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1.
Medicine (Baltimore) ; 99(50): e23221, 2020 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-33327241

RESUMEN

BACKGROUND: Angle class II malocclusion is clinically complex and common malocclusion type, which affects beauty. Conventional treatment has the disadvantages of long course of treatment, high cost, easy recurrence and limited curative effect. Clinical practice shows that micro-implant anchorage has certain advantages in the treatment of Angle II malocclusion, but lacks the evidence of evidence-based medicine. This study systematically evaluates the efficacy and safety of micro-implant anchorage in the treatment of Angle class II malocclusion. METHODS: A systematic search was performed by retrieving on English databases (PubMed, Embase, Web of Science, and the Cochrane Library) and Chinese databases (CNKI, Wanfang, Weipu [VIP], CBM). Besides, manually search for Google and Baidu academic of micro-implant anchorage in the treatment of Angle class II malocclusion in randomized controlled clinical research. The retrieval time limit was from the establishment of the database to September 2020. Two researchers independently extracted and evaluated the quality of the data in the included study. A meta-analysis was performed using RevMan5.3 software. RESULTS: In this study, the efficacy and safety of micro-implant anchorage against Angle class II malocclusion were evaluated by SNA, BNA, ANB, NLA°, Adverse reaction. CONCLUSIONS: This study will provide reliable evidence-based evidence for the clinical application of micro-implant anchorage in the treatment of Angle class II malocclusion. ETHICS AND DISSEMINATION: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.OSF Registration number: DOI 10.17605/OSF.IO/UPBR8.


Asunto(s)
Implantes Dentales , Maloclusión de Angle Clase II/terapia , Métodos de Anclaje en Ortodoncia/métodos , Ortodoncia Correctiva/métodos , Implantes Dentales/efectos adversos , Humanos , Métodos de Anclaje en Ortodoncia/efectos adversos , Ortodoncia Correctiva/efectos adversos
2.
Cient. dent. (Ed. impr.) ; 17(2): 139-146, mayo-ago. 2020. tab
Artículo en Español | IBECS | ID: ibc-195102

RESUMEN

Hablamos de sonrisa gingival cuando se altera la armonía establecida entre los dientes, labios y encía, exponiendo más allá de 2 mm de encía coronal a los incisivos maxilares, una circunstancia que, en ocasiones, genera un problema estético para algunos pacientes. La etiopatogenia de dicha condición se resume en tres facetas: dentoperiodontal (erupción pasiva alterada y erupción activa alterada), ósea (esquelética y/o dentoalveolar) y muscular (labio superior corto e hipermovilidad labial).Una condición multifactorial como la sonrisa gingival precisa un abordaje multidisciplinar: cirugía plástica periodontal, ortodoncia, cirugía ortognática, reposición labial, infiltración de toxina botulínica y tratamiento estético complementario


The excessive gingival display when a patient smiles (from 2 mm or more) is known as gummy smile. When the harmony established between the teeth, lips and gum is altered, exhibiting short clinical crown of the maxillary anterior teeth, in occasions generates an aesthetic problem for some patients.There are different etiologies of gummy smile, it concludes in three facets: dentoperiodontal (Altered Passive Eruption and Altered Active Eruption), bone defect (excessive vertical bone growth, dentoalveolar extrution) and muscular (short upper lip and upper lip hyperactivity), and the combination of some of these factors.A multifactorial condition requires a multidisciplinary boarding: plastic periodontal surgery, orthodontic, orthognathic surgery, lip reduction, infiltration of Botulinum toxin and complementary aesthetic treatment


Asunto(s)
Humanos , Técnicas Cosméticas , Sonrisa/fisiología , Músculos Faciales/anatomía & histología , Músculos Faciales/fisiología , Dimensión Vertical , Sobrecrecimiento Gingival/cirugía , Ortodoncia/métodos , Ortodoncia Correctiva/métodos , Periodoncia , Cirugía Ortognática
3.
Niger J Clin Pract ; 23(8): 1110-1119, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32788489

RESUMEN

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


Asunto(s)
Diente Premolar/cirugía , Incisivo , Labio , Maloclusión/terapia , Adolescente , Adulto , Cefalometría/estadística & datos numéricos , Estética , Femenino , Humanos , Incisivo/patología , Labio/anatomía & histología , Labio/patología , Masculino , Ortodoncia Correctiva/métodos , Radiografía , Estudios Retrospectivos , Extracción Dental , Resultado del Tratamiento , Adulto Joven
4.
Niger J Clin Pract ; 23(5): 589-595, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32367863

