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1.
Cell Prolif ; 53(5): e12810, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32472648

RESUMEN

OBJECTIVES: Gli1+ cells have received extensive attention in tissue homeostasis and injury mobilization. The aim of this study was to investigate whether Gli1+ cells respond to force and contribute to bone remodelling. MATERIALS AND METHODS: We established orthodontic tooth movement (OTM) model to assess the bone response for mechanical force. The transgenic mice were utilized to label and inhibit Gli1+ cells, respectively. Additionally, mice that conditional ablate Yes-associated protein (Yap) in Gli1+ cells were applied in the present study. The tooth movement and bone remodelling were analysed. RESULTS: We first found Gli1+ cells expressed in periodontal ligament (PDL). They were proliferated and differentiated into osteoblastic cells under tensile force. Next, both pharmacological and genetic Gli1 inhibition models were utilized to confirm that inhibition of Gli1+ cells led to arrest of bone remodelling. Furthermore, immunofluorescence staining identified classical mechanotransduction factor Yap expressed in Gli1+ cells and decreased after suppression of Gli1+ cells. Additionally, conditional ablation of Yap gene in Gli1+ cells inhibited the bone remodelling as well, suggesting Gli1+ cells are force-responsive cells. CONCLUSIONS: Our findings highlighted that Gli1+ cells in PDL directly respond to orthodontic force and further mediate bone remodelling, thus providing novel functional evidence in the mechanism of bone remodelling and first uncovering the mechanical responsive property of Gli1+ cells.


Asunto(s)
Remodelación Ósea/fisiología , Huesos/metabolismo , Huesos/fisiología , Proteína con Dedos de Zinc GLI1/metabolismo , Animales , Diferenciación Celular/fisiología , Mecanotransducción Celular/fisiología , Ratones , Ratones Transgénicos , Osteoclastos/metabolismo , Osteoclastos/fisiología , Ligamento Periodontal/metabolismo , Ligamento Periodontal/fisiología , Estrés Mecánico , Técnicas de Movimiento Dental/métodos
2.
PLoS One ; 15(4): e0231492, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32320408

RESUMEN

OBJECTIVE: This meta-analysis aimed at critically assessing currently available evidence regarding the overall effectiveness of Piezocision in accelerating orthodontic tooth movement, as well as the adverse effects of this intervention in orthodontic patients. SEARCH METHODS: Electronic search of 6 databases and additional manual searches up to April 2019 without restrictions, also update the search was done by 20th November. SELECTION CRITERIA: Randomized controlled trials (RCT) and controlled clinical trials (CCT) reporting piezocision-assisted orthodontics versus conventional orthodontics were included in the review. DATA COLLECTION AND ANALYSIS: The data are expressed by mean differences (MD), 95% confidence intervals, fixed-effect model or random-effect model in the meta-analysis in regard to statistical heterogeneity analyses (tau2, and I2). Included randomized studies were assessed for risk of bias using the new Cochrane Risk of Bias tool (ROB.2) and the non-randomized studies were assessed using (ROBINS I) tool. The studies were graded according to the GRADE approach. RESULTS: Fourteen papers for 13 unique trials were included in this systematic review and eight studies were included in the meta-analysis. The meta-analysis showed that the mean difference of the canine retraction rate in the first and second month after piezocision was 0.66 mm/month and 0.48mm/month, respectively. A total canine retraction rate in the first two months after piezocision was statistically significant (0.57 mm/month, p<0.00001), favoring the piezocision group with a high heterogeneity between studies I2 = 69%. For the total treatment time outcome measure, there was a statistically significant difference in the overall treatment time (MD 101.64 Days, 95% CI, 59.24-144.06) favoring the piezocision group. CONCLUSIONS: Low quality evidence suggests that piezocision is an effective surgical procedure in accelerating the rate of canine retraction in the first two months and reducing the treatment duration. However, this effect appears to be clinically insignificant. SYSTEMATIC REVIEW REGISTRATION: CRD42019136303.


