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1.
Oral Health Prev Dent ; 18(3): 633-641, 2020 Jun 08.
Artículo en Inglés | MEDLINE | ID: mdl-32700517

RESUMEN

PURPOSE: This retrospective cohort study investigated the long-term effectiveness of one type of maxillary and 2 types of mandibular fixed lingual retainers. MATERIALS AND METHODS: Eighty orthodontic patients in retention for 10-15 years were included. Irregularity index, intercanine width, overjet (OJ) and overbite (OB) were measured on plaster models at 3 occasions: (T1) pre-treatment, (T2) post-treatment and (T3) 10-15 years post-treatment. Analyses assessed the effect of the retainer type and time on mandibular irregularity, intercanine width and retainer failure. RESULTS: In the mandible, the irregularity index increased (0.43 mm) between T2 and T3 for the 0.027" ß-titanium (TMA) retainers bonded to canines only while it was stable (-0.02 mm) for the 0.016" x 0.022" braided stainless steel retainers (SS6) bonded to all six anterior teeth. The intercanine width was relatively stable in both groups during the entire observation period. In the maxilla, the irregularity index was stable between T2 and T3 (+0.07 mm). The intercanine width increased (+2.02 mm) during treatment T1-T2 and was stable (-0.02 mm) in the retention phase T2 to T3. CONCLUSIONS: In the mandible, SS6 retainers were slightly more effective in maintaining alignment compared to the TMA retainers. In the maxilla, the SS4 retainers without canine extensions were effective in maintaining alignment. All retainers were effective in maintaining the intercanine width.


Asunto(s)
Maloclusión de Angle Clase II , Maxilar , Humanos , Mandíbula , Retenedores Ortodóncicos , Estudios Retrospectivos
2.
Prog Orthod ; 21(1): 22, 2020 Jun 29.
Artículo en Inglés | MEDLINE | ID: mdl-32596755

RESUMEN

BACKGROUND: Long-term retention with fixed retainers with a high success rate seems to be a reasonable solution to minimize or prohibit relapse of orthodontic treatment. METHODS: Two hundred sixty patients between 13 and 30 years old were recruited for this study. The 0.0175 stainless steel twisted wire (G&H Orthodontics, USA) was compared with a single-strand ribbon titanium lingual retainer wire (Retainium, Reliance orthodontics, USA) was used. When treatment was completed, the retainers were bonded from canine to canine in the mandibular arch of the participants. In the follow-up visits, the patients were recalled every 3 months during the 24 months. Detachments, the time of debonding, and side effects were recorded. Statistical analysis was performed by a blinded statistician using a statistical package for Social Science (SPSS, Version20). After descriptive statistics, Kaplan-Meier analysis was performed to measure the survival rates of each retainer. P value < 0.05 was considered as significant. RESULTS: Finally, 138 patients who received twisted wire splint and 112 patients who received ribbon wire were included in the analysis. The average duration of success was about 23 months for twisted wire and ribbon wire, according to the Kaplan-Meier estimates. The analysis showed no significant overall difference between the treatments (p = 0.13). Failure rates in terms of detachments in all groups occurred at the enamel junction, and it was 25 in twisted retainer group (18.1%) and was 10 in ribbon retainer group (8.9%); the Kaplan-Meier analysis test detected a significant difference in the failure rates between the groups (p = 0/006). CONCLUSIONS: Although the conventional twisted stainless steel wire and single-strand titanium flat metal ribbon wire as fixed orthodontic retainers have the same clinical effects, it was shown that the ribbon wire has less failure in terms of detachments.


Asunto(s)
Recubrimiento Dental Adhesivo , Alambres para Ortodoncia , Adolescente , Adulto , Humanos , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos Fijos , Retenedores Ortodóncicos , Acero Inoxidable , Adulto Joven
3.
J Oral Rehabil ; 47(6): 766-774, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32242981

RESUMEN

To evaluate the changes in occlusal surface area (OSA) and occlusal force distribution (OFD) following the wear of Vacuum-formed (VFR), Hawley (HR) and Bonded (BR) retainers, using T-Scan III. A total of 60 subjects using three different maxillary and mandibular orthodontic retainers, VFR (n:20), HR (n:20) and BR (n:20), were included in this study. The changes in OSA and OFD were evaluated using the T-Scan III. The evaluations were made 2 hours after debonding orthodontic appliances (T0) and in the 3rd (T1) and 6th (T2) months of the retention phase. For left (LDA), right (RDA) and posterior dental arches (PDA), intragroup comparison of OSA showed significant increase in the VFR and HR groups at T1-T2 and T0-T2 time intervals and in the BR group at T0-T1 and T0-T2 time intervals. For the anterior dental arch (ADA), only the increase in the HR group at T0-T1 and T0-T2 time intervals was found significant. When compared between the groups, the changes between HR and BR groups detected at T1-T2 time interval for the RDA and at T0-T1 and T0-T2 time intervals for the ADA were found significant. Intragroup comparison of OFD displayed significant changes only in the BR group. At T0-T1 time interval, the decrease in the ADA and the increase in the PDA were found significant. Also, intergroup OFD comparison exhibited significant differences between HR and BR groups at T0-T1 time interval for ADA and PDA. Although no significant differences were found between the VFR group, the increase in OSA occurred faster in the PDA in the BR group, whereas in the ADA it was significant only in the HR group.


Asunto(s)
Fuerza de la Mordida , Diseño de Aparato Ortodóncico , Humanos , Aparatos Ortodóncicos Fijos , Retenedores Ortodóncicos , Vacio
4.
Am J Orthod Dentofacial Orthop ; 157(2): 156-164.e17, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32005466

RESUMEN

INTRODUCTION: The objective of this systematic review was to assess the available evidence in the literature for the effects of fixed orthodontic retainers on periodontal health. METHODS: The following databases were searched up to August 31, 2019: Medline, EMBASE, the Cochrane Oral Health Group's Trials Register, CENTRAL, ClinicalTrials.gov, the National Research Register, and Pro-Quest Dissertation Abstracts and Thesis database. Randomized controlled trials (RCTs), controlled clinical trials, cohort studies of prospective and retrospective design, and cross-sectional studies reporting on periodontal measurements of patients who received fixed retention after orthodontic treatment were eligible for inclusion. The quality of the included RCTs was assessed per the revised Cochrane risk of bias tool for randomized trials (RoB 2.0), whereas the risk of bias of the included cohort studies was assessed using the Risk Of Bias In Nonrandomized Studies of Interventions tool. A modified version of the Newcastle-Ottawa scale was used for cross-sectional studies. RESULTS: Eleven RCTs, 4 prospective cohort studies, 1 retrospective cohort study, and 13 cross-sectional studies fulfilled the inclusion criteria. The quality of evidence was low for most of the included studies. In contrast to the general consensus, 2 RCTs, 1 prospective cohort study, and 2 cross-sectional studies reported poorer periodontal conditions in the presence of a fixed retainer. The results of the included studies comparing different types of fixed retainers were heterogeneous. CONCLUSIONS: According to the currently available literature, orthodontic fixed retainers seem to be a retention strategy rather compatible with periodontal health, or at least not related to severe detrimental effects on the periodontium.


Asunto(s)
Retenedores Ortodóncicos , Enfermedades Periodontales , Estudios Transversales , Humanos , Estudios Prospectivos , Estudios Retrospectivos
5.
J Orthod ; 47(1): 47-54, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-32009494

RESUMEN

OBJECTIVE: To compare young people's experiences of wearing a range of orthodontic appliances. DESIGN: A cross-sectional, qualitative study with purposive sampling. SETTING: UK dental teaching hospital. PARTICIPANTS: Twenty-six orthodontic patients aged 11-17 years. METHODS: Patients participated in in-depth semi-structured interviews. All interviews were transcribed verbatim and analysed thematically. RESULTS: Young people reported physical, practical and emotional impacts from their appliances. Despite these reported impacts, participants described 'getting used' to and, therefore, not being bothered by their appliance. Framework analysis of the data identified a multi-dimensional social process of managing everyday life with an appliance. This involves addressing the 'dys-appearance' of the body through physically adapting to an appliance. This process also includes psychological approaches, drawing on social networks, developing strategies and situating experiences in a longer-term context. Engaging in this process allowed young people to address the physical, practical and emotional impacts of their appliances. CONCLUSION: This qualitative research has identified how young people manage everyday life with an appliance. Understanding this process will help orthodontists to support their patients.


Asunto(s)
Aparatos Ortodóncicos Funcionales , Aparatos Ortodóncicos Removibles , Adolescente , Niño , Estudios Transversales , Emociones , Humanos , Aparatos Ortodóncicos , Aparatos Ortodóncicos Fijos , Retenedores Ortodóncicos , Investigación Cualitativa
6.
Am J Orthod Dentofacial Orthop ; 157(1): 128-131, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-31901270

RESUMEN

Preservation of the maxillary lateral incisor space after orthodontic treatment in an adolescent patient traditionally requires the use of a retainer with a lateral pontic, commonly referred to as a "flipper," which is minimally effective in the long term. This article illustrates a technique for chairside fabrication of a Maryland bridge retainer for semi-permanent retention. A stainless steel braided palatal wire is bonded to the anterior teeth. A pontic is then built intraorally with flowable composite, using the palatal wire as scaffolding. The retainer is maintained until the patient is of age for a more permanent restoration.


Asunto(s)
Dentadura Parcial Fija con Resina Consolidada , Adolescente , Humanos , Diseño de Aparato Ortodóncico , Retenedores Ortodóncicos , Alambres para Ortodoncia
7.
Eur J Orthod ; 42(1): 86-92, 2020 Jan 27.
Artículo en Inglés | MEDLINE | ID: mdl-31323673

RESUMEN

OBJECTIVE: This cross-sectional study aimed to explore the level of knowledge and expectations people deciding on a future orthodontic treatment have about post-orthodontic retention and to investigate the influence of sociocultural characteristics. MATERIAL AND METHODS: A total of 227 consecutive people involved as legal decision maker (as patient, parent, or legal guardian) for a prospective orthodontic treatment (mean age 37.1 years; 37.3 per cent male) received before their first appointment a questionnaire to assess their knowledge and expectations about post-orthodontic retention. Data were analysed descriptively, whereas predictors were identified with logistic regressions at P value of less than or equal to 0.05. RESULTS: Among the 220 responders, 46.3 per cent (n = 99) knew that retention appliances are used after orthodontic treatment and 52.8 per cent (n = 113) believed perfect results can guarantee stability, whereas at the same time, 77.8 per cent (n = 168) knew that teeth can move on their own without any orthodontic appliances. The majority considered stability of the orthodontic result important or extremely important (94.5 per cent; n = 206), preferred bonded over removable retainers (67.2 per cent; n = 133), believed the orthodontist to be primarily responsible for a stable result (73.2 per cent; n = 158), and found it appropriate to charge for recall visits (72.9 per cent; n = 153). Participants' gender, age, education, nationality, and past orthodontic experiences within the close family significantly influenced answers. LIMITATIONS: The setting of a single-centred survey conducted in one university moderates the generalizability of the portrayed results. CONCLUSIONS: Although stability of orthodontic treatment results is very important to people deciding about a prospective orthodontic treatment, knowledge regarding the need for post-orthodontic retention varies and may at times be contradictious. Sociocultural factors seem to influence the level of knowledge and the expectations on post-orthodontic retention.


Asunto(s)
Toma de Decisiones , Retenedores Ortodóncicos , Ortodoncistas , Educación del Paciente como Asunto , Adulto , Estudios Transversales , Femenino , Humanos , Consentimiento Informado , Masculino , Estudios Prospectivos , Encuestas y Cuestionarios
8.
J Orthod ; 47(1): 72-77, 2020 03.
Artículo en Inglés | MEDLINE | ID: mdl-31697179

RESUMEN

INTRODUCTION: Retention is a crucial part of orthodontic treatment; however, patients often do not wear their retainers as advised. The British Orthodontic Society developed the 'Hold that Smile' campaign in 2017, to improve patient knowledge about retention. Information is provided in two formats: a cartoon and a conventional film. OBJECTIVE: To assess whether patients find the 'Hold that Smile' videos useful and whether they improved patients' intended retainer wear. The gold standard was that 90% of patients should intend to wear their retainers in the long term after watching the videos. DESIGN: National multicentre audit. SETTING: Nine units in the UK. METHODS: Patients aged ⩾ 10 years, in fixed appliances or retention, watched the retainer videos and then completed a questionnaire that was designed specifically for this audit. Each unit collected data for approximately 30 patients. RESULTS: Data were collected for 278 patients in total. The average age was 17.9 years; 64.4% of patients were female and 35.6% were male. Most patients (86.3%) watched both videos and, of these, 44.1% preferred the film, 31.3% preferred the cartoon and 24.6% had no preference. The majority of patients (81.3%) felt that the film provided them with new information, compared with a lower percentage (48.5%) for the cartoon. More patients said they would recommend the film (76.3%) compared with the cartoon (63.3%). Before watching the videos, 77.0% of patients felt they knew about long-term retainer wear and 74.3% of those intended to wear their retainers in the long term. After watching the videos, 96.4% of all patients thought they would now wear their retainers long term. CONCLUSION: After watching the videos, there was a notable increase in the number of patients planning to wear their retainers long term and the gold standard was met. Therefore, these videos may be beneficial in improving understanding and compliance with retention.


Asunto(s)
Retenedores Ortodóncicos , Sociedades Odontológicas , Adolescente , Preescolar , Femenino , Humanos , Masculino , Diseño de Aparato Ortodóncico , Cooperación del Paciente , Sonrisa , Encuestas y Cuestionarios
9.
Eur J Orthod ; 42(1): 52-59, 2020 Jan 27.
Artículo en Inglés | MEDLINE | ID: mdl-31329861

RESUMEN

AIMS: To identify if lower incisor movements after orthodontic treatment are due to the relapse of the orthodontic treatment or due to natural growth. SUBJECTS AND METHODS: The subjects consisted of 92 patients who have had orthodontic treatment, divided into three groups, group 1: 38 individuals had no retainer in the lower jaw. Group 2: 24 individuals had a retainer 0.028 inch, a spring hard wire bonded to the mandibular canines only. Group 3: 30 individuals had a 0.0195-inch Twist-Flex wire, bonded to all mandibular incisors and canines. Study models before orthodontic treatment (T0), immediately after orthodontic treatment (T1), 6 years after orthodontic treatment (T2), and 12 years after orthodontic treatment (T3) were used for the measurements. The wires in groups 2 and 3 were removed after mean 2.6 years (SD 1.49). Little Irregularity Index (LII), inter-canine distance, available mandibular anterior space, and number of crowded incisors were registered. A Tooth Displacement Index (TDI) was developed to measure the tooth displacement directions at T0 and T3. RESULTS: The LII showed equal values before treatment (T0) and at the follow-up registrations (T2 and T3). But about 25 per cent of the tooth displacements at T2 and T3 did not exist before treatment, at T0. This indicates usual growth changes and not relapse of the orthodontic treatment. CONCLUSION: As about 25 per cent of the displaced incisors can be considered as an effect of natural growth, not a relapse of the orthodontic treatment, it is valuable to use a displacement index in combination with other variables for investigations of stability after orthodontic treatment. Importance of the present study is that it is possible to differ between relapse and usual growth changes.


Asunto(s)
Arco Dental , Retenedores Ortodóncicos , Técnicas de Movimiento Dental , Estudios de Seguimiento , Humanos , Incisivo , Maloclusión , Recurrencia , Resultado del Tratamiento
10.
Am J Orthod Dentofacial Orthop ; 156(6): 717-726.e2, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31784005

RESUMEN

INTRODUCTION: The aim of this 2-arm parallel trial was to assess patient compliance objectively with Hawley or vacuum-formed retainers in the maxillary arch in a 3-month period after active orthodontic treatment through the use of the thermosensitive microsensor TheraMon. METHODS: Patients who had just completed orthodontic treatment in the Postgraduate Orthodontic Clinic, School of Dentistry, National and Kapodistrian University of Athens and in a private orthodontic practice were randomly allocated to either the Hawley or vacuum-formed group for retention. Eligibility criteria included patients aged 12-18 years who had undergone orthodontic treatment in both arches for ≤ 5 years. The main outcome was the average objective daily difference in compliance measured with TheraMon between patients receiving either Hawley or vacuum-formed retainers in the maxillary arch for 3 months. Secondary outcomes pertained to the average objective difference in compliance between the 2 retainers for the first month in retention and the association between objective measurements of compliance and diary-reported duration of wear for both the first and 3- month periods. Randomization was implemented with a computer-generated randomization list; allocation was concealed in sequentially numbered, sealed, opaque envelopes. Blinding to the study protocol was not feasible either for the patient or orthodontist. Patients were instructed to wear the retainer full-time. Data were analyzed using nonparametric statistics and linear regression with standard errors based on the bootstrap method. RESULTS: Seventy-seven patients (median age 14.8 years; interquartile range 1.5; range 12.1-17.6) were randomized in a 1:1 ratio to either a Hawley or vacuum-formed retainer. Baseline characteristics did not present significant differences between groups. One patient from the Hawley group was excluded from 3 months' follow-up owing to a microsensor fault. Objectively assessed median daily wear time for the Hawley group was 15.3 hours (interquartile range 6.8), whereas for the vacuum-formed group it was 18.3 hours (interquartile range 4.6) for the 3-month interval. Patients allocated to vacuum-formed retainers had higher wearing values of 2.10 h/d compared with the Hawley group, after adjusting for trial settings (mean difference 2.10; 95% confidence interval 0.32-3.89; P = 0.02). Patients from private orthodontic practice had an increased potential for compliance of 2.16 h/d compared with university settings after adjusting for type of appliance (mean difference 2.16; 95% confidence interval 0.34-3.97; P = 0.02). A significant correlation was detected between objective assessment and self-reported compliance for both retention protocols in the first and 3-month intervals. No harm was observed during follow-up. CONCLUSIONS: This study found relatively high compliance in the short-term retention phase for both appliances. Vacuum-formed retainers were better accepted by adolescent patients, whereas those proceeding to private orthodontic practice were more compliant. There was a positive and statistically significant correlation between objective and subjective measures of compliance. REGISTRATION: This trial was registered in ClinicalTrials.gov: NCT03683862. FUNDING: No funding or conflict of interest to be declared. PROTOCOL: The protocol was not published before trial commencement.


Asunto(s)
Diseño de Aparato Ortodóncico , Retenedores Ortodóncicos , Cooperación del Paciente , Adolescente , Niño , Humanos , Maxilar , Vacio
11.
BMC Oral Health ; 19(1): 250, 2019 11 20.
Artículo en Inglés | MEDLINE | ID: mdl-31747943

RESUMEN

BACKGROUND: Oral lichenoid reaction (OLR) is a type IV cell-mediated immune response in the oral cavity. There is an established relationship between various dental materials and OLR, but few cases reports reported the occurrence of a lichenoid reaction in association with the use of a Hawley retainer. CASE PRESENTATION: A female patient (twenty years of age) has been complaining of a reddish painful area on the tongue, which started one year ago and has been increasing in size over time. The patient completed orthodontic treatment two years ago and has been using a Hawley retainer for orthodontic retention since then. After performing histological analysis and patch test, the lesion was diagnosed as a lichenoid reaction to the Hawley retainer. Topical corticosteroids were prescribed, and the patient was asked to stop using the retainer and followed for six months. CONCLUSIONS: It is difficult to diagnose lichenoid lesions and even more challenging to differentiate between OLP and OLR, therefore it is essential to do a full intraoral and extraoral examination. OLL can occur in association with Hawley retainer, which we believe could be because it is made of an acrylic based material. Generally, OLL resolves after removal of the cause.


Asunto(s)
Erupciones Liquenoides/diagnóstico , Retenedores Ortodóncicos/efectos adversos , Lengua/patología , Femenino , Humanos , Liquen Plano Oral , Erupciones Liquenoides/inducido químicamente , Adulto Joven
12.
J Contemp Dent Pract ; 20(7): 857-862, 2019 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-31597809

RESUMEN

AIM: The aim of this article is to provide an insight into the various modalities of retention and types of appliance used in achieving this objective. BACKGROUND: Maintaining the orthodontically treated teeth in their corrected position is a challenging and ominous task since the inception of this specialty. Orthodontic retainers play a pivotal role in preventing posttreatment tooth movement, thereby maintaining the esthetic, function, and stability of the stomatognathic system. RESULTS: An extensive study of literature suggests that there are significant variations in the results describing the effectiveness, cost factors, survival times, oral hygiene status, and regimen of various orthodontic retention appliances. In terms of patient's satisfaction and speech articulation, vacuum-formed retainers (VFRs) are better than Hawley retainers. Occlusal contacts are better achieved with Hawley retainers than VFRs. CONCLUSION: Currently, there is insufficient high-quality evidence in favor of a particular retention appliance/regime or protocol. There is a need for further evidence-based high-quality studies/randomize controlled trial studies (RCTs) to evaluate different orthodontic retention appliances and regime after the orthodontic treatment. CLINICAL SIGNIFICANCE: Irrespective of the appliance, the patients should be prepared for a long-term or indefinite retention phase following orthodontic treatment to prevent relapse.


Asunto(s)
Retenedores Ortodóncicos , Satisfacción del Paciente , Humanos , Diseño de Aparato Ortodóncico , Recurrencia , Técnicas de Movimiento Dental , Vacio
13.
Braz Oral Res ; 33: e078, 2019 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-31432928

RESUMEN

The aim of this study was to assess, correlate, and compare users' perceptions and preference related to maxillary removable retainers. Volunteers were recruited to use four retainer types: conventional wrap-around (CWA), wrap-around with an anterior opening (OWA), "U" wrap-around (UWA), and clear thermoplastic retainer (CT). The main outcomes were the volunteers' perceptions, evaluated with a 100-mm visual analogue scale, and their preferred retainer. The retainers were used for 21 days each (washout intervals of 7 days). Nineteen volunteers (27 ± 4.53 years) were randomly divided into four groups that used the four retainers, but with a different sequence. Perceptions were evaluated immediately after the use of each retainer and the preference at the end of the research. Repeated measures ANOVA and Friedman tests with post-hoc Tukey's test (intergroup comparisons), and Pearson and Spearman analyses (correlations between perceptions) were applied. The WA retainers did not significantly differ among themselves. The CT was rated significantly worse in speech (p ≤ 0.001), discomfort (p < 0.001), and occlusal interference (p < 0.001), and did not significantly differ from the others in esthetics. Users preferred significant more the WA retainers in comparison with the CT retainers. The occlusal interference caused by the CT was positively correlated to other perceptions, such as changes in speech and discomfort. WA retainers presented similar preference and perceptions, but were significantly better than the CT. The CT occlusal coverage appeared to be the primary cause of its rejection.


Asunto(s)
Diseño de Aparato Ortodóncico/estadística & datos numéricos , Retenedores Ortodóncicos/normas , Prioridad del Paciente/estadística & datos numéricos , Adulto , Análisis de Varianza , Estudios Cruzados , Femenino , Humanos , Masculino , Maxilar , Valores de Referencia , Estadísticas no Paramétricas , Resultado del Tratamiento , Escala Visual Analógica , Adulto Joven
14.
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
15.
Dental Press J Orthod ; 24(3): 64-70, 2019 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-31390451

RESUMEN

INTRODUCTION: bonded fixed retainers are often used to stabilize the results obtained with the orthodontic treatment. It is important that they do not prejudice dental health, as they will be used for a long period. OBJECTIVE: The purpose of the present study was to compare periodontal indexes between two types of bonded fixed retainers, conventional 3 x 3 plain retainer (0.8-mm orthodontic wire, bonded to the canines only) and a manufactured braided retainer (0.2 x 0.7-mm stainless steel wire, bonded to all anterior teeth) after use. METHODS: a test group of 15 volunteers (aged from 18 to 25 years) used both the conventional retainer and braided retainer for six months. A randomized longitudinal study design, with a two week washout interval, was applied. The dental plaque index, gingival index and dental calculus index were evaluated. Furthermore, the calculus accumulated along the retainer wire was measured and all patients answered a questionnaire about the use, acceptance and comfort of both types of retainers. RESULTS: the scores for plaque and gingival indexes were higher for the braided retainer (p< 0.05) on the lingual and proximal surfaces. The same occurred with the calculus index on the lingual surfaces (p< 0.05). The calculus index along wire was higher for the braided retainer (p< 0.05). All patients preferred the conventional retainer, and said that it was also more comfortable to use. CONCLUSION: it was concluded that the conventional retainer showed better periodontal indexes than the braided type.


Asunto(s)
Recubrimiento Dental Adhesivo , Retenedores Ortodóncicos , Adolescente , Adulto , Índice de Placa Dental , Humanos , Estudios Longitudinales , Diseño de Aparato Ortodóncico , Alambres para Ortodoncia , Índice Periodontal , Adulto Joven
16.
AAPS PharmSciTech ; 20(7): 260, 2019 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-31332579

RESUMEN

Orthodontic retainers are wearable customizable medical devices for dental protection or alignment. Here, clonidine hydrochloride (CH)-loaded wearable personalized 3D printed orthodontic retainers were studied for local sustained-release of drugs. CH powders were mixed with PEG 4000, Tween 80, poly(lactic acid), and polycaprolactone. The mixture was hot-melt extruded to form a filament that was 3D printed to a customizable original orthodontic retainer with the fused deposition modeling (FDM) method. The original retainer showed a burst release of CH in the early stage of the dissolution process though a sustained release appeared in the late stage. The in vivo burst release of CH would lead to unexpected side effect. The original retainer was modified by coating with hydrophilic polymers or washing with buffered solutions to obtain the coated or washed retainer. The coated retainer still showed a burst release while the washed retainer showed an optimal sustained release. Many CH microparticles existed on the surface of original retainers according to the scanning electron microscopic image so that the burst release was unavoidable. The hydrophilic polymer coating method did not change the release profile because the polymer was also rapidly dissolved. However, most of the surface CH can be eliminated by washing so that the burst release dissappeared in the washed retainer. Furthermore, the simulated CH concentration-time profiles in the circulation of humans of the washed retainer showed the stable and appropriate drug levels for more than 3 days. Wearable personalized 3D printed drug-loaded orthodontic retainers are a promising drug-device for sustained release of drugs.


Asunto(s)
Agonistas de Receptores Adrenérgicos alfa 2/administración & dosificación , Clonidina/administración & dosificación , Preparaciones de Acción Retardada , Retenedores Ortodóncicos , Impresión Tridimensional , Dispositivos Electrónicos Vestibles , Adulto , Femenino , Humanos , Polímeros
17.
Prog Orthod ; 20(1): 28, 2019 Jul 22.
Artículo en Inglés | MEDLINE | ID: mdl-31328248

RESUMEN

BACKGROUND: The long-term evidence regarding failures of fixed retainers is limited and the aim of this cohort study was to assess the long-term risk of failure of one type of maxillary and two types of mandibular fixed lingual retainers. TRIAL DESIGN: Retrospective cohort study. METHODS: Eighty-eight patients in retention 10-15 years after orthodontic treatment were included. The type of failure; number of failures per tooth, per patient, and retainer; and adverse effects were assessed by (1) a questionnaire, (2) clinical examination, and (3) screening patients' clinical charts. Descriptive statistics were calculated and a Cox regression was used to assess possible predictors for mandibular retainer survival. RESULTS AND CONCLUSIONS: In the mandible, 47 (53.4%) .016″ × .022″ braided stainless steel retainers (SS) were bonded to all six anterior teeth, and 41 (46.6%) .027″ ß-titanium (TMA) retainers were bonded to the canines only. From the SS retainers 40.4% and of the TMA retainers 61% had no failures during the whole observation period. SS failures per retainer were 2.17 (3.15) vs. 0.66 (1.03) for TMA. The type of retainer was the only significant predictor for failure. In the maxilla, 82 (93.2%) .016″ × .022″ braided SS retainers were bonded to all four incisors and six retainers (6.8%) to all six anterior teeth. The latter group was not further analyzed due to the small sample size. From the retainers bonded to all four incisors, 74.4% had no failure during the whole observation period. SS average number of failures per retainer bonded to the four incisors was 1.14 (SD 2.93). Overall, detachments were the most frequent type of first failure followed by composite damage. From the original mandibular retainers 98.9% and of the original maxillary retainers 97.6% were still in situ 10-15 years after debonding. No adverse torque changes were observed. LIMITATIONS: Potential effects of selection bias, information bias, and attrition bias as well as possible confounding factors cannot be fully excluded in this study.


Asunto(s)
Recubrimiento Dental Adhesivo , Maxilar , Estudios de Cohortes , Humanos , Mandíbula , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos Fijos , Retenedores Ortodóncicos , Estudios Retrospectivos
18.
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
19.
J Orthod ; 46(3): 212-219, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-31151360

RESUMEN

OBJECTIVE: To explore factors influencing adherence to vacuum-formed retainer wear over a minimum period of four years. DESIGN: A qualitative study based on a randomised controlled trial assessing the effectiveness of orthodontic retainers. SETTING: Institute of Dentistry, Queen Mary University of London. PARTICIPANTS: Fifteen participants wearing vacuum-formed retainers for at least four years. METHODS: One-to-one semi-structured interviews were undertaken on a criterion-based purposive sample of participants wearing vacuum-formed retainers. The interviews were audio-recorded, transcribed verbatim and analysed using Framework Methodology. RESULTS: High self-reported levels of adherence in the early stages of retention were linked to a desire to maintain orthodontic outcomes and the negative perception of potential post-treatment changes. However, adherence typically reduced over time due to a combination of factors including the negative impact of retainers on quality of life and pragmatic issues related to retainer wear. Network support was found to be important in the short and long term, with instances of self-directed wear and negative beliefs concerning the importance of retainer wear and predisposition to post-treatment changes. Lack of follow-up appointments and immaturity of participants prompted independent decisions to cease retainer wear. CONCLUSIONS: Six key influencers of prolonged adherence with vacuum-formed retainer wear were identified. Future strategies to improve adherence should account for these while also being responsive to time elapsed since debond and patient age.


Asunto(s)
Diseño de Aparato Ortodóncico , Calidad de Vida , Humanos , Retenedores Ortodóncicos , Investigación Cualitativa , Vacio
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