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1.
Medicine (Baltimore) ; 99(13): e19430, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-32221067

RESUMEN

INTRODUCTION: Loss of a dental element can generate several repercussions in the stomatognathic system. According to the latest survey by the Ministry of Health, in 2010, Brazilian adults had, on average, 7 missing teeth. This loss may lead to movement of the adjacent teeth and the antagonist, which would make prosthetic rehabilitation harder to do. Anchoring systems, such as mini-implants, have been increasingly used as a treatment option because they act with heavy but controlled forces and without side effects. Recent studies have shown that photobiomodulation (PBM) can accelerate orthodontic movement in molar intrusion. The objective of this study will be to evaluate the effect of PBM on the acceleration of the orthodontic movement of molar verticalization and its effect on pain and inflammation of the periodontal tissues. PATIENT CONCERNS:: the concerns assessments will be done over the study using anamnesis interviews and specific questionnaire. DIAGNOSIS: verticalization will be evaluated by clinical and radiographic analysis. INTERVENTIONS: Thirty four healthy patients aged 30 to 60 years, who need to recover the prosthetic space for oral rehabilitation after loss of the posterior inferior dental elements and inclination of the adjacent element, will be randomly divided into 2 groups: G1 (control group) - verticalization by mini-implant + PBM simulation (placebo); G2 (experimental group) - verticalization by mini-implant + PBM. The movements will occur with the aid of mini-implants and elastomeric chains ligatures. The PBM will occur with diode laser application, 808 nm, 100 mW, receiving 1J per point, 10 seconds, 10 points (5 per buccal and 5 per lingual) and radiant exposure of 25 J/cm. The orthodontic forces of verticalization (corresponding to any exchange of elastomeric ligation) will be applied every 30 days and the PBM will be applied immediately, 3 and 7 days of each month, for a period of 3 months. The crevicular gingival fluid (CGF) will be collected on the 1st, 3rd, and 7th days after the first activation, and then on the 3rd day of the following 2 months. OUTCOMES: Interleukins IL1ß, IL-6, IL-8, IL-10, and TNF-α will be analyzed by ELISA. Panoramic radiography will be performed at baseline and 90 afterwards to ascertain the amount (in degrees) of verticalization. To evaluate the pain, the Visual Analog Scale (VAS) will be used in all the consultations, and to evaluate the quality of life, the Oral Health Impact Profile (OHIP-14) questionnaire will be applied. Analgesics will be given and the quantity of drugs will be counted. If the data are normal, they will be submitted to Student t test. The data will be presented as means ± SD and the value of p will be defined as <0.05. DISCUSSION: This protocol will determine the effectiveness of photobiomoduation regarding the orthodontic movement of molar verticalization. ETHICS AND DISSEMINATION: This protocol received approval from the Human Research Ethics Committee of Universidade Nove de Julho (certificate number: 3 533 219). The data will be published in a peer-reviewed periodical.


Asunto(s)
Interleucinas/biosíntesis , Terapia por Luz de Baja Intensidad/métodos , Diente Molar/efectos de la radiación , Técnicas de Movimiento Dental/métodos , Adulto , Brasil , Método Doble Ciego , Femenino , Líquido del Surco Gingival , Humanos , Láseres de Semiconductores , Masculino , Persona de Mediana Edad , Dolor/etiología , Dimensión del Dolor , Calidad de Vida , Técnicas de Movimiento Dental/efectos adversos , Factor de Necrosis Tumoral alfa/biosíntesis
2.
Pain Res Manag ; 2019: 6271835, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31772695

RESUMEN

Background: This first-in-human study in Saudi orthodontic patients has evaluated the role of low-level laser therapy (LLLT) in pain perception (PP). The outcome of single application of LLLT with 4 different treatment modalities (TM) on PP are evaluated following orthodontic bracket bonding on maxilla. Materials and Methods: A prospective clinical intervention with implementation of parallel technique in each group, 32 orthodontic patients with ectopic canine requiring fixed orthodontic appliance were enrolled and randomly allocated to the 4 groups: LLLT + self-ligating (SL) bracket, LLLT + conventional (Conv.) bracket, non-LLLT + SL bracket, and non-LLLT + Conv. bracket. Orthodontic bracket bonding from 1st molar to 1st molar and superelastic 0.012 inch NiTi were applied for the maxilla. For each patient, maxillary 1st molar to molar received a single application of LLLT using a 940 nm Ga-Al-As laser device on 5 different points labially/buccally and palatally. Main outcome measure was the degree of PP score during the 1st week of orthodontic tooth movement (OTM) after 4 hours, 24 hours, 3 days, and 7 days of both LLLT and non-LLLT treatment applications. A questionnaire with an 11-point numeric rating scale (NRS) was used for PP. Results: Mean ± SD of PP in the LLLT + SL group was 3.33 ± 1.4, 3.58 ± 1.06, 2.31 ± 0.67, and 1.89 ± 0.54 in 4 hours, 24 hours, 3 days, and 7 days, respectively. Compared to all 4 TM groups, LLLT groups showed better PP. More statistically significant differences were found in LLLT groups. No harms were encountered. Limitations: The intervention provider and the patient were not blinded to the intervention. Conclusion: The LLLT + SL group revealed significantly promising benefits on PP during OTM.