RESUMEN

Background: The prevalence of white spot lesions/tooth demineralization during orthodontic fixed appliance therapy ranges widely from 2 to 96% of patients. The purpose of this study was to evaluate measures used by orthodontists practicing in Nigeria to manage demineralization during and after fixed orthodontic treatment and how it compares with the available evidence-based information. Method: Study group comprised of 60 practitioners (21 orthodontists and 39 orthodontic residents) in Nigeria. Self-administered questionnaires were used to obtain information on the measures they use to prevent the occurrence of demineralization at the onset and during orthodontic treatment, as well as the management of its occurrence at treatment completion. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 17.0. Descriptive statistics were used. Level of significance was set at P < 0.05. Results: Responses obtained showed that 96.7% of orthodontic practitioners routinely advised their patients on tooth cleaning methods; the use of manual orthodontic toothbrush (78.3%) and dental floss (51.7%) being popularly recommended methods. However, 51.7% used a specific demineralization preventive protocol at the start of treatment. Oral hygiene instruction was observed to be the most commonly adopted protocol (51.7%), followed by fluoride rinses (41.7%) (considered relatively ineffective). Extraoral hygiene instruction was the most common treatment protocol used when tooth demineralization occurred during and after treatment (56.7% and 73.3% respectively). Approximately 92% of the orthodontists agreed on the need for the development of a basic protocol to prevent demineralization. Conclusion: The demineralization preventive measures used by Nigerian orthodontists and orthodontic residents are inconsistent and not based on evidence-based information. The development of standardized demineralization prevention protocol was therefore recommended.


Asunto(s)
Caries Dental/prevención & control , Higiene Bucal/métodos , Aparatos Ortodóncicos/efectos adversos , Ortodoncia Correctiva/métodos , Ortodoncistas , Pautas de la Práctica en Odontología , Desmineralización Dental/prevención & control , Adulto , Cariostáticos/uso terapéutico , Odontología Basada en la Evidencia/métodos , Femenino , Fluoruros/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Nigeria , Soportes Ortodóncicos/efectos adversos , Encuestas y Cuestionarios , Cepillado Dental
5.
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
6.
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
7.
J Pediatr Hematol Oncol ; 42(3): 198-203, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-31851070

RESUMEN

Rapid blood cell turnover and bone marrow expansion caused by beta-thalassemia (ßT) result in craniofacial and dentoalveolar anomalies. This report presents a systematic review of the literature over the past 50 years on orthodontic and surgical considerations in the management of ßT-affected patients. Seventeen publications encompassed 24 patients, 11 male individuals and 13 female individuals, 7 to 43 years of age. Eleven patients underwent only surgical treatment, eleven combined orthodontic-surgical treatment, and 2 orthodontic treatment. Surgical treatment primarily addressed typical maxillary overgrowth by maxillary reshaping, premaxillary segmental repositioning, or complete Le Fort I impaction and set back osteotomy. In severe maxilla-mandibular discrepancy and/or increased lower facial height, a bilateral sagittal split mandibular osteotomy is the treatment of choice. Although surgery involves risks of excessive bleeding, morbidity, and impaired nasal esthetics, little attention is given to the orthodontic modality. In conclusion, the current literature recommends early interceptive orthodontics aimed to decrease dentoskeletal deformities, severe malocclusion, and soft tissue imbalance. Treatment includes maxillo-mandibular orthopedic and functional manipulation with dentoalveolar treatment, which might either prevent orthosurgical procedures later or reduce its extent. This suggested a multidisciplinary approach comprising a hematologist, a pediatrician, a pediatric dentist, and an orthodontist, which might also significantly improve the patient's quality of life.


Asunto(s)
Anomalías Craneofaciales/etiología , Anomalías Craneofaciales/terapia , Ortodoncia Correctiva/métodos , Procedimientos Ortopédicos/métodos , Talasemia beta/complicaciones , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Maloclusión/etiología , Maloclusión/terapia , Adulto Joven
8.
Acta Odontol Scand ; 78(4): 297-302, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31833442

RESUMEN

Objective: To evaluate the influence of mandibular third molars on relapse of mandibular anterior crowding in orthodontically treated patients.Material and Methods: Sample included orthodontic records of 108 patients: Group 1: 72 patients (39 female; 33 male) with third molars present in the postretention evaluation stage. Group 2: 36 patients (18 female; 18 male) who did not present the third molars in the postretention evaluation stage. Panoramic radiographs and dental models were evaluated at three different stages: pre-treatment; posttreatment and postretention. Panoramic radiographs showed the presence or absence of third molars in the 3 evaluated stages and on the dental models, overbite and mandibular anterior crowding was measured by the Little Irregularity Index. For intergroup comparisons, t-tests and a multifactorial regression analysis were used.Results: There was no statistically significant difference in the relapse of mandibular anterior crowding among the groups with and without mandibular third molars at the postretention stage.Conclusion: The presence or absence of mandibular third molars did not influence the relapse of mandibular anterior crowding in orthodontically treated patients.


Asunto(s)
Maloclusión/terapia , Mandíbula/patología , Tercer Molar , Ortodoncia Correctiva/métodos , Cefalometría , Femenino , Humanos , Masculino , Recurrencia
9.
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
10.
Rev. esp. cir. oral maxilofac ; 41(4): 178-182, oct.-dic. 2019. ilus, tab
Artículo en Español | IBECS | ID: ibc-191803

RESUMEN

OBJETIVOS: Comparar la variación de la dimensión del espacio orofaríngeo (EO) en el prequirúrgico, postquirúrgico inmediato y postquirúrgico de 5 a 24 meses después de la cirugía de retroceso mandibular (CRM). MATERIALES Y MÉTODOS: Se evaluaron las radiografías cefalométricas prequirúrgicas, postquirúrgicas inmediatas y postquirúrgicas de 5 a 24 meses de 20 pacientes con CRM del Servicio de Cirugía Oral y Maxilofacial de dos instituciones. Se cuantificó la dimensión del EO en diferentes momentos. RESULTADOS: No se encontraron diferencias de significación entre la cantidad de retroceso mandibular y la variación de la dimensión del EO. CONCLUSIONES: Existe una leve disminución de la dimensión del EO después de la CRM. No son estadísticamente significantes entre los momentos de evaluación. No se encontró correlación entre el retroceso mandibular y la disminución del EO


OBJECTIVE: The aim of this study was to compare the variation in the size of the oropharyngeal space (OS) in the preoperative, immediate postoperative and post-operative 5 to 24 months according to the amount of mandibular setback. MATERIAL AND METHOD: Variation were evaluated on cephalometric radiographs taken few days before the surgery (Rx1), immediate postoperative (Rx2) and postoperative long time (5 to 24 months) (Rx3). The subjects were 20 patients (18 - 36 years) in whom dentofacial deformity class III was corrected by bilateral sagittal split ramus osteotomy setback. Surgery was done in two Oral and Maxillofacial specialized institutions, since 2003 to 2010. We examined the size of the oropharyngeal space at different times before and after mandibular setback surgery. RESULTS: These shows no significant difference between the amount of mandibular setback and decrease the size of the oropharyngeal space. It was determined that the oropharyngeal space immediately after surgery increases and decreases over time as a result of soft and hard tissue adaptation. CONCLUSIONS: We conclude that there is a slight decreased in the anteroposterior dimension of oropharynx after mandibular setback surgery, however the variations is no statistically significant difference between the moments of evaluation (the amount of mandibular recoil and the decrease in OS)


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Osteotomía Mandibular/métodos , Boca/anatomía & histología , Reconstrucción Mandibular/métodos , Maloclusión de Angle Clase III/cirugía , Estudios Retrospectivos , Complicaciones Posoperatorias , Síndromes de la Apnea del Sueño/epidemiología , Resultado del Tratamiento , Ortodoncia Correctiva/métodos , Osteotomía Mandibular/estadística & datos numéricos , Anomalías de la Boca/cirugía , Reconstrucción Mandibular/efectos adversos , Cefalometría/métodos
11.
Georgian Med News ; (294): 62-68, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31687951

RESUMEN

Recently, there has been a tendency for the growth of dentognathic deformities of various origins, accompanied by phonetic abnormalities. Aim - to increase the effectiveness of orthodontic treatment of dentognathic deformities, accompanied by phonetic disorders, by developing and justifying a set of diagnostic and therapeutic measures based on a multidisciplinary approach. The influence of the state of ENT organs on the formation of dentognathic deformities and phonetic disturbances is studied in 155 children. A clinical dental examination and orthodontic treatment is performed in 82 patients aged 6-12 years. Individual corrective speech therapy work has been carried out to overcome the defects of the phonological side of speech. A certain pathological "chain" of cause-effect relationships of dentognathic deformities with phonetic disorders and diseases of the ENT organs became the basis for a multidisciplinary approach to solving the problems identified. The qualitative and quantitative dependence of sound deterioration on the type of orthognathic deformities is established. A complex of diagnostic and therapeutic measures for patients with dental deformities accompanied by phonetic disorders, consisting of motivational, diagnostic and therapeutic blocks, has been developed and introduced into practice. The proposed complex of diagnostic and treatment measures made it possible to increase the efficiency of orthodontic treatment of children with dentognathic deformities with disturbances of sound pronunciation depending on the type of bite by means of a multidisciplinary approach involving an otolaryngologist, speech therapist, children's therapist and surgeon, which was confirmed in 86.6% of patients by the improvement of electromyography, anthropometric measurements of scanned models of jaws, cephalometry; the analysis of cone-beam computed tomography data showed a significant increase in the upper respiratory tract volume by 53.8±4.2%.


Asunto(s)
Anomalías Maxilofaciales/diagnóstico , Anomalías Maxilofaciales/cirugía , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Fonética , Prognatismo/cirugía , Trastornos del Habla/cirugía , Cefalometría , Niño , Humanos , Imagenología Tridimensional , Prognatismo/diagnóstico por imagen , Reproducibilidad de los Resultados , Trastornos del Habla/diagnóstico , Resultado del Tratamiento
12.
Am J Orthod Dentofacial Orthop ; 156(4): 531-544, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582125

RESUMEN

Progressive condylar resorption, also known as idiopathic condylar resorption, is an uncommon, aggressive, degenerative disease of the temporomandibular joint (TMJ) seen mostly in adolescent girls and young women. This condition leads to loss of condylar bone mass, decrease of mandibular ramal height, steep mandibular and occlusal plane angles, and an anterior open bite. In 3 case reports, we review the pathogenesis of TMJ degenerative disease and the clinical management of TMJ arthrosis. We emphasize that TMJ arthritic disease should be discussed in dental circles as a pathologic entity in the same way that orthodontists discuss arthritic disease in orthopedic circles. Regarding the degenerative pathology of the TMJ, treatment goals include restored function and pain reduction. The treatment methods used to achieve these goals can range from noninvasive therapy to minimally invasive and invasive surgery. Most patients can be treated noninvasively, and the importance of disease prevention and conservative management in the overall treatment of TMJ disease must be acknowledged. The decision to manage TMJ osteoarthrosis surgically must be based on evaluation of the patient's response to noninvasive treatments, mandibular form and function, and effect of the condition on his or her quality of life.


Asunto(s)
Resorción Ósea/diagnóstico por imagen , Resorción Ósea/cirugía , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteoartritis/diagnóstico por imagen , Osteoartritis/cirugía , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/terapia , Adulto , Resorción Ósea/patología , Niño , Terapia Combinada , Progresión de la Enfermedad , Femenino , Humanos , Cóndilo Mandibular/patología , Cóndilo Mandibular/cirugía , Osteoartritis/patología , Calidad de Vida , Trastornos de la Articulación Temporomandibular/patología , Resultado del Tratamiento
13.
Am J Orthod Dentofacial Orthop ; 156(4): 555-565, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582127

RESUMEN

A common dilemma when treating anterior open bite is understanding its etiology. Idiopathic condylar resorption (ICR) can cause open bite in affected individuals. Although it is prudent to not treat patients with ICR until active resorption has ceased, orthodontists may begin treating them because anterior open bite from ICR may not appear before or during their orthodontic treatment. This article reports a 12-year-old female who was diagnosed with ICR 10 months after completion of her orthodontic treatment for a Class II Division 1 malocclusion. When a young patient with a high mandibular angle and previous skeletal or dental Class II malocclusion returns with an open bite during the retention phase, the patient's condyles must be carefully examined to determine whether any temporomandibular joint disorder, such as ICR, is present. Currently, the controversy over the cause and the cure for ICR is continuing to challenge orthodontists in diagnoses and treatments. Orthodontists should closely monitor and offer informed treatment options to patients with risk factors for ICR or signs of its pathology that might develop at any stage of orthodontic treatment, including the retention period.


Asunto(s)
Resorción Ósea/complicaciones , Resorción Ósea/terapia , Maloclusión de Angle Clase II/terapia , Cóndilo Mandibular/patología , Enfermedades Mandibulares/patología , Enfermedades Mandibulares/terapia , Mordida Abierta/etiología , Mordida Abierta/terapia , Ortodoncia Correctiva/métodos , Trastornos de la Articulación Temporomandibular/terapia , Resorción Ósea/diagnóstico por imagen , Cefalometría , Niño , Terapia Combinada , Estética Dental , Femenino , Humanos , Maloclusión de Angle Clase II/diagnóstico por imagen , Enfermedades Mandibulares/diagnóstico por imagen , Mordida Abierta/diagnóstico por imagen , Trastornos de la Articulación Temporomandibular/diagnóstico por imagen , Resultado del Tratamiento
14.
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
15.
Am J Orthod Dentofacial Orthop ; 156(3): 375-382, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474267

RESUMEN

INTRODUCTION: The aim of this work was to compare the skeletal and dental outcomes of 1- versus 2-phase treatment in Class II subjects with difficult-to-treat high-angle severe Class II malocclusions. METHODS: The sample of 120 cases was collected from the private offices of 3 experienced clinicians. The following selection criteria were used: (1) ANB ≥6°, (2) SN-GoGn ≥37° or mandibular plane to Frankfort horizontal plane ≥30°; and (3) overjet ≥6 mm. Patients were classified into either the early or the late treatment group according to dental age (early Tx: ≥5 primary teeth; late Tx: otherwise). Thirty-four angular, linear, and proportional measurements were determined for each patient. Statistical significance was assessed with the use of a 2-tailed t test, analysis of covariance test, and chi-square test. RESULTS: The results showed that early 2-phase treatment for severe Class II high-angle patients offered no skeletal anteroposterior advantages over late 1-phase treatment. Severe high-angle Class II patients also showed similar dental anteroposterior outcomes with the use of both approaches. Vertically there was a higher frequency of increased mandibular plane angles and extrusion of upper incisors and lower molars in the late treatment group. CONCLUSIONS: Early 2-phase treatment for severe Class II high-angle patients offered no skeletal or dental advantage over late 1-phase treatment.


Asunto(s)
Maloclusión de Angle Clase II/terapia , Ortodoncia Correctiva/métodos , Adolescente , Cefalometría/métodos , Niño , Femenino , Humanos , Incisivo , Masculino , Mandíbula , Maxilar , Diente Molar , Sobremordida/terapia , Factores de Tiempo , Resultado del Tratamiento
16.
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
17.
Saudi Med J ; 40(9): 954-957, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31522225

RESUMEN

OBJECTIVES: To investigated the diagnostic performance of circumpubertal eruption stages which identify skeletal maturity stages using the cervical vertebral maturation (CVM) method in a Saudi population. METHODS: This is a retrospective cross-sectional study. Lateral cephalograms, panoramic radiographs, and intraoral pictures of 600 orthodontic patients (284 boys, 316 girls) who met inclusion criteria were assessed. Records were retrieved between January 2016 and April 2018. The diagnostic performance of eruption stages for identifying skeletal maturity was tested with positive likelihood ratios (LHR+). RESULTS: Prevalence of each CVM stage in the eruption stages was reported. For every eruption stage, LHR+ was reported in order to identify every CVM stage. The majority of the LHR+ values were ≤3.5, with a significant value of ≥10 for the identification of the post-pubertal growth stage. The other eruptions stages did not strongly predict skeletal maturity. CONCLUSION: In treatment planning for cases that require identifying the growth peak, the use of eruption stages is not recommended as an indicator of skeletal maturity except for the early permanent dentition stage where strong diagnostic performance for identifying post-pubertal skeletal growth stage has been shown.


Asunto(s)
Determinación de la Edad por el Esqueleto/métodos , Desarrollo Óseo/fisiología , Vértebras Cervicales/diagnóstico por imagen , Dentición Permanente , Erupción Dental/fisiología , Adolescente , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Ortodoncia Correctiva/métodos , Radiografía Panorámica , Estudios Retrospectivos
18.
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
19.
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
20.
Am J Orthod Dentofacial Orthop ; 156(1): 137-147, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256827

RESUMEN

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


Asunto(s)
Maloclusión de Angle Clase II/terapia , Ortodoncia Correctiva/métodos , Sobremordida/terapia , Piezocirugía/efectos adversos , Adolescente , Diente Premolar/cirugía , Tornillos Óseos , Cefalometría , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Incisivo/diagnóstico por imagen , Incisivo/patología , Incisivo/cirugía , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/cirugía , Mandíbula , Maxilar/diagnóstico por imagen , Maxilar/patología , Maxilar/cirugía , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos , Soportes Ortodóncicos , Alambres para Ortodoncia , Sobremordida/diagnóstico por imagen , Sobremordida/cirugía , Radiografía Panorámica , Resorción Radicular/etiología , Técnicas de Movimiento Dental/métodos , Resultado del Tratamiento , Dimensión Vertical
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