METHODS: Twenty-eight patients were selected. Plaque index (PI), bleeding on probing (BOP), width of keratinized gingiva, levels of 40 bacterial species, and of 3 cytokines (IL-1ß, MMP-8, and TNF-α) in gingival crevicular fluid (GCF) were evaluated at T0, before orthodontic treatment; T1, 6 months; and T2, 12 months post-treatment. Non-parametric, Friedman, Wilcoxon, ANOVA, and Spearman correlation coefficient tests were used for statistical analyses, with the significance level of 5%. RESULTS: No significant difference was found for the width of keratinized gingiva, but PI presented a significant increase at T1 and T2 (p < 0.05) when compared with T0. The percentage of sites with BOP increased significantly from T0 to T1 (p < 0.05); however, at T2, the values decreased and did not differ anymore from T0 (p > 0.05). In the microbiological analysis, red complex pathogens were in significantly greater proportions in T2 compared with T0 (p < 0.05). There was no statistically significant difference in the cytokine levels between the periods but there was a positive correlation between BOP and IL-1ß (r = 0.49 p = .01) and TNF-α (r = 0.39 and p = .05). CONCLUSION: In conclusion, corrective orthodontic treatment caused clinical periodontal alterations regarding biofilm accumulation and gingival bleeding, with alteration of periodontopathogens.


Asunto(s)
Líquido del Surco Gingival , Ortodoncia Correctiva , Índice de Placa Dental , Humanos , Índice Periodontal , Factor de Necrosis Tumoral alfa
2.
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 de Angle Clase II/patología , Maloclusión de Angle Clase II/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
3.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(2): 86-92, 2020 Feb 09.
Artículo en Chino | MEDLINE | ID: mdl-32074668

RESUMEN

Objective: To investigate the influential factors related to the long-term effect of periodontal-orthodontic treatment in patients with aggressive periodontitis (AgP). Methods: A retrospective analysis was conducted in 25 AgP patients, who have received periodontal-orthodontic treatment in Peking University School and Hospital of Stomatology. Changes in the ratio of the residual alveolar bone height (RBH) was measured at three time points: baseline (T0), post orthodontic treatment (T1), and the last re-visit 3 years after orthodontic treatment (T2). Root abnormity was evaluated by observing periapical radiographs, and its relationship with alveolar bone loss after orthodontic treatment was analyzed. A multi-level analysis on factors related to the clinical outcome (alveolar bone height change) was performed. Results: Totally 693 teeth of 25 patients at T0 and T1 and 368 teeth of 14 patients at T2 were investigated. During the periodontal-orthodontic treatment, the RBH was mainly influenced by root abnormity (estimation value -2.392), tooth position (estimation value for upper teeth vs. lower teeth 3.139, and anterior teeth vs. posterior teeth -3.469) and the baseline RBH at T0 (estimation value -0.391) (P<0.05). Teeth with root abnormity, teeth in mandibular and anterior area, and teeth with higher RBH showed less change in T1-T0 RBH values. In the long-term follow-up, RBH was mainly influenced by tooth position (estimation value for upper teeth vs. lower teeth 3.735, and anterior teeth vs. posterior teeth -5.318), the baseline RBH and probing depth (PD) at T0. Teeth in mandibular and anterior area, teeth with higher RBH (estimation value -0.498) and PD (estimation value -1.594) (P<0.05) showed less change in T0-T2 RBH values. Conclusions: During orthodontic treatment, teeth with abnormal root, lower teeth, anterior teeth, and teeth with high RBH were unfavorable factors for bone gain. In the long-term observation, lower teeth, anterior teeth, teeth with high RBH and PD at first visit were unfavorable factors for bone gain.


Asunto(s)
Periodontitis Agresiva/terapia , Maloclusión/terapia , Diente/patología , Pérdida de Hueso Alveolar , Humanos , Ortodoncia Correctiva , Estudios Retrospectivos
4.
BMC Oral Health ; 20(1): 22, 2020 01 28.
Artículo en Inglés | MEDLINE | ID: mdl-31992277

RESUMEN

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


Asunto(s)
Proceso Alveolar/cirugía , Trasplante Óseo/métodos , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteogénesis/fisiología , Osteotomía/métodos , Aumento de la Cresta Alveolar/métodos , Humanos , Ortodoncia Correctiva/instrumentación , Técnicas de Movimiento Dental/métodos , Resultado del Tratamiento
8.
Oral Maxillofac Surg Clin North Am ; 32(1): 89-103, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31685343

RESUMEN

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


Asunto(s)
Métodos de Anclaje en Ortodoncia , Ortodoncia Correctiva , Procedimientos Quirúrgicos Ortognáticos , Planificación de Atención al Paciente , Humanos , Satisfacción del Paciente , Calidad de Vida , Encuestas y Cuestionarios
9.
Oral Maxillofac Surg Clin North Am ; 32(1): 135-151, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31685347

RESUMEN

Post orthognathic surgery patient management is critical for high-quality and predictable outcomes. Surgeons and orthodontists must have the knowledge and ability to implement postsurgical management protocols and strategies to provide the best care and outcomes possible. This article presents basic concepts, philosophies, treatment protocols, risks, and potential complications associated with postsurgical patient management. Postsurgical orthodontic goals are to maximize the occlusal fit and provide predictable means to retain the occlusion. Aggressive orthodontic mechanics may be required to provide the best occlusal fit. Complications can occur, but early recognition of complications and implementation of corrective tactics should minimize adverse outcomes.


Asunto(s)
Ortodoncia , Cirugía Ortognática , Procedimientos Quirúrgicos Ortognáticos , Cefalometría , Humanos , Ortodoncia Correctiva
10.
Oral Maxillofac Surg Clin North Am ; 32(1): 105-116, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31685348

RESUMEN

Idiopathic condylar resorption (ICR), alternatively called progressive condylar resorption, is an uncommon aggressive form of degenerative disease of the temporomandibular joint seen mostly in adolescent and young women. ICR occurring before the completion of growth results in a shorter mandibular condyloid process, ramus and body, compensatory growth at the gonial angle and coronoid process, as well as an increase in anterior facial vertical dimension. Management options discussed include oral appliances, orthodontics, medical management, orthognathic surgery with and without disc repositioning, and alloplastic temporomandibular joint replacement.


Asunto(s)
Resorción Ósea , Cóndilo Mandibular/cirugía , Ortodoncia Correctiva , Procedimientos Quirúrgicos Ortognáticos/métodos , Trastornos de la Articulación Temporomandibular/cirugía , Adolescente , Resorción Ósea/etiología , Femenino , Humanos , Cóndilo Mandibular/patología , Aparatos Ortopédicos , Articulación Temporomandibular
11.
Oral Maxillofac Surg Clin North Am ; 32(1): 71-82, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31744601

RESUMEN

Complications in orthognathic surgery are commonly a result of inadequate preoperative planning and communication between the surgeon and orthodontist. Unfavorable outcomes can often be avoided when overall treatment goals along with a surgical and orthodontic plan are developed and agreed upon by the orthodontist, surgeon, and patient before the start of active tooth movement or any surgical procedures. Continuous evaluation of the patient's progress throughout treatment and subsequent communication between the surgeon and orthodontist are recommended to prevent frequent errors, such as inadequate dental decompensation, poor appliance selection or management, and occasional contraindicated orthodontic elastic traction or tooth movements.


Asunto(s)
Maloclusión , Ortodoncia Correctiva/métodos , Ortodoncia , Cirugía Ortognática/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Planificación de Atención al Paciente , Humanos , Grupo de Atención al Paciente , Complicaciones Posoperatorias
12.
Am J Orthod Dentofacial Orthop ; 156(6): 791-799, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31784012

RESUMEN

INTRODUCTION: The aim of this study was to evaluate the trends and rates of Medicaid-funded orthodontic treatment provided by orthodontists to children younger than 18 years in Oklahoma. METHODS: Enrollment and claims data were evaluated from the Oklahoma Medicaid program for a 7-year period, January 2010 through December 2016. Medicaid total enrollment data by age, sex, race or ethnicity, and county were included. Claims data were collected both for any dental services and comprehensive orthodontic treatment for adolescents. Descriptive statistics were used for the study variables. Proportions and odds ratios were calculated and compared using a chi-square test. RESULTS: Children aged between 15 and 18 years received orthodontic treatment more frequently than children aged between 6 and 14 years. Females received orthodontic treatment more frequently than males. Caucasians received orthodontic treatment more frequently than other races. Children who live in rural areas received orthodontic treatment more frequently than those living in urban areas. CONCLUSIONS: Comprehensive orthodontic patients are more likely to be Caucasian females between the ages of 15 and 18 years living in rural areas. The Hispanic community is growing significantly in the Medicaid population. Access to care is still a problem faced by many.


Asunto(s)
Medicaid , Ortodoncia Correctiva , Adolescente , Niño , Atención Odontológica , Femenino , Hispanoamericanos , Humanos , Masculino , Oklahoma , Ortodoncia Correctiva/economía , Ortodoncia Correctiva/estadística & datos numéricos , Estados Unidos
13.
Am J Orthod Dentofacial Orthop ; 156(6): 823-831, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31784016

RESUMEN

INTRODUCTION: An accurate prediction in the soft tissue changes is of great importance for orthodontic treatment planning. Previous studies on the accuracy of the Dolphin visual treatment objective (VTO) in predicting treatment results were mainly focused on orthognathic treatment. The accuracy of Dolphin VTO prediction for orthodontic treatment is, however, poorly understood. The aim of this study was to evaluate the accuracy of Dolphin VTO prediction in soft tissue changes after orthodontic treatment by comparing the changes between predicted and actual values. METHODS: A total of 157 patients were screened for eligibility, and 34 young adult patients (8 males, 26 females; mean age 24.8 ± 3.9 years) were finally included in the study based on the inclusion and exclusion criteria. The landmarks and parameters of the Holdaway soft tissue analysis were used for the cephalometric analyses. The cephalometric tracings of the actual treatment result and the Dolphin predicted treatment outcome were superimposed to calculate the prediction errors. Paired t test was used to compare the statistical differences between the predicted and actual treatment outcomes of the parameters used in the Holdaway soft tissue analysis. RESULTS: There were significant differences between the predicted and actual values in parameters of the Holdaway soft tissue analysis (P < 0.05). The prediction of the landmarks in the lips region (ie, subnasale, soft tissue A-point, upper lip, lower lip, and soft tissue B-point) was inclined to be overestimated horizontally and underestimated vertically, whereas the prediction of the landmarks belonging to the chin region (ie, soft tissue pogonion, soft tissue gnathion, and soft tissue menton) was inclined to be underestimated horizontally and overestimated vertically. The most accurate prediction was found in the soft tissue A-point, whereas the least accurate one was found in the soft tissue in the chin region. The prediction was relatively more accurate in the vertical direction than in the horizontal direction. CONCLUSIONS: The Dolphin VTO prediction in soft tissue changes after the orthodontic treatment in patients with bimaxillary protrusion is the most accurate for the soft tissue A-point and the least accurate for the soft tissue chin region.


Asunto(s)
Cara , Maloclusión , Ortodoncia Correctiva , Adulto , Cefalometría , Mentón , Cara/anatomía & histología , Femenino , Predicción , Humanos , Labio , Masculino , Programas Informáticos , Adulto Joven
14.
Am J Orthod Dentofacial Orthop ; 156(6): 858-869, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31784020

RESUMEN

A 19-year-old woman with a skeletal Class III pattern, anterior and posterior crossbites, and a low mandibular plane angle was treated with nonextraction camouflage treatment. The total active treatment time was 17 months. After treatment, her occlusion, smile esthetics, and soft tissue profile were significantly improved.


Asunto(s)
Oclusión Dental , Maloclusión de Angle Clase III , Ortodoncia Correctiva , Cefalometría , Estética Dental , Femenino , Humanos , Maloclusión de Angle Clase III/terapia , Sonrisa , Adulto Joven
15.
Am J Orthod Dentofacial Orthop ; 156(6): 870-877, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31784021

RESUMEN

INTRODUCTION: This study aimed to evaluate the ability of dental clinicians to predict posttreatment dental arch forms in patients with malocclusion with the aid of 3D imaging and digital software in comparison with a conventional method. METHODS: Pretreatment and posttreatment dental plaster casts of 100 patients (200 maxillary models and 200 mandibular models) were selected. Three orthodontists selected the best-fitted archwires among 5 commercially available preformed nickel-titanium archwires using 2 methods. In the conventional method, they fit the archwires to pretreatment casts, and in the digital method, they fit the scanned wire to a 3D digital model, using Ortho-Aid, a locally developed 3D software, using clinical bracket points as reference for wire fitness. The predicted posttreatment archwire in each method was compared with the best-fit archwire on the actual posttreatment model of each patient in both methods, and the level of agreement was calculated. The interobserver agreement between the 3 orthodontists in each method was evaluated using intraclass correlation coefficient and the Dahlberg formula. RESULTS: Orthodontists predicted the final treatment outcome in 50% of cases using the conventional method and 58% using the digital method. However, the range of method error was significantly higher in the conventional method (0.425-3.853 mm for the conventional vs 0.451-0.584 mm for the digital). CONCLUSIONS: Although the clinicians' ability to predict the final dental arch form after orthodontic treatment and the agreement between clinicians increased by the use of digital equipment, orthodontists can predict the final arch form in about 60% of patients.


Asunto(s)
Arco Dental , Imagenología Tridimensional , Alambres para Ortodoncia , Ortodoncia Correctiva , Aleaciones Dentales , Arco Dental/anatomía & histología , Arco Dental/diagnóstico por imagen , Modelos Dentales , Predicción , Humanos , Mandíbula , Programas Informáticos
16.
Eur J Paediatr Dent ; 20(4): 330-334, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31850779

RESUMEN

SEC III protocol: Early treatment of dentoskeletal Class III malocclusions. The early treatment of dentoskeletal Class III malocclusion is one of the more challenging situations for orthodontists, mainly for the uncertainty of stable long-term results due to the interaction of both environmental and genetic aetiological factors. Several interceptive protocols have been proposed during the past decades. The SEC III protocol includes two occlusal acrylic Splints combined with Class III elastics and chin cup. The protocol was proposed to facilitate Class III dentoskeletal correction by eliminating the intercuspation and the tongue thrust with clockwise mandibular rotation and minimal dentoalveolar compensation. The main difference with all the other appliances is the vertical control, which is crucial in difficult cases such as hyperdivergent Class III malocclusions.


Asunto(s)
Maloclusión de Angle Clase III , Maloclusión , Ortodoncia , Cefalometría , Niño , Aparatos de Tracción Extraoral , Humanos , Mandíbula , Ortodoncia Correctiva , Ortodoncia Interceptiva
17.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(12): 793-797, 2019 Dec 09.
Artículo en Chino | MEDLINE | ID: mdl-31874476

RESUMEN

With the improvement of people's living standards and oral health education, the demand for orthodontic treatment is increasing. The comprehensive goal of orthodontic treatment is not only to obtain esthetic dentition and appearance, but also to obtain oral health, general health and mental and psychological health. Therefore, how to effectively prevent the risks in orthodontic treatment is particularly important, and it is also an important content that orthodontists must master. In this paper, the prevention of related risks in orthodontic treatment was discussed.


Asunto(s)
Atención Odontológica , Ortodoncia Correctiva , Gestión de Riesgos , Estética Dental , Humanos , Maloclusión/terapia
18.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(12): 803-807, 2019 Dec 09.
Artículo en Chino | MEDLINE | ID: mdl-31874478

RESUMEN

Facial aesthetic defect is obviously different from facial aesthetic standard. Orthodontic treatment may expose or even magnify other facial aesthetic defects while solving patients' main problems. There are many aesthetic traps in facial bone structure, soft tissue and teeth. Orthodontists should comprehensively recognize patients' dentofacial aesthetic defects. When solving major problems, we should keep an eye on the changes of minor problems and other uncontrollable factors. Potential risks should be clearly recognized and prevented.


Asunto(s)
Estética Dental , Maloclusión/terapia , Ortodoncia Correctiva , Gestión de Riesgos , Atención Odontológica , Humanos
19.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 54(12): 808-814, 2019 Dec 09.
Artículo en Chino | MEDLINE | ID: mdl-31874479

RESUMEN

Temporomandibular joint (TMJ) related signs and symptoms are frequently found in adolescent and adult orthodontic patients. TMJ health has long been considered important in orthodontic treatment for many decades, and routine screening and management of TMJ problems should be emphasized in orthodontic population. This paper was to review the TMJ problems in orthodontic patients and to set the strategy in clinical orthodontics.


Asunto(s)
Maloclusión/terapia , Ortodoncia Correctiva , Trastornos de la Articulación Temporomandibular/etiología , Humanos , Gestión de Riesgos , Articulación Temporomandibular/fisiopatología
20.
Evid Based Dent ; 20(4): 107-108, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31863043

RESUMEN

Design Prospective cohort study.Cohort selection A large cohort of 13-year-old children who participated in a South Australian population oral health study. a total of 1859 participants residing in metropolitan Adelaide were mailed a self-administered questionnaire when they turned 30 years of age.Data analysis Demographic data (sex, education level and income), dental behaviour (brushing habits, dental visits in past two years) and receipt of fixed orthodontic treatment were coded as dichotomous data. Psychosocial factors (self-efficacy, health competence, social support and optimism) were recorded on Likert scale as continuous measures. Severity of baseline malocclusion in untreated 13-year-olds was recorded using Dental Aesthetic Index (DAI).Regression analysis was performed to detect for associations between orthodontic treatment and each psychosocial factor and all independent variables were included in adjusted generalised linear models. Statistical significance level was set at p <0.05.Results Data from 448 participants (24%) informed the study results. Statistically significant association was found between low income (<80,00 AUD) and basic secondary education with each of the four psychosocial variables studied. Severity of baseline malocclusion (indicated by DAI) or prior orthodontic treatment was not associated with better psychosocial outcomes. Importantly, better psychosocial outcomes were observed among participants who had no prior orthodontic treatment.Conclusions Prior orthodontic treatment had no influence on psychosocial outcomes over the long-term.


Asunto(s)
Maloclusión , Ortodoncia Correctiva , Adolescente , Adulto , Australia , Niño , Estudios de Cohortes , Humanos , Estudios Prospectivos , Autoimagen
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