Asunto(s)
Terapia por Luz de Baja Intensidad/métodos , Soportes Ortodóncicos/efectos adversos , Manejo del Dolor/métodos , Dolor/etiología , Técnicas de Movimiento Dental/métodos , Adolescente , Adulto , Femenino , Humanos , Masculino , Dolor/prevención & control , Dimensión del Dolor/métodos , Percepción del Dolor/efectos de la radiación , Estudios Prospectivos , Arabia Saudita , Encuestas y Cuestionarios , Técnicas de Movimiento Dental/efectos adversos , Adulto Joven
3.
Medicine (Baltimore) ; 98(43): e17325, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31651838

RESUMEN

BACKGROUND: Pain stemming from the placement of elastomeric separators and the exchanging of wires and accessories is the greatest reason for abandoning orthodontic treatment. Indeed, discomfort related to treatment exerts a negative impact on quality of life due to the difficulty chewing and biting. This paper proposes a study to evaluate the analgesic effects of photomiobodulation (PBM) on individuals undergoing orthodontic treatment. METHODS: The sample will be composed of 72 individuals who receiving elastomeric separators on the mesial and distal faces of the maxillary first molars. The patients will be randomly allocated to 2 groups: an experimental group irradiated with low-level laser and a sham group submitted to simulated laser irradiation. Upon the placement of the separators, the experimental group will receive a single application of PBM on the mesial and distal cervical portion and apical third of the molars. Perceived pain will be analyzed after one hour using the visual analog scale in both groups. Samples will be taken of the gingival crevice with absorbent paper for 30 seconds for the analysis of cytokines using ELISA and the results of the 2 groups will be compared. The patients will sign a statement of informed consent. Statistical analysis will be performed with the Student's t test and analysis of variance (ANOVA). DISCUSSION: The expectation is that the patients in the irradiated group will have a lower perception of pain and lower quantity of cytokines compared to those in the sham group. The purpose of the study is to establish an effective method for PBM with the use of low-level infrared laser (Ga-Al-As with a wavelength of 808 nm and output power of 100 mW) for reductions in pain and inflammatory cytokines related to orthodontic treatment. TRIAL REGISTRATION: This protocol was registered in ClinicalTrial.gov, under number NCT03939988. It was first posted and last updated in May 6, 2019.


Asunto(s)
Elastómeros/efectos adversos , Terapia por Luz de Baja Intensidad/métodos , Aparatos Ortodóncicos/efectos adversos , Dolor Asociado a Procedimientos Médicos/terapia , Técnicas de Movimiento Dental/efectos adversos , Adolescente , Adulto , Análisis de Varianza , Femenino , Humanos , Masculino , Diente Molar , Dimensión del Dolor , Dolor Asociado a Procedimientos Médicos/etiología , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento , Adulto Joven
4.
Am J Orthod Dentofacial Orthop ; 156(1): 87-93, 2019 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-31256846

RESUMEN

INTRODUCTION: The aim of this study was to evaluate the effects of mechanical vibration and low-level laser therapy on orthodontic pain after placement of the initial archwire. METHODS: Sixty subjects with 3-6 mm maxillary dental crowding, a nonextraction fixed treatment plan, and no medical history were included in this study. The subjects were randomly divided into 3 groups, equally distributed by sex. In each subject, preadjusted edgewise appliances were placed in the maxillary arch from the left first molar to the right first molar, and a 0.014-inch round nickel-titanium archwire was fully engaged with elastomeric ties and cut at the end of first molar bondable tube. In group 1 (mean age 13.98 ± 2.68 y), mechanical vibration was performed 3 times: immediately, 24 hours, and 48 hours after engagement of the initial archwire. In group 2 (mean age 14.86 ± 2.06 y), low-level laser therapy was applied once: immediately after the insertion of the initial archwire. Group 3 (mean age 14.41 ± 1.78 y) served as the control group. Pain scores were determined with the use of a visual analog scale (VAS). RESULTS: Although no statistically significant differences were found among the groups (P >0.05), the mean VAS scores for the mechanical vibration group were consistently lower than those of the control and low-level laser therapy groups at all measured time points. CONCLUSIONS: The mechanical vibration group had lower, though nonsignificant, VAS scores for all measured time points. Additional clinical trials are recommended for more definitive conclusions.


Asunto(s)
Terapia por Luz de Baja Intensidad/métodos , Maloclusión/terapia , Alambres para Ortodoncia , Manejo del Dolor/métodos , Técnicas de Movimiento Dental/métodos , Vibración/uso terapéutico , Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Maxilar , Diente Molar , Níquel , Diseño de Aparato Ortodóncico , Dolor/etiología , Dimensión del Dolor , Titanio , Técnicas de Movimiento Dental/efectos adversos , Técnicas de Movimiento Dental/instrumentación , Adulto Joven
5.
Acta Med Okayama ; 73(3): 255-262, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31235974

RESUMEN

Orthodontists need to understand the orthodontic risks associated with systemic disorders. Axenfeld-Rieger syndrome (ARS) is a rare autosomal dominant disorder with genetic and morphological variability. The risks of orthodontic treatment in ARS patients have been unclear. Here we describe the correction of an anterior open bite in a 15-year-old Japanese female ARS patient by molar intrusion using sectional archwires with miniscrew implants. An undesirable development of external apical root resorption (EARR) was observed in all intrusive force-applied posterior teeth during the patient's orthodontic treatment, suggesting that ARS patients have a higher risk of EARR than the general population.


Asunto(s)
Segmento Anterior del Ojo/anomalías , Anomalías del Ojo/complicaciones , Enfermedades Hereditarias del Ojo/complicaciones , Mordida Abierta , Resorción Radicular/etiología , Adolescente , Pérdida de Hueso Alveolar , Tornillos Óseos , Femenino , Humanos , Riesgo , Técnicas de Movimiento Dental/efectos adversos
6.
Am J Orthod Dentofacial Orthop ; 155(4): 543-551, 2019 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-30935609

RESUMEN

INTRODUCTION: To evaluate the stress at the apical third of the pulp and neurovascular bundle (NVB) during 5 types of orthodontic movement at different levels of bone loss. Furthermore, correlations among bone loss, orthodontic appliances, and stress increase were assessed. METHODS: Based on cone-beam computed tomography datasets, 10 models of the mandibular second premolar were created. Each of these models was subjected to a gradual horizontal bone loss simulation (0-8 mm). Orthodontic forces of 20 g, 60 g, and 120 g were applied during the finite element analysis (FEA). For each bone loss level, stress values were evaluated with the use of Abaqus at the apical third of the pulp and the NVB. RESULTS: The stress manifested at the apical third of the pulp was smaller than that at the NVB. The highest apical NVB stress was found for rotation (0.000546 N/mm2 for 8 mm bone loss) whereas the lowest stress resulted after translational movements (2.35E-04 MPa for 8 mm bone loss). The FEA showed that Proffit's indicated orthodontic forces did not significantly disturb the pulpal blood flow and damage the apical NVB. Up to a doubling of the NVB stress, bone loss correlated with the force reduction to obtain similar stress levels compared with teeth with no bone loss. CONCLUSIONS: The present findings indicate that the stress manifested at the apical third of the pulp is smaller than that at NVB. Rotational movements induce the highest stress and translational forces develop the lowest stress related to the physiologic capillary blood pressure. Furthermore, in situations with reduced periodontium, lower forces are needed to reach the maximum tolerable stress compared with teeth with intact periodontium.


Asunto(s)
Pulpa Dental/fisiopatología , Técnicas de Movimiento Dental , Adulto , Tomografía Computarizada de Haz Cónico , Modelos Dentales , Pulpa Dental/diagnóstico por imagen , Análisis del Estrés Dental , Análisis de Elementos Finitos , Humanos , Masculino , Estrés Mecánico , Técnicas de Movimiento Dental/efectos adversos
7.
Am J Orthod Dentofacial Orthop ; 155(3): 313-329, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30826034

RESUMEN

INTRODUCTION: This systematic review assesses the literature regarding the association between orthodontic tooth movement and external root resorption. By determining the evidence level supporting the association, the results could provide clinical evidence for minimizing the deleterious effect of orthodontic tooth movement. METHODS: Electronic databases, including MEDLINE, PubMed, Embase, Scopus, CINAHL, Cochrane Library, and LILACS, were searched up to February 2018, with hand searching of selected orthodontic journals undertaken to identify any preelectronic publications. Searches were undertaken with no restrictions on year, publication status, or language. Selection criteria included randomized controlled trials conducted with the use of fixed orthodontic appliances or sequential thermoplastic aligners on human patients. The quality of included studies was assessed with the use of the Cochrane Risk of Bias Tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Inter-rater agreement of the review authors was used for the inclusion of primary articles, risk of bias assessment, and evaluation of the quality of evidence (GRADE), and it was calculated with the use of the Cohen kappa statistic. RESULTS: A total of 654 articles were retrieved in the initial search. After the review process, 25 articles describing 24 individual trials met the inclusion criteria. Sample sizes ranged from 6 to 154 patients. Most articles were classified as having unclear risks of bias and very low to low quality of evidence. CONCLUSIONS: There is very low to low evidence for supporting positive associations between root resorption and increased force levels, force continuity, intrusive forces, and treatment duration. Moreover, by including a pause in treatment for patients experiencing root resorption, it may be possible for the clinician to reduce the severity of the condition. Of the included studies, the most common methodologic flaws include the absence of a control group, appropriate randomization strategy, and adequate examinations before and after treatment.