Asunto(s)
Técnicas de Movimiento Dental/métodos , Ensayos Clínicos como Asunto , Humanos , Ortodoncia/métodos , Ensayos Clínicos Controlados Aleatorios como Asunto
3.
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
4.
BMC Oral Health ; 20(1): 22, 2020 01 28.
Artículo en Inglés | MEDLINE | ID: mdl-31992277

RESUMEN

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


Asunto(s)
Proceso Alveolar/cirugía , Trasplante Óseo/métodos , Ortodoncia Correctiva/métodos , Procedimientos Quirúrgicos Ortognáticos/métodos , Osteogénesis/fisiología , Osteotomía/métodos , Aumento de la Cresta Alveolar/métodos , Humanos , Ortodoncia Correctiva/instrumentación , Técnicas de Movimiento Dental/métodos , Resultado del Tratamiento
5.
Comput Methods Biomech Biomed Engin ; 23(7): 295-302, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-31985276

RESUMEN

The objective of this study was to assess the biomechanical effects of different corticotomy designs used for orthodontic anterior retraction through finite element analysis. MATERIALS AND METHODS: A basic finite element model simulating retraction of anterior teeth was built reversely from CBCT films of an adult patient with protruded maxillary anterior teeth. Another thirteen FE models were created according to different corticotomy designs varied with site width and the extent of incision. The initial displacement, Von Mises stress and pressure stress of dento-alveolar structures was computerized and analyzed. RESULTS: Corticotomy can increase the initial displacement of anterior segment including teeth and surrounding alveolar bone, change the distribution of Von Mises stress in cancellous bone and the pressure stress in periodontal ligament of anterior teeth. When the incision was near the periphery of apical, the anterior segment showed the greatest displacement, the cancellous bone at either sockets or incision region showed the maximum stress. Bilateral incision combined with palatal incision showed approximate initial displacement and stress distribution with circumscribing incision. While the incision width increased, the biomechanical effects of corticotomy amplified. CONCLUSIONS: Varied corticotomy designs can change the biomechanical effects on dento-alveolar structures. The incision near the periphery of apical and bilateral incision combined with palatal incision may be the optimized design used for retraction of anterior teeth.


Asunto(s)
Análisis de Elementos Finitos , Técnicas de Movimiento Dental/métodos , Adulto , Fenómenos Biomecánicos , Humanos , Maxilar/cirugía , Ligamento Periodontal/cirugía , Estrés Mecánico , Diente/cirugía
6.
Oral Maxillofac Surg Clin North Am ; 32(1): 15-26, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31685344

RESUMEN

Impacted teeth occur in a significant number of patients. Their management requires coordinated efforts of orthodontists and oral and maxillofacial surgeons. Specifically, optimal results require a prompt orthodontic diagnosis and treatment plan with execution of either closed or open exposure of impacted teeth by the oral and maxillofacial surgeon. Failure to consider orthodontic mechanics and proper surgical technique can lead to suboptimal results. Thus, orthodontist/oral and maxillofacial surgeon communication is essential for success and patient education and shared decision-making is mandatory before initiating treatment.


Asunto(s)
Métodos de Anclaje en Ortodoncia , Planificación de Atención al Paciente , Técnicas de Movimiento Dental/métodos , Diente Impactado/cirugía , Humanos , Cirujanos Oromaxilofaciales
7.
Oral Maxillofac Surg Clin North Am ; 32(1): 27-37, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31685345

RESUMEN

As orthodontic treatment has advanced in complexity and in frequency, more recent techniques, using temporary skeletal anchorage, were developed to help correct more severe occlusal and dentofacial discrepancies that were treated with orthognathic surgery alone previously. These techniques have allowed the orthodontist to move teeth against a rigid fixation, allowing for more focused movements of teeth and for orthopedic growth modification. These types of treatments using rigid fixation have allowed for greater interaction between the orthodontist and the oral and maxillofacial surgeon, and have vastly enhanced the treatment planning for the orthodontist in today's society.


Asunto(s)
Métodos de Anclaje en Ortodoncia , Procedimientos Quirúrgicos Ortognáticos/métodos , Planificación de Atención al Paciente , Técnicas de Movimiento Dental/métodos , Humanos , Diseño de Aparato Ortodóncico
8.
Oral Maxillofac Surg Clin North Am ; 32(1): 83-88, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31685346

RESUMEN

Patients and orthodontists seek to reduce treatment time in braces. Rapid canine retraction through dentoalveolar distraction osteogenesis is one of several treatment approaches to reduce treatment in braces. This article provides an overview of technique of dentoalveolar distraction osteogenesis to accomplish rapid canine retraction and associated outcomes. When this treatment protocol is implemented well, rapid canine retraction is achieved predictably with minimal side effects. Although current evidence suggests that adverse sequelae, such as root resorptions and pulp devitalization, are rare, prospective clinical studies that are adequately powered and documenting long-term follow-up of these outcomes are lacking.


Asunto(s)
Procedimientos Quirúrgicos Orales/métodos , Métodos de Anclaje en Ortodoncia , Diseño de Aparato Ortodóncico , Osteogénesis por Distracción/métodos , Osteotomía/métodos , Técnicas de Movimiento Dental/métodos , Humanos , Maxilar , Métodos de Anclaje en Ortodoncia/efectos adversos , Métodos de Anclaje en Ortodoncia/instrumentación , Aparatos Ortodóncicos , Procedimientos Quirúrgicos Ortognáticos , Estudios Prospectivos , Resultado del Tratamiento
9.
J Craniofac Surg ; 31(1): 172-177, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31842074

RESUMEN

This retrospective research aimed to highlight the changes of occlusal plane in Class II hyperdivergent subjects that received cervical headgear treatment and compared them to untreated controls in order to evaluate the occlusal changes that might be connected to a potential mandibular rotation.The sample of this investigation was represented by 20 hyperdivergent Class II subjects (10 males, 10 females; mean age 8.54) corrected by using cervical headgear (treated group) and 21 Class II patients (11 males, 10 females; mean age 8.41) hyperdivergent who had no therapy (control group). Lateral head films were studied for all the patients before treatment (T1) and after therapy (T2) for both groups; cephalometric analysis was used in order to seek the modifications between time points and between groups.Means and standard deviation have been computed for both groups. In order to confront the modification between the time points within the same group the Wilcoxon test was applied. The Mann-Whitney U test was applied to confront the dissimilarities between groups at T2.As a result of the Class II correction by using the cervical headgear treatment the occlusal plane was lowered and flattened compared to T1 and to the control group; the upper molars showed extrusion to the palatal plane, there was a significant forward rotation of mandible and the vertical dimension was not significantly modified. Downward and backward displacement of the upper jaw occurred.


Asunto(s)
Dimensión Vertical , Cefalometría , Niño , Femenino , Cabeza , Humanos , Masculino , Maloclusión de Angle Clase II/terapia , Cuello , Estudios Retrospectivos , Rotación , Estadísticas no Paramétricas , Técnicas de Movimiento Dental/métodos
10.
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
11.
Am J Orthod Dentofacial Orthop ; 156(4): 453-463, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582117

RESUMEN

INTRODUCTION: Extraction of one mandibular incisor in adolescents and adults can simplify orthodontic treatment in 2 major circumstances: (1) severe crowding of the mandibular but not the maxillary incisors, and (2) mild anterior crossbite with good alignment in both arches. Despite its potential advantages, this method has had limited use in most practices. There have been 3 major objections: (1) the possibility of unsightly black triangles because of loss of interdental papilla height, (2) a possible tooth size discrepancy that would affect occlusal relationships, and (3) patient concerns about a visible extraction site. All 3 objections now can be overcome. METHODS: For 37 consecutively treated single-incisor-extraction patients, preparation of the extraction site for the tooth to be extracted was done by tipping it lingually while simultaneously closing the space in front of it. Treatment outcomes and the effect of age at the time of treatment were evaluated. RESULTS: In patients below age 20, this approach eliminated post-treatment black triangles and almost eliminated partial loss of the interdental papilla. It reduced the previously reported prevalence of these problems in patients aged 20-40 years and did not seem to be helpful in those aged over 40 years. This positive effect was achieved because of maintenance of alveolar crest height that supports the interdental papillae. Tooth size discrepancy caused by incisor extraction was largely compensated by the different labio-lingual orientation of maxillary and mandibular anterior teeth. The extraction space quickly disappeared during extraction site preparation. CONCLUSIONS: The new procedure of extraction site preparation described in this paper offers more favorable outcomes for post-treatment prevalence of black triangles in younger patients but shows limited efficacy in older patients. Camouflage of a mild skeletal Class III problem is the major indication for this extraction pattern. About 3% of Icelandic orthodontic patients appear to be good candidates for this treatment, and this finding should be reasonably generalizable to other populations of European descent.


Asunto(s)
Incisivo/cirugía , Mandíbula/cirugía , Extracción Dental/métodos , Técnicas de Movimiento Dental/métodos , Adolescente , Adulto , Anciano , Cefalometría/métodos , Niño , Estética Dental , Femenino , Humanos , Islandia , Incisivo/diagnóstico por imagen , Masculino , Maloclusión de Angle Clase III/terapia , Mandíbula/diagnóstico por imagen , Persona de Mediana Edad , Fotograbar , Resultado del Tratamiento
12.
Am J Orthod Dentofacial Orthop ; 156(4): 512-521.e6, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31582123

RESUMEN

INTRODUCTION: This prospective cohort study aimed to evaluate canine substitution supported by skeletal anchorage as a viable treatment protocol for patients with maxillary lateral incisor agenesis (MLIA) and skeletal Class I or Class III. METHODS: Patients (n = 30) who met the following criteria were recruited: (1) bilateral MLIA or unilateral MLIA with a riziform contralateral incisor with a planned extraction; (2) skeletal Class I or Class III; and (3) dentoalveolar discrepancy in the mandible <5 mm. The archwire sequence routine was administered, combined with a rapid palatal expander, temporary intraoral skeletal anchorage device, and intermaxillary traction with Class III elastics. The results of the cephalometric analyses, peer assessment rating indexes, and the patient's smile self-evaluation using the visual analog scale were compared between initial and final treatments. RESULTS: This study indicated that closing the space in patients with Class I or Class III malocclusion by using temporary intraoral skeletal anchorage devices in the mandible, along with Class III elastics, yielded satisfactory outcomes. Proper occlusion was established by mesialization of the maxillary teeth and correction of the intermaxillary discrepancy, thereby yielding beneficial and significant cephalometric changes after the treatment. The soft tissue profile was maintained when it was harmonious before the treatment and improved posttreatment in patients in whom the profile was initially inharmonious. All occlusions improved, as evidenced by the peer assessment rating index. Smile esthetics were also enhanced after orthodontic treatment for all patients. CONCLUSIONS: Canine substitution may be safely offered to patients with Class I and Class III skeletal pattern and MLIA.


Asunto(s)
Anodoncia/terapia , Diente Canino , Maloclusión de Angle Clase III/terapia , Maloclusión de Angle Clase I/terapia , Métodos de Anclaje en Ortodoncia/métodos , Técnicas de Movimiento Dental/métodos , Adolescente , Cefalometría , Niño , Terapia Combinada , Estética Dental , Aparatos de Tracción Extraoral , Femenino , Humanos , Masculino , Técnica de Expansión Palatina , Estudios Prospectivos , Resultado del Tratamiento , Escala Visual Analógica , Adulto Joven
13.
Am J Orthod Dentofacial Orthop ; 156(3): 326-336, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474262

RESUMEN

INTRODUCTION: Orthodontic mini-implants aid in the correction of distocclusions via direct anchorage (pull from mini-implant to teeth) and indirect anchorage (teeth pulled against other teeth anchored by the mini-implant). The aim of this study was to compare stress levels on the periodontal ligament (PDL) of maxillary buccal teeth in direct and indirect distalization against orthodontic mini-implants and accounting for individual variation in maxillary anatomy and biomechanical characteristics of the compact bone. METHODS: A 3D model of the maxilla containing the different components (teeth, PDL, trabecular and cortical bones) was generated from a computed tomographic scan. Cortical bone was divided into several areas according to previously defined zones. Bone stiffness and thickness data, obtained from 11 and 12 cadavers, respectively, were incorporated into the initial model to simulate the individual cortical bone variation at the different locations. Subsequently, a finite element analysis was used to simulate the distalization modalities. RESULTS: Stresses at the buccal, palatal, mesial, and distal surfaces were significantly different between adjacent teeth under stiffness but not thickness variation. In both distalization modalities, low or no significant correlations were found between stress values and corresponding cortical bone thicknesses. High significant and inverted correlations were observed at the first molar between stress amounts and cortical bone stiffness (direct modality: -0.68 < r < -0.72; indirect modality: -0.80 < r < -0.82; P <0.05). CONCLUSIONS: With the use of a novel finite element approach that integrated human data on variations in bone properties, findings suggested that cortical bone stiffness may influence tooth movement more than bone thickness. Significant clinical implications could be related to these findings.


Asunto(s)
Análisis del Estrés Dental/métodos , Análisis de Elementos Finitos , Técnicas de Movimiento Dental/métodos , Fenómenos Biomecánicos , Tornillos Óseos , Simulación por Computador , Implantes Dentales , Humanos , Imagenología Tridimensional/métodos , Maxilar/anatomía & histología , Maxilar/diagnóstico por imagen , Modelos Anatómicos , Diente Molar , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Diseño de Aparato Ortodóncico , Ligamento Periodontal , Estrés Mecánico , Técnicas de Movimiento Dental/instrumentación , Torsión Mecánica
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): 355-364, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474265

RESUMEN

INTRODUCTION: The aim of this work was to analyze data of patients with failed or delayed eruption of first and second permanent molars, to assess the effectiveness of the treatment methods used. METHODS: Epidemiologic and clinical data of 125 patients (mean age 14.08 ± 4.04 years) with 197 affected molars (30 first and 167 second molars) were retrospectively analyzed. The treatment outcome was known in 161 molars after patient drop-out (20 patients with 36 molars). The cases were categorized into 8 groups according to the choice of treatment: orthodontic uprighting, surgical-orthodontic uprighting, surgical uprighting, surgical repositioning, surgical exposure, first or second molar extraction, third molar extraction, or removal of pathologic conditions. RESULTS: The overall treatment outcome was positive in 141 molars (87.6%). It was positive in all cases treated with orthodontic uprighting (7 molars), surgical exposure (10 molars), surgical uprighting (38 molars), and surgical repositioning (8 molars), but it was significantly lower for surgical-orthodontic uprighting (34/48 molars, 70.8%). The positive outcome was significantly lower for inclusion (52/68 molars, 76.5%) than for early-diagnosed condition (11/11 molars, 100%) and retention (78/82 molars, 95.1%), and for total bone crown coverage (21/28 molars, 75.0%) than for osteomucosal or mucosal crown coverage (120/133 molars, 90.2%). CONCLUSIONS: This study demonstrates that an early diagnosis results in a better outcome regardless of the treatment used, with the number of cases with a positive outcome being higher in younger patients.


Asunto(s)
Diente Molar/patología , Anomalías Dentarias , Erupción Dental , Técnicas de Movimiento Dental/métodos , Diente Impactado/terapia , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Italia , Modelos Logísticos , Masculino , Diente Molar/cirugía , Tercer Molar/cirugía , Estudios Retrospectivos , Diente Impactado/diagnóstico , Diente Impactado/cirugía , Resultado del Tratamiento , Adulto Joven
16.
Am J Orthod Dentofacial Orthop ; 156(3): 401-411, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31474270

RESUMEN

A 24-year-old man presented with a severe skeletal class III malocclusion, associated with an anterior and posterior crossbite in the left side, upper and lower lip eversion, skeletal asymmetry, midline discrepancy, diastemas in the maxillary and mandibular dental arches, and agenesis of maxillary lateral incisors and canines with retained deciduous teeth. Treatment was performed with the use of the Win Lingual System. When the 0.016 × 0.022-inch NiTi archiwire was applied, the deciduous teeth were extracted and replaced with temporary crowns connected to the appliance. After the aligning, leveling, and diastema closure phases, a modified Le Fort II osteotomy, a mandibular setback with a bilateral sagittal split osteotomy and a genioplasty were performