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1.
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
2.
Am J Orthod Dentofacial Orthop ; 156(3): 312-325, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474261

RESUMEN

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


Asunto(s)
Mordida Abierta/terapia , Ortodoncia Correctiva/estadística & datos numéricos , Ortodoncistas/estadística & datos numéricos , Pautas de la Práctica en Odontología/estadística & datos numéricos , Anciano , Cefalometría , Femenino , Humanos , Incisivo , Masculino , Mandíbula , Persona de Mediana Edad , Mordida Abierta/diagnóstico por imagen , Mordida Abierta/epidemiología , Aparatos Ortodóncicos/estadística & datos numéricos , Ortodoncia Correctiva/instrumentación , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos , Encuestas y Cuestionarios , Técnicas de Movimiento Dental/instrumentación , Técnicas de Movimiento Dental/métodos , Técnicas de Movimiento Dental/estadística & datos numéricos , Estados Unidos/epidemiología
3.
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
4.
Am J Orthod Dentofacial Orthop ; 156(2): 186-192, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375228

RESUMEN

INTRODUCTION: The purpose of this study was to compare and evaluate salivary microbial levels and periodontal status in patients using a fixed lingual retainer, a removable vacuum-formed retainer, or a Hawley retainer after orthodontic treatment with fixed appliances. METHODS: Forty-five patients who finished their orthodontic treatment with fixed appliances and were about to start the retention phase were randomly divided into the following 3 groups of 15 individuals each: the fixed lingual retainer group, the vacuum-formed retainer group, and the Hawley retainer group. Periodontal measurements, such as the plaque index, gingival index, probing depth, and bleeding on probing, were obtained at the following 4 time points: at debonding (T0) and 1 week (T1), 5 weeks (T2), and 13 weeks (T3) after debonding. Saliva samples were collected 3 times in total: at T0, T2, and T3. A quantitative analysis for Streptococcus mutans and Lactobacillus casei was performed with the use of real-time polymerase chain reaction. The Kruskal-Wallis test and 1-way analysis of variance were used for the statistical comparisons of the groups. RESULTS: No statistically significant difference in salivary S mutans and L casei levels was found among the 3 groups (P >0.05). They showed no statistically significant differences in plaque index, gingival index, bleeding on probing, and probing depth values (P >0.05). All periodontal parameters showed statistically significant decreases from T0 to T3 in all 3 groups (P <0.001). The S mutans and L casei levels were decreased significantly from T2 to T3 in the lingual retainer and Hawley retainer groups, whereas they decreased significantly from T0 to T3 in the vacuum-formed retainer group. CONCLUSIONS: Fixed and removable orthodontic retainers do not differ in salivary S mutans and L casei levels and periodontal status. With all retainers, regardless of whether they are fixed or removable, oral hygiene improved after orthodontic treatment with fixed appliances.


Asunto(s)
Aparatos Ortodóncicos Fijos/efectos adversos , Aparatos Ortodóncicos Removibles/efectos adversos , Retenedores Ortodóncicos/efectos adversos , Índice Periodontal , Saliva/microbiología , Adolescente , Adulto , Análisis de Varianza , Niño , ADN Bacteriano , Índice de Placa Dental , Femenino , Humanos , Lactobacillus casei , Masculino , Higiene Bucal , Diseño de Aparato Ortodóncico , Ortodoncia Correctiva/efectos adversos , Ortodoncia Correctiva/instrumentación , Streptococcus mutans , Vacio , 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 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
6.
Am J Orthod Dentofacial Orthop ; 156(1): 125-136, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256825

RESUMEN

This case report describes the successful treatment of a 14-year-old girl with severe bilateral idiopathic condylar resorption and resultant mandibular retrusion, increased overjet, and anterior open bite. The nonextraction treatment plan included (1) aligning and leveling the teeth in both arches, (2) performing Le Fort I maxillary osteotomy, bilateral condylectomy, and mandibular joint replacement, and (3) postsurgical correction of the malocclusion. The orthodontic treatment was initiated with the use of custom lingual appliances followed by orthognathic surgery planned with virtual surgical planning. Patient-fitted and customized temporomandibular joint implants were designed and manufactured based on the patient's stereolithic bone anatomic model. Treatment was concluded with detailed orthodontic finishing. Optimum esthetic and functional results were achieved with the cooperation of 2 specialties and the use of state-of-the-art technology.


Asunto(s)
Tirantes , Prótesis Articulares , Cóndilo Mandibular/cirugía , Mordida Abierta/cirugía , Mordida Abierta/terapia , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Trastornos de la Articulación Temporomandibular/terapia , Adolescente , Puntos Anatómicos de Referencia , Resorción Ósea/complicaciones , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/cirugía , Resorción Ósea/terapia , Cefalometría , Estética Dental , Femenino , Humanos , Imagenología Tridimensional , Mandíbula/cirugía , Cóndilo Mandibular/diagnóstico por imagen , Maxilar/cirugía , Mordida Abierta/diagnóstico por imagen , Aparatos Ortodóncicos , Aparatos Ortodóncicos Fijos , Ortodoncia Correctiva/instrumentación , Osteotomía , Planificación de Atención al Paciente , Radiografía Panorámica , Articulación Temporomandibular/diagnóstico por imagen , Articulación Temporomandibular/cirugía , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/cirugía , Resultado del Tratamiento
7.
Am J Orthod Dentofacial Orthop ; 155(6): 844-850, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31153505

RESUMEN

INTRODUCTION: The primary objective of this study was to assess the effectiveness of the mini tooth positioner in improving the quality of orthodontic treatment outcomes, as measured by the American Board of Orthodontics (ABO) cast-radiograph evaluation (CRE). METHODS: Thirty patients were treated prospectively with a minipositioner for 4-6 weeks immediately after debond. Sixteen patients who had received a maxillary vacuum-formed retainer (VFR) and fixed mandibular canine-to-canine retainer at time of debond were enrolled retrospectively as control subjects. Models from time of debond (T1) were graded with the use of the ABO CRE and compared with models obtained 4-6 weeks after debond (T2) for each group. RESULTS: For the minipositioner group, the overall CRE score improved significantly by an average of 6.77 points. Significant improvements were noted in the categories of alignment and rotations (-0.68), marginal ridges (-1.40), buccolingual inclination (-0.45), overjet (-0.97), and occlusal contacts (-3.00). For the control group, overall CRE score improved significantly by an average of 1.16 points. Only the categories of overjet (-0.38) and occlusal contacts (-1.22) showed significant improvements. CONCLUSIONS: The minipositioner is an effective tool in improving the overall finish of orthodontic treatment. In the 4-6 weeks after debond evaluated in this study, the minipositioner significantly outperformed the maxillary VFR/mandibular fixed canine-to-canine retainer in improving final treatment outcomes.


Asunto(s)
Retenedores Ortodóncicos , Ortodoncia Correctiva/instrumentación , Adolescente , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Diseño de Aparato Ortodóncico , Estudios Prospectivos , Resultado del Tratamiento
8.
Orthod Fr ; 90(1): 65-74, 2019 Mar.
Artículo en Francés | MEDLINE | ID: mdl-30994450

RESUMEN

INTRODUCTION: Asymmetrical orthodontic cases frequently prove very difficult to correct. Anchorage mini-screws are often needed to treat these cases when the malocclusion is of maxillary origin. Nonetheless, a precise biomechanical assessment must be made to avoid undesirable sideeffects resulting from the mechanics used. Whether one uses a continuous or a segmented archwire, adverse events can occur and must be planned for in order to contain them. MATERIALS AND METHODS: The authors will first give an overview of the possible undesirable effects using the continuous arch technique and the principles underlying the segmented archwire technique. Various clinical cases will also be described to support their argument. CONCLUSION: The advantage of the segmented techniques lies in the precision and speed of the movements obtained in the three dimensions of space. However, they can also present major drawbacks. In practice, these techniques seem best-suited to complex atypical cases, and particularly cases involving asymmetry of the frontal and transverse planes.


Asunto(s)
Asimetría Facial/complicaciones , Asimetría Facial/terapia , Maloclusión/complicaciones , Maloclusión/terapia , Diseño de Aparato Ortodóncico , Alambres para Ortodoncia/clasificación , Artefactos , Fenómenos Biomecánicos , Tornillos Óseos , Femenino , Humanos , Mandíbula/cirugía , Maxilar/patología , Maxilar/cirugía , Métodos de Anclaje en Ortodoncia/efectos adversos , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Diseño de Aparato Ortodóncico/efectos adversos , Diseño de Aparato Ortodóncico/clasificación , Diseño de Aparato Ortodóncico/métodos , Ortodoncia Correctiva/efectos adversos , Ortodoncia Correctiva/instrumentación , Ortodoncia Correctiva/métodos , Planificación de Atención al Paciente/normas
9.
Am J Orthod Dentofacial Orthop ; 155(4): 560-571, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30935611

RESUMEN

INTRODUCTION: We report the successful treatment of a 38-year-old woman with bilateral idiopathic condylar resorption and anterior open bite. She had incompetent lips, a gummy smile, increased lower facial height, high mandibular plane angle, skeletal and dental Class II malocclusion with mild mandibular crowding, increased overjet, and mandibular midline deviation to the right. METHODS: The treatment plan included: (1) presurgical alignment and leveling of the teeth in both arches; (2) jaw motion tracking (JMT) to detect mandibular movement; (3) 3-piece maxillary osteotomies with mandibular reconstruction and bilateral coronoidectomies; and (4) postsurgical correction of the malocclusion. The orthodontic treatment was performed with the use of custom lingual braces and clear brackets and the orthognathic surgery was planned with the use of virtual surgical planning. RESULTS: The idiopathic condylar resorption and anterior open bite were treated, crowding was eliminated in the lower anterior segment, correction of skeletal and dental Class II malocclusion was obtained, mandibular plane angle was reduced, and facial profile improved. CONCLUSIONS: The results suggest that esthetic and functional results can be achieved with the cooperation of 2 specialties and with the use of state-of-the-art technology.


Asunto(s)
Resorción Ósea/cirugía , Mordida Abierta/cirugía , Aparatos Ortodóncicos Fijos , Trastornos de la Articulación Temporomandibular/cirugía , Adulto , Resorción Ósea/complicaciones , Resorción Ósea/diagnóstico por imagen , Resorción Ósea/terapia , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Imagenología Tridimensional , Mordida Abierta/complicaciones , Mordida Abierta/diagnóstico por imagen , Mordida Abierta/terapia , Aparatos Ortodóncicos , Ortodoncia Correctiva/instrumentación , Ortodoncia Correctiva/métodos , Trastornos de la Articulación Temporomandibular/complicaciones , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/terapia
10.
Am J Orthod Dentofacial Orthop ; 155(4): 572-583, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30935612

RESUMEN

This article reports the camouflage treatment of a female patient, aged 15 years 2 months, who had a Class II Division 1 malocclusion with severe anterior protrusion and deep incisor overbite. The camouflage treatment plan included bilateral extraction of the maxillary first premolars combined with the use of temporary anchorage devices (TADs) and tension coil springs to retract canines into the extraction spaces and then the 4 incisors. The treatment included use of a mandibular fixed labial arch with minimal use of Class II elastics to correct mild mandibular spacing and level the curve of Spee. Ideal overjet and overbite relationships were established, and the final result was well balanced and esthetically pleasing. The molars were finished in a Class II relationship. Total treatment time was 2 years 6 months. Cephalometric superimpositions revealed that mandibular molars were not disturbed by the limited use of Class II elastics. Surgical miniscrews in canine and incisor retraction in Class II Division 1 malocclusion are an alternate type of temporary anchorage that reduce or remove reliance on conventional intermaxillary anchorage.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Métodos de Anclaje en Ortodoncia , Ortodoncia Correctiva/métodos , Adolescente , Femenino , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Ortodoncia Correctiva/instrumentación , Radiografía Dental , Radiografía Panorámica
11.
J Craniofac Surg ; 30(1): e15-e17, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30439736

RESUMEN

Orthopedic functional appliances are usually used to correct patients with retrognathic mandible. However, a part of cases have a trend of relapse after splint treatment. The aim of this study was to explore the role of temporomandibular joint disc position in functional appliance treatment. This study included 8 patients who had 1 joint anterior disc displacement with reduction (ADDWR) and the other joint anterior disc displacement without reduction (ADDWoR) confirmed by magnetic resonance imaging (MRI). Only the ADDWR joint could return to its normal position after wearing the anterior repositioning appliances (ARAs). Condylar morphology, condylar height, and disc length were evaluated 6 months after ARA treatment. The MRI showed that new bone appeared on 7 joints with ADDWR and on 1 joint with ADDWoR. The condylar height has increased 1.4 mm in the ADDWR group, while 0.1 mm shorter in the ADDWoR group. Disc length has increased from 8.5 to 8.7 mm in the ADDWR group and 0.4 mm shorter in the ADDWoR group after wearing the ARA. Our results suggested that it is noneffective of functional appliance used for class II malocclusion adolescents with ADDWoR and only a normal disc-condyle relationship benefits condyle growth by functional appliance. Thus it is important to reposition the disc as soon as possible.


Asunto(s)
Luxaciones Articulares/terapia , Ortodoncia Correctiva/instrumentación , Retrognatismo/terapia , Disco de la Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/patología , Trastornos de la Articulación Temporomandibular/terapia , Adolescente , Niño , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Maloclusión de Angle Clase II/terapia , Cóndilo Mandibular/diagnóstico por imagen , Cóndilo Mandibular/patología , Ferulas Oclusales , Recurrencia , Disco de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen
12.
Eur J Orthod ; 41(2): 133-142, 2019 03 29.
Artículo en Inglés | MEDLINE | ID: mdl-30007300

RESUMEN

OBJECTIVE: To compare treatment duration between 0.018-inch and 0.022-inch slot systems and determine factors influencing treatment duration. SUBJECTS AND METHODS: Eligible participants aged 12 years or over were allocated to the 0.018-inch or 0.022-inch slot MBT appliance (3M-Unitek, Monrovia, California, USA) using block randomization in groups of 10. Outcome measures included duration of: 1. overall treatment, 2. levelling and alignment, 3. working and finishing, and 4. appointment numbers and other treatment-related factors. Parametric tests (independent samples t-test) and non-parametric tests (chi-square with Fisher's exact tests and Mann-Whitney U-test) assessed differences between groups. A multiple linear regression analysis identified factors influencing treatment duration (P < 0.05). RESULTS: Of the 187 participants randomized (1:1 ratio), 34 withdrew or were excluded (protocol deviations or poor cooperation). There were 77 patients in the 0.018-inch slot group and 76 patients in the 0.022-inch slot group (overall mean age: 19.1 years). Baseline characteristics were similar between groups (P > 0.05). The mean duration of treatment for the 0.018-inch and 0.022-inch slot groups was 29.3 and 31.2 months, respectively. There were no statistically significant differences between the two treatment groups in terms of treatment duration, duration of the key stages of treatment, and number of appointments (P > 0.05). The regression analysis revealed 33.0 per cent of variance in treatment duration was explained by age at bonding, Class II division 2 malocclusion, number of failed appointments, number of emergency appointments, and transfer to another clinician. There were no adverse events. LIMITATIONS: It was impossible to blind clinicians or patients to allocation and oral hygiene and periodontal outcomes were not assessed. CONCLUSIONS: There was no statistically or clinically significant difference in treatment duration between 0.018-inch and 0.022-inch slot bracket systems. Increasing patient age, Class II division 2 malocclusion, number of failed and emergency appointments, and multi-operator treatment all increase orthodontic treatment duration. REGISTRATION: The trial was registered with ClinicalTrials.gov on 5 March 2014, registration number: NCT02080338. PROTOCOL: The protocol was published at DOI: 10.1186/1745-6215-15-389.


Asunto(s)
Maloclusión/terapia , Soportes Ortodóncicos , Ortodoncia Correctiva/instrumentación , Adolescente , Adulto , Citas y Horarios , Niño , Femenino , Humanos , Masculino , Maloclusión de Angle Clase II/terapia , Diseño de Aparato Ortodóncico , Cooperación del Paciente/estadística & datos numéricos , Proyectos de Investigación , Método Simple Ciego , Factores de Tiempo , Resultado del Tratamiento , Adulto Joven
13.
Eur J Orthod ; 41(2): 154-164, 2019 03 29.
Artículo en Inglés | MEDLINE | ID: mdl-30007330

RESUMEN

OBJECTIVE: To compare orthodontically induced inflammatory root resorption (OIIRR) and patient perception of pain during orthodontic treatment between 0.018-inch and 0.022-inch slot bracket systems. SUBJECTS AND METHODS: Eligible participants aged 12 years or above were allocated to treatment with the 0.018-inch or 0.022-inch slot MBT appliance (3M Unitek, Monrovia, California, USA) using block randomization in groups of 10. OIIRR was assessed radiographically using standardized periapical radiographs before and after 9 months from the start of treatment. Patient perception of pain was assessed using a validated patient questionnaire at 6 months from the start of treatment. Parametric tests (t-test) and non-parametric tests (chi-square with Fisher's exact tests and Kruskal-Wallis test) assessed differences between the groups (P < 0.05). The correlation between severity of OIIRR and abnormal root morphology, history of dental trauma, and pain during treatment was assessed. RESULTS: Of the 187 participants randomized (1:1 ratio), 34 withdrew or were excluded (protocol deviations or poor cooperation). There were 77 patients in the 0.018-inch slot group and 76 patients in the 0.022-inch slot group (overall mean age: 19.1 years). Baseline characteristics were similar between groups (P > 0.05). There was no significant difference in the severity of the OIIRR nor patient perception of pain between the two study groups (P = 0.115 and P = 0.08 respectively). The correlation between the severity of OIIRR and abnormal root morphology or history of dental trauma was not statistically significant (P = 0.086 and P = 0.313). Moreover, there was no significant correlation between the severity of OIIRR and pain during treatment (R = 0.045, P = 0.617). LIMITATIONS: It was impossible to blind clinicians or patients to allocation, and oral hygiene and periodontal outcomes were not assessed. CONCLUSIONS: The effect of bracket slot size on the severity of OIIRR and patient perception of pain are not significant. TRIAL REGISTRATION: The trial was registered with ClinicalTrials.gov on 5 March 2014, registration number: NCT02080338.


Asunto(s)
Maloclusión/terapia , Soportes Ortodóncicos/efectos adversos , Ortodoncia Correctiva/efectos adversos , Ortodoncia Correctiva/instrumentación , Resorción Radicular/etiología , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Diseño de Aparato Ortodóncico , Ortodoncia Correctiva/métodos , Dimensión del Dolor/métodos , Percepción del Dolor , Medición de Resultados Informados por el Paciente , Radiografía Dental , Resorción Radicular/diagnóstico por imagen , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Adulto Joven
14.
Eur J Orthod ; 41(2): 143-153, 2019 03 29.
Artículo en Inglés | MEDLINE | ID: mdl-30007333

RESUMEN

OBJECTIVE: To compare the quality of orthodontic treatment between 0.018-inch and 0.022-inch slot bracket systems. SUBJECTS AND METHODS: Eligible participants aged 12 years or over were allocated to the 0.018-inch or 0.022-inch slot MBT appliance (3M-Unitek, Monrovia, California, USA) using block randomization in groups of 10. Outcome measures included: 1. ABO cast-radiograph evaluation (CR-EVAL), 2. peer assessment rating (PAR) scores, 3. incisor inclination, and 4. patient perception using the Index of Orthodontic Treatment Need aesthetic component (IOTN AC) and three validated questionnaires before, during and after treatment. Parametric tests [independent samples t-test and two-way analysis of variance (ANOVA)] and non-parametric tests (chi-square with Fisher's exact tests and Mann-Whitney U-test) assessed differences between groups (P < 0.05). RESULTS: Of the 187 participants randomized (1:1 ratio), 34 withdrew or were excluded (protocol deviations or poor cooperation). There were 77 patients in the 0.018-inch slot group and 76 patients in the 0.022-inch slot group (overall mean age: 19.1 years). Baseline characteristics were similar between groups (P > 0.05). The mean total ABO CR-EVAL scores were 34.7 and 34.5; mean percentage PAR score reduction 74.1 per cent and 77.1 per cent; mean change for maxillary incisor inclination 2.9 degrees and 1.6 degrees and for mandibular incisor inclination 2.7 degrees and 1.4 degrees for the 0.018-inch and 0.022-inch groups, respectively. Improvement in patient perception of aesthetics after treatment was statistically significant for both groups (P < 0.05). However, there were no statistically significant differences between the two treatment groups for ABO CR-EVAL, percentage PAR score reduction, incisor inclination, and patient perception of treatment (P > 0.05). No adverse events were observed during treatment. LIMITATIONS: It was impossible to blind clinicians or patients to allocation and oral hygiene and periodontal outcomes were not assessed. CONCLUSIONS: There were no statistically or clinically significant differences in the quality of occlusal outcomes, incisor inclination and patient perception of treatment between 0.018-inch and 0.022-inch slot bracket systems. REGISTRATION: The trial was registered with ClinicalTrials.gov on 5 March 2014, registration number: NCT02080338. PROTOCOL: The protocol was published at DOI: 10.1186/1745-6215-15-389.


Asunto(s)
Maloclusión/terapia , Soportes Ortodóncicos , Ortodoncia Correctiva/instrumentación , Calidad de la Atención de Salud , Adolescente , Adulto , Niño , Estética Dental , Femenino , Humanos , Masculino , Maloclusión/patología , Mandíbula/patología , Diseño de Aparato Ortodóncico , Ortodoncia Correctiva/métodos , Ortodoncia Correctiva/normas , Medición de Resultados Informados por el Paciente , Adulto Joven
16.
Am J Orthod Dentofacial Orthop ; 155(1): 48-56, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30591165

RESUMEN

INTRODUCTION: The purpose of this research was to compare the effects of Herbst appliance therapy using incremental vs maximum advancement in late adolescent and young adult patients with Class II skeletal malocclusion. METHODS: Forty-two patients with skeletal Class II malocclusion were treated with cast-splint Herbst appliances. The subjects were randomly allocated into 2 groups according to activation type: incremental advancement (IA) and maximum advancement (MA). Initial forward movement in the IA group was 4 to 5 mm and was followed by subsequent bimonthly advancements of 2 mm. Single-step advancement was achieved in the MA group until an edge-to-edge incisor relationship or an overcorrected Class I molar relationship was obtained. Total treatment times were 9.7 ± 1.1 months for the IA group and 9.5 ± 1.1 months for the MA group. Dental, skeletal, and soft tissue measurements were performed on lateral cephalograms taken just before and at the end of the Herbst appliance therapy. Statistical significance was set at P ≤ 0.05. RESULTS: All mandibular skeletal dimensions increased, and improvements of the sagittal maxillomandibular parameters were found in both groups. Protrusion and proclination of the mandibular incisors were greater in the IA group (95.90° ± 5.34°) compared with the MA group (92.04° ± 7.92°). Other dentoalveolar changes in both groups were intrusion of the maxillary first molars, and extrusion of the mandibular first molars and maxillary incisors. The mentolabial sulcus was flattened, soft tissue convexity was reduced, and forward movement of mandibular soft tissues was seen after Herbst therapy. CONCLUSIONS: Similar skeletal, dental, and soft tissue changes were obtained in both groups after Herbst therapy. Greater proclination and more protrusion of the mandibular incisors were found in the IA group.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Aparatos Ortodóncicos Funcionales , Ortodoncia Correctiva/métodos , Adolescente , Cefalometría , Femenino , Humanos , Masculino , Mandíbula/anatomía & histología , Avance Mandibular/métodos , Ortodoncia Correctiva/instrumentación , Resultado del Tratamiento , Adulto Joven
17.
Eur J Orthod ; 41(1): 21-28, 2019 01 23.
Artículo en Inglés | MEDLINE | ID: mdl-29617755

RESUMEN

Background: Increased awareness on the role of oral functions in the aetiology of Class II deformities has led to the wide spread of myofunctional training appliances as easy and possibly effective treatment for children with Class II malocclusion but their efficacy is yet to be proven. Objectives: To evaluate soft- and hard-tissue changes following 12 months of Class II division 1 treatment in growing patients with a conventional functional appliance (a modified Activator) versus a myofunctional Trainer system (T4K®). Setting and sample population: Department of Orthodontics, Dental School. Participants, study design, and methods: Sixty Class II division 1 children (8-12 years old) were recruited from primary schools and were distributed randomly into two equal groups. Randomization was based on a computer-generated sequence of random numbers. Data analysis included: the Activator group (28 patients, mean age = 10.6 ± 1.3 years); the T4K® group (26 patients, mean age = 10.3 ± 1.4 years). Skeletal, dentoalveolar, and soft tissues changes were assessed using standardized lateral cephalograms collected before and after 12 months of treatment. No blinding was applied in this trial. Results: Improvement in the Class II skeletal and dentofacial characteristics were significantly greater in the Activator group when compared with the T4K® group. The improvement was evident in a significant decrease in the skeletal angle ANB with Activator (x¯ = -1.89 ± 1.12) compared to T4K® (x¯ = -0.9 ± 1.01) (P = 0.01), a significant greater increase in the facial convexity angle with Activator (x¯ = 2.61 ± 3.71) more than T4K® (x¯ = 0.2 ± 2.51) (P = 0.04), and a significant reduction in the overjet (x¯ = -3.0 ± 2.3 mm) compared to (x¯ = -1.5 ± 1.9 mm; P = 0.01) with Activator versus T4k®, respectively (P = 0.001). Limitations: This study was a short-term study (12-month follow-up). Conclusions: The results of the current study indicated that the Activator was more effective than the T4K® in treating Class II division 1 growing patients. Registration: The trial was not registered in any major database of clinical trials. Protocol: The protocol was not published before the commencement of the trial but can be given upon request.


Asunto(s)
Aparatos Activadores , Maloclusión de Angle Clase II/terapia , Terapia Miofuncional/métodos , Ortodoncia Correctiva/instrumentación , Cefalometría/métodos , Niño , Cara/patología , Femenino , Humanos , Masculino , Maloclusión de Angle Clase II/patología , Ortodoncia Correctiva/métodos , Sobremordida/terapia , Resultado del Tratamiento
18.
Eur J Orthod ; 41(2): 172-179, 2019 03 29.
Artículo en Inglés | MEDLINE | ID: mdl-29924309

RESUMEN

BACKGROUND: The aetiology of temporomandibular disorders (TMD) is controversial and post-orthodontic long-term TMD data of Class II populations are scarce. OBJECTIVES: To analyse the long-term (≥15 years) effects of Herbst-multibracket appliances (MBA) Class II treatment (Tx) on signs and symptoms of TMD. SUBJECTS AND METHODS: All patients (University of Giessen, Germany) who underwent Herbst-MBA Tx (end of active Tx ≥ 15 years ago), could be located and agreed to participate in a recall. Available records from before (T0) and after (T1) active Tx were used for comparison with the recall data (T2). All findings were classified according to research diagnostic criteria for temporomandibular disorders (RDC/TMD) and diagnostic criteria for temporomandibular disorders (DC/TMD) as well as the Helkimo index. RESULTS: Seventy-two out of 152 patients participated at age 33.7 ± 3.0 years. Complete TMD data-sets (T0 + T1 + T2) were available for 33 participants. Participants and non-participants did not differ significantly at T0 or T1 in terms of general clinical data, occlusal relationship or TMD prevalence. At all time-points, 79-91 per cent of the patients were free of TMD signs and symptoms (RDC/TMD and DC/TMD). The TMD prevalence fluctuated: 21 per cent (T0), 9 per cent (T1), 15 per cent (T2). Similar findings with a trend towards improvement during T0-T1 and recurrence during T1-T2 were seen for the Helkimo index. There were no statistically significant differences. LIMITATIONS: The participation rate of only 62 per cent, the disparate availability of records (T0, T1), the fact that the patients were not treated at exactly the same time period and that no untreated control group is available. CONCLUSION: In the long-term (≥15 years) Herbst-MBA Class II Tx neither seems to increase nor decrease the risk for developing TMD.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Ortodoncia Correctiva/efectos adversos , Trastornos de la Articulación Temporomandibular/etiología , Adolescente , Adulto , Niño , Estudios Transversales , Femenino , Humanos , Estudios Longitudinales , Masculino , Maloclusión de Angle Clase II/complicaciones , Aparatos Ortodóncicos Funcionales/efectos adversos , Ortodoncia Correctiva/instrumentación , Prevalencia , Índice de Severidad de la Enfermedad , Adulto Joven
19.
Orthod Fr ; 89(4): 397-410, 2018 12.
Artículo en Francés | MEDLINE | ID: mdl-30565558

RESUMEN

INTRODUCTION: Dental intrusion has long been considered one of the most difficult movements to induce in orthodontics. Using conventional mechanics, the main difficulty lies in the need to ensure anchorage control, which is highly complicated to achieve, so as to avoid parasitic movements. In this framework, mini-screws have proven to offer a very effective means of anchorage, allowing greater control over intrusion of the anterior and posterior teeth and a simpler biomechanical movement opening up new therapeutic perspectives for the orthodontist. OBJECTIVE: The aim of this study was to describe the clinical and biomechanical application of mini-screws for dental intrusion.


Asunto(s)
Tornillos Óseos , Métodos de Anclaje en Ortodoncia/instrumentación , Diseño de Aparato Ortodóncico , Técnicas de Movimiento Dental/instrumentación , Implantes Dentales , Humanos , Maloclusión/terapia , Ortodoncia Correctiva/instrumentación , Ortodoncia Correctiva/métodos , Técnicas de Movimiento Dental/métodos
20.
Eur J Paediatr Dent ; 19(4): 282-286, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30567444

RESUMEN

CASE REPORT: This case report shows a compliance-free treatment of an anterior open bite in a 11-year-old girl. This treatment is also non invasive, therefore well accepted by the patient and her parents.


Asunto(s)
Mordida Abierta/terapia , Aparatos Ortodóncicos , Ortodoncia Correctiva/instrumentación , Cefalometría , Niño , Femenino , Humanos , Mordida Abierta/diagnóstico por imagen , Diseño de Aparato Ortodóncico , Cooperación del Paciente , Radiografía Panorámica
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