Asunto(s)
Resorción Radicular/etiología , Resorción Radicular/prevención & control , Técnicas de Movimiento Dental/efectos adversos , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto
8.
Angle Orthod ; 89(5): 788-796, 2019 09.
Artículo en Inglés | MEDLINE | ID: mdl-30855181

RESUMEN

OBJECTIVES: To evaluate the correlation between pain and tissue reactions during induced tooth movement (ITM). MATERIALS AND METHODS: Forty-two male Wistar rats (Rattus norvegicus; ∼90 days of age, 300 g) were used. The animals were divided into seven groups of six rats each: one control group and six experimental groups subjected to ITM by continuous force (CF) or interrupted continuous force (ICF) for 1, 3, and 5 days. Hyalinization of the periodontal ligament (PL) and occurrence of pain were observed. Animal behavior (walking, climbing, immobile posture, resting/sleeping, and directed face grooming) and the presence of chemical mediators associated with nociception, cyclooxygenase-2 (COX-2), and interleukin-1 beta (IL-1ß) in the PL were analyzed. RESULTS: There was a moderate positive correlation between hyalinization and the presence of COX-2 (rs = 0.404; P < .05) and IL-1ß (rs = 0.429; P < .05). There was a moderate negative correlation between hyalinization and exploratory behaviors (walking, r = -0.586, P < .01; climbing, r = -0.573, P < .01), and a moderate positive correlation between hyalinization and resting/sleeping (r = 0.467; P < .01). CONCLUSIONS: The results suggest a correlation between pain and undesirable tissue reactions in ITM.


Asunto(s)
Dolor , Ligamento Periodontal , Técnicas de Movimiento Dental , Animales , Fenómenos Biomecánicos , Masculino , Nocicepción , Dolor/etiología , Ratas , Ratas Wistar , Técnicas de Movimiento Dental/efectos adversos
9.
Angle Orthod ; 89(4): 617-623, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-30753091

RESUMEN

OBJECTIVES: To evaluate the effectiveness of verbal behavior modification, acetaminophen, and the combined effectiveness of verbal behavior modification along with acetaminophen on orthodontic pain. MATERIALS AND METHODS: One hundred and forty orthodontic fixed appliance patients were randomly assigned to four groups. Group A was administered acetaminophen, group B was given verbal behavior modification, group C was administered acetaminophen as well as verbal behavior modification, and group D was placebo-controlled. A visual analog scale was used to assess pain intensity after 1 week of separator placement. RESULTS: Group A had less mean pain intensity when compared to group B at 6 hours (P < .001) and at 1 (P < .001) and 2 (P = .002) days. Group C patients encountered less mean pain intensity when compared to group B patients at 6 hours (P < .001) and at 1 (P < .001), 2 (P < .001), and 4 (P = .001) days. There was a statistically significant difference between groups A and C (group C experienced less pain intensity) after 6 hours (P = .004) and at day 4 (P = .009) after separator placement. CONCLUSIONS: Acetaminophen is the main agent of orthodontic pain reduction after separator placement, with verbal behavior serving as an adjunct to it.


Asunto(s)
Acetaminofén , Analgésicos no Narcóticos , Manejo del Dolor , Técnicas de Movimiento Dental , Conducta Verbal , Acetaminofén/uso terapéutico , Analgésicos no Narcóticos/uso terapéutico , Terapia Conductista , Método Doble Ciego , Humanos , Ibuprofeno , Dolor/etiología , Dimensión del Dolor , Método Simple Ciego , Técnicas de Movimiento Dental/efectos adversos
10.
Bull Tokyo Dent Coll ; 60(1): 39-52, 2019 Feb 28.
Artículo en Inglés | MEDLINE | ID: mdl-30700640

RESUMEN

The goal of this study was to investigate how the height of the archwire hook and implant anchor affect tooth movement, stress in the teeth and alveolar bone, and the center of resistance during retraction of the entire maxillary dentition using a multibracket system. Computed tomography was used to scan a dried adult human skull with normal occlusion. Three-dimensional models of the maxillary bone, teeth, brackets, archwire, hook, and implant anchor were created and used for finite element analysis. The heights of the hook and the implant anchor were set at 0, 5, or 10 mm from the archwire. Orthodontic force of 4.9 N was systematically applied between the hook and the implant anchor and differential stress distributions and tooth movements observed for each traction condition. With horizontal traction, the archwire showed deformation in the superior direction anterior to the hook and in the inferior direction posterior to the hook. Differences in traction height and direction resulted in different degrees of deformation, with biphasic movement clearly evident both in front of and behind the hook. With horizontal traction of the hook at a height of 0 mm, all the teeth moved distally, but not with any other type of traction. At a height of 5 mm or 10 mm, deformation showed an increase. The central incisor showed extrusion under all traction conditions, with the amount showing a reduction as the height of horizontal or posterosuperior traction increased. The center of resistance was located at the root of the 6 anterior teeth and entire maxillary dentition. The present results suggest that it is necessary to consider deformation of the wire and the center of resistance during en-masse retraction with implant anchorage.


Asunto(s)
Análisis del Estrés Dental , Métodos de Anclaje en Ortodoncia/efectos adversos , Técnicas de Movimiento Dental/efectos adversos , Modelos Dentales , Análisis de Elementos Finitos , Humanos , Maloclusión/terapia , Maxilar , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Alambres para Ortodoncia , Corona del Diente/patología , Técnicas de Movimiento Dental/instrumentación , Técnicas de Movimiento Dental/métodos
11.
Eur J Orthod ; 41(2): 180-187, 2019 03 29.
Artículo en Inglés | MEDLINE | ID: mdl-30668660

RESUMEN

OBJECTIVE: To analyse cost-effectiveness of anchorage reinforcement with buccal miniscrews and with molar blocks. We hypothesized that anchorage with miniscrews is more cost-effective than anchorage with molar blocks. TRIAL DESIGN: A single-centre, two-arm parallel-group randomized controlled trial. METHODS: Adolescents (age 11-19 years) in need of treatment with fixed appliance, premolar extractions, and en masse retraction were recruited from one Public Dental Health specialist centre. The intervention arm received anchorage reinforcement with buccal miniscrews during space closure. The active comparator received anchorage reinforcement with molar blocks during levelling/alignment and space closure. The primary outcome measure was societal costs defined as the sum of direct and indirect costs. Randomization was conducted as simple randomization stratified on gender. The patients, caregivers, and outcome assessors were not blinded. RESULTS: Eighty patients were randomized into two groups. The trial is completed. All patients were included in the intention-to-treat analysis. The median societal costs for the miniscrew group were €4681 and for the molar block group were €3609. The median of the difference was €825 (95% confidence interval (CI) 431-1267). This difference was mainly caused by significantly higher direct costs consisting of material and chair time costs. Differences in chair time costs were related to longer treatment duration. No serious harms were detected, one screw fractured during insertion and three screws were lost during treatment. GENERALIZABILITY AND LIMITATIONS: The monetary variables are calculated based on a number of local factors and assumptions and cannot necessarily be transferred to other countries. Variables such as chair time, number of appointments, and treatment duration are generalizable. Owing to the study protocol, the benefit of miniscrews as a stable anchorage has not been fully utilized. CONCLUSIONS: When only moderate anchorage reinforcement is needed, miniscrews are less cost-effective than molar blocks. The initial hypothesis was rejected. Miniscrews provide better anchorage reinforcement at a higher price. They should be used in cases where anchorage loss cannot be accepted. TRIAL REGISTRATION: NCT02644811.


Asunto(s)
Tornillos Óseos/economía , Métodos de Anclaje en Ortodoncia/economía , Métodos de Anclaje en Ortodoncia/instrumentación , Técnicas de Movimiento Dental/economía , Técnicas de Movimiento Dental/instrumentación , Adolescente , Citas y Horarios , Diente Premolar/cirugía , Tornillos Óseos/efectos adversos , Costo de Enfermedad , Análisis Costo-Beneficio , Femenino , Costos de la Atención en Salud/estadística & datos numéricos , Humanos , Masculino , Diente Molar , Suecia , Factores de Tiempo , Extracción Dental , Técnicas de Movimiento Dental/efectos adversos , Técnicas de Movimiento Dental/métodos , Adulto Joven
12.
Eur J Orthod ; 41(1): 67-79, 2019 01 23.
Artículo en Inglés | MEDLINE | ID: mdl-29771300

RESUMEN

Background: Orthodontically induced external root resorption (OIRR) is a pathologic consequence of orthodontic tooth movement. However, the limitations of two-dimensional radiography suggest that cone beam computed tomography (CBCT) with its three-dimensional capabilities might be more suitable to assess OIRR. Objective: The aim of this study was to assess in an evidence-based manner data on linear or volumetric OIRR measurements of permanent teeth by means of CBCT, during and/or after the end of orthodontic treatment. Search methods: Unrestricted electronic and hand searches were performed up to January 2017 in 15 databases. Selection criteria methods: Randomized clinical trials, prospective, and retrospective non-randomized studies assessing OIRR during and/or after orthodontic treatment using CBCT in human patients were included. Data collection and analysis: After duplicate study selection, data extraction, and risk-of-bias assessment according to the Cochrane guidelines, random-effects meta-analyses, followed by subgroup, meta-regression, and sensitivity analyses were also performed in order to evaluate factors that affect OIRR. Results: A total of 33 studies (30 datasets) were included in the qualitative analysis while data from 27 of them were included in the quantitative analysis. Direct comparisons from randomized trials found little to no influence of appliance-related factors on OIRR. Explorative analyses including non-randomized studies found a pooled OIRR of 0.79 mm based on all included studies and 0.86 mm when OIRR was assessed at the end of orthodontic treatment. Statistically significant differences in OIRR were found according to tooth type or jaw, inclusion of extractions, treatment duration, and diagnostic accuracy of the CBCT. Conclusions: Based on the results of this study, CBCT seems to be a reliable tool to examine OIRR during or at the end of orthodontic treatment. Although the average OIRR measured with CBCT seems to lack clinical relevance, there are certain factors that may affect OIRR following orthodontic treatment. Nevertheless, due to data heterogeneity and low quality of the included studies, the corresponding results should be interpreted with some caution. Registration: PROSPERO (CRD42016030131).


Asunto(s)
Resorción Radicular/etiología , Técnicas de Movimiento Dental/efectos adversos , Tomografía Computarizada de Haz Cónico/métodos , Humanos , Radiografía Dental/métodos , Resorción Radicular/diagnóstico por imagen
13.
Orthod Craniofac Res ; 22(1): 32-37, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30451366

RESUMEN

OBJECTIVES: To evaluate the amount of external apical root resorption (EARR) secondary to orthodontic treatment in patients with Short Root Anomaly (SRA) compared to patients with average root lengths using Cone Beam Computed Tomography (CBCT). SETTINGS AND SAMPLE POPULATION: Cone beam computed tomography scans of 23 SRA and 26 control patients were selected from 232 pretreatment scans from a single private practice. MATERIALS AND METHODS: Cone beam computed tomography scans before (T1) and after orthodontic treatment (T2) were evaluated for differences in the change in tooth and root length of the maxillary incisors between both groups. Gender, treatment duration and age were examined as covariates. RESULTS: The mean values for root and tooth length of the maxillary incisors decreased by a range of 0.6 to 1.3 mm after orthodontic treatment. There was no significant difference between the groups for the majority of the measurements although there was a trend for less EARR in the SRA group. The maxillary left central incisor had significantly less proportional and non-proportional loss in tooth length in the SRA group. Age, gender and treatment duration were not associated with change in the proportional and non-proportional lengths for both groups. CONCLUSION: Patients with SRA did not exhibit a significant difference in the proportional and non-proportional change of length after orthodontic treatment when compared to the controls for most measurements. Only tooth length for the maxillary left central incisor had significantly less reduction after orthodontic treatment for both the proportional and non-proportional measurements in the SRA group compared to the control group.


Asunto(s)
Resorción Radicular/etiología , Ápice del Diente/anomalías , Técnicas de Movimiento Dental/efectos adversos , Estudios de Casos y Controles , Tomografía Computarizada de Haz Cónico , Femenino , Humanos , Masculino , Estudios Retrospectivos , Factores de Riesgo , Resorción Radicular/diagnóstico por imagen , Ápice del Diente/diagnóstico por imagen , Adulto Joven
14.
J Orofac Orthop ; 80(1): 1-8, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30242441

RESUMEN

PURPOSE: Aim of the present study was to investigate the prevalence of gingival recession and related factors in teeth with low occlusal function (open bite and infraversion) after orthodontic treatment. METHODS: From January 2014 to December 2017, 403 patients received orthodontic treatment. Their gingival recession and related factors before and after treatment were retrospectively analyzed. RESULTS: The prevalence of gingival recession in patients with infraversion and open bite after orthodontic treatment were 80.6 and 75.0%, respectively; these values were 43.4 and 47.5% before treatment, respectively. Notably, the Miller index of gingival recession increased after orthodontic treatment (P < 0.05). The risk of gingival recession in patients with infraversion or open bite after orthodontic treatment was remarkably higher than the risk in other patients (odds ratio [OR] = 16.712 and 5.073, respectively); the gingival recession rate was related to treatment with tooth extraction (OR = 2.043), as well as gingival biotype (OR = 0.341) and gingival index (GI) before orthodontic treatment (OR = 97.404; P < 0.05). CONCLUSIONS: Patients with these two types of low occlusal function are more likely to exhibit gingival recession after orthodontic treatment. Moreover, the prevalence of gingival recession after orthodontic treatment is higher among patients who have undergone tooth extraction during orthodontic treatment, and among those who exhibit thin gingival biotype and high gingival index before orthodontic treatment.


Asunto(s)
Recesión Gingival/etiología , Maloclusión/terapia , Mordida Abierta/terapia , Técnicas de Movimiento Dental/efectos adversos , Adolescente , Femenino , Recesión Gingival/epidemiología , Humanos , Masculino , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Técnicas de Movimiento Dental/métodos , Adulto Joven
15.
J Oral Rehabil ; 46(3): 257-267, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-30378703

RESUMEN

BACKGROUND: Although inflammation can alter cytokines release and nerve function, it is not yet fully established if orthodontic-induced inflammation can cause significant extraoral trigeminal somatosensory alterations and release of inflammatory chemical mediators. OBJECTIVE: The primary aim of this study was to investigate the impact of orthodontic separator and short-term fixed orthodontic appliance on the extraoral trigeminal somatosensory function and concentrations of cytokines in the gingival crevicular fluid (GCF). METHODS: Twenty-two female patients were evaluated as follow: baseline, 24 hour-after elastomeric separator (-aES), 24 hour- and 1 month-after bonding brackets (-aBB) at both arches. The outcome variables were as follows: self-reported pain (Visual Analog Scale), QSTs (current perception threshold-CPT, cold detection threshold-CDT, warm detection threshold-WDT, mechanical detection threshold-MDT, mechanical suprathreshold-MST and wind-up ratio-WUR. All QSTs were performed at infra-orbital and mental nerve entry zone at patient`s dominant side. In addition, GCF samples in order to assess cytokines profile (IL-1ß,IL-8,IL-6 and TNF-α) were collected. ANOVA and Tukey's post hoc analyses were performed (a = 5%). RESULTS: Patients reported higher pain intensity 24 hour-aBB compared to baseline and 24 hour-aES (P < 0.050). Patients were less sensitive to pin-prick pain (MST) at 24 hour-aBB and 1 month-aBB compared to baseline (P < 0.006). Significant increases in IL-6 levels were observed 24 hour-aBB (P < 0.001). Multiple comparison analysis showed significant increase in IL-1ß levels (P < 0.001) and TNF-α (P < 0.001) 1 month-aBB compared to baseline. CONCLUSION: Elastomeric separators only induced mild pain and were not able to significantly increase proinflammatory cytokines level in the GCF. In addition, orthodontic fixed appliance may induce only minor somatosensory changes at extraoral trigeminal locations.


Asunto(s)
Citocinas/metabolismo , Dolor Facial/fisiopatología , Líquido del Surco Gingival/metabolismo , Mediadores de Inflamación/metabolismo , Aparatos Ortodóncicos Fijos/efectos adversos , Técnicas de Movimiento Dental/efectos adversos , Adolescente , Niño , Dolor Facial/metabolismo , Femenino , Humanos , Dimensión del Dolor , Umbral Sensorial/fisiología , Adulto Joven
16.
Am J Orthod Dentofacial Orthop ; 154(4): 524-534, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-30268263

RESUMEN

INTRODUCTION: The purpose of this study was to evaluate the short-term impact of rapid maxillary expansion (RME) on the eruption paths of ectopically and normally erupting maxillary canines in the mixed dentition. METHODS: Thirty-two patients with 49 ectopically erupting canines (EEC group; age, 9.53 ± 1.10 years) and 18 patients with 27 normally erupting canines (NEC group; age, 9.25 ± 1.06 years) underwent RME. Thirty-six subjects with 54 normally erupting canines composed the untreated control group (UC group; age, 9.03 ± 0.72 years). Horizontal, vertical, and angular positions of canines and adjacent teeth were evaluated in the expanded (EEC and NEC groups) and unexpanded (UC group) patients using panoramic radiographs taken at 2 times with a 1-year interval. The radiographic evaluation methods included score ranking and proportional measurements to minimize panoramic radiograph limitations. Statistical comparisons were performed among the groups (P <0.05). RESULTS: Before expansion, the EEC group's canines were significantly closer to the midline, more distant from the occlusal plane, and more mesially angulated than those in the UC group. After expansion, the canine positions in the EEC and UC groups were similar, whereas the NEC group had a more favorable canine position for eruption. The EEC and NEC groups showed similar canine positional changes, whereas the UC group had the smallest changes. The positions of teeth adjacent to the canine were also significantly affected by RME, and these changes may be associated with improvement of the ectopic canine position. CONCLUSIONS: The changes produced by RME reduced the percentage of ectopic eruption paths and maintained the nonectopic eruption percentage.


Asunto(s)
Diente Canino/anatomía & histología , Diente Canino/patología , Técnica de Expansión Palatina/efectos adversos , Resorción Radicular/etiología , Erupción Ectópica de Dientes/etiología , Erupción Dental , Brasil , Niño , Diente Canino/efectos de los fármacos , Arco Dental/diagnóstico por imagen , Dentición Mixta , Femenino , Humanos , Incisivo/anatomía & histología , Incisivo/diagnóstico por imagen , Masculino , Maxilar/diagnóstico por imagen , Maxilar/patología , Radiografía Panorámica , Resorción Radicular/diagnóstico por imagen , Ápice del Diente/anatomía & histología , Ápice del Diente/patología , Erupción Ectópica de Dientes/diagnóstico por imagen , Técnicas de Movimiento Dental/efectos adversos , Raíz del Diente/anatomía & histología , Raíz del Diente/diagnóstico por imagen , Diente Primario
17.
J Appl Oral Sci ; 26: e20170626, 2018 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-30304125

RESUMEN

OBJECTIVE: The purpose of this study was to histologically evaluate pulp and dentin under induced tooth movement (ITM) with different types of forces. MATERIAL AND METHODS: The maxillary right first molars of rats were submitted to movement with continuous (CF), continuous interrupted (CIF) and intermittent (IF) forces during 5, 7 and 9 days with nickel-titanium (NiTi) closed-coil springs exerting 50cN force magnitude. The groups were histologically evaluated as for cellularity pattern, presence of dystrophic, hemodynamic alterations in the pulp as well dentin alterations. The main observed alterations were related to hemodynamic pulp characteristics, such as presence of thrombosis, vascular congestion and hemorrhages. The hemodynamic alterations were statistically evaluated by Shapiro-Wilk normality test and analysis of variance by the Kruskall-Wallis test. RESULTS: There was no significant differences observed between groups in the different types of applied forces and duration of ITM (vascular congestion, p=1.000; hemorrhage, p=0.305; thrombosis, p=1.000). CONCLUSIONS: Pulp tissue alterations resulting from ITM were limited to hemodynamic events, without progressing to irreversible degeneration, regardless of the type of force applied.


Asunto(s)
Pulpa Dental/patología , Dentina/patología , Técnicas de Movimiento Dental/efectos adversos , Animales , Pulpa Dental/irrigación sanguínea , Masculino , Modelos Animales , Necrosis , Ratas Wistar , Factores de Tiempo
18.
Dental Press J Orthod ; 23(4): 36-42, 2018 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-30304152

RESUMEN

To biologically explain why the orthodontic treatment does not induce pulp necrosis and calcific metamorphosis of the pulp, this paper presents explanations based on pulp physiology, microscopy and pathology, and especially the cell and tissue phenomena that characterize the induced tooth movement. The final reflections are as follows: 1) the orthodontic movement does not induce pulp necrosis or calcific metamorphosis of the pulp; 2) there is no literature or experimental and clinical models to demonstrate or minimally evidence pulp alterations induced by orthodontic movement; 3) when pulp necrosis or calcific metamorphosis of the pulp is diagnosed during orthodontic treatment or soon after removal of orthodontic appliances, its etiology should be assigned to concussion dental trauma, rather than to orthodontic treatment; 4) the two pulp disorders that cause tooth discoloration in apparently healthy teeth are the aseptic pulp necrosis and calcific metamorphosis of the pulp, both only induced by dental trauma; 5) the concussion dental trauma still requires many clinical and laboratory studies with pertinent experimental models, to increasingly explain its effects on the periodontal and pulp tissues.


Asunto(s)
Pulpa Dental/fisiología , Ortodoncia , Técnicas de Movimiento Dental , Animales , Pulpa Dental/patología , Necrosis de la Pulpa Dental , Humanos , Metamorfosis Biológica/fisiología , Necrosis , Técnicas de Movimiento Dental/efectos adversos
19.
Orthod Craniofac Res ; 21(4): 216-224, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30251334

RESUMEN

The aim was to assess the influence of corticosteroid therapy (CST) on orthodontic tooth movement (OTM). A narrative review of studies performed in animal models. Indexed databases were searched up to and including May 2018 to address the following focused question: "Does CST affect OTM?" The following eligibility criteria were imposed: (a) original studies; (b) presence of a control group (OTM without CST); (c) intervention: effect of CST on OTM; and (d) statistical analysis. Quality assessment was performed using the Animal Research Reporting In Vivo Experiment (ARRIVE) guidelines. Case series, case reports, commentaries, historic reviews and letters to the Editor were excluded. Ten studies performed on animal models were included. The experimental duration ranged between 3 and 49 days. Two studies reported that CST decreases the magnitude of OTM, two studies showed no significant influence of CST on OTM, and two studies found that CST increases OTM. Two studies reported CST significantly decreases bone density and increases bone resorption during OTM. In one study, CST significantly decreased orthodontically induced root resorption. The minimum, median and highest scores (out of 20) based on ARRIVE guidelines were 7, 15.5 and 18, respectively. The influence of CST on OTM in animal models remains debatable.


Asunto(s)
Corticoesteroides/uso terapéutico , Técnicas de Movimiento Dental/efectos adversos , Animales , Densidad Ósea , Remodelación Ósea/efectos de los fármacos , Bases de Datos Factuales , Modelos Animales , Resorción Radicular/etiología
20.
Angle Orthod ; 88(6): 740-747, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-30124322

RESUMEN

OBJECTIVES:: To identify risk factors for apical root resorption (ARR) of maxillary and mandibular incisors using mathematical quantification of apical root displacement (ARD) and multiple linear mixed-effects modeling. MATERIALS AND METHODS:: Periapical radiographs of maxillary and mandibular incisors and lateral cephalograms of 135 adults were taken before and after orthodontic treatment. ARR was measured on the periapical radiographs, and movement of central incisors was evaluated on the superimposed pre- and posttreatment lateral cephalograms. ARD was mathematically calculated from pretreatment tooth length, inclination change, and movement of the incisal edge. Linear mixed-effects model analysis was performed to identify risk factors for ARR, and standardized coefficients (SCs) were calculated to investigate the relative contribution of the risk factors to ARR. RESULTS:: Vertical ARD showed the highest SCs for both maxillary and mandibular incisors. Horizontal ARD showed the second highest SC for mandibular incisors but was not significantly correlated with the ARR of maxillary incisors. When horizontal and vertical ARDs were included in the mixed-effects model, the use of self-ligating brackets was significantly correlated with increased ARR of mandibular incisors. CONCLUSIONS:: ARD is a critical factor for ARR after orthodontic treatment. Careful monitoring of ARR is recommended for patients requiring significant ARD of incisors.


Asunto(s)
Resorción Radicular/etiología , Técnicas de Movimiento Dental/efectos adversos , Adulto , Cefalometría , Femenino , Humanos , Incisivo/diagnóstico por imagen , Masculino , Radiografía Dental , Factores de Riesgo , Resorción Radicular/diagnóstico por imagen , Ápice del Diente/diagnóstico por imagen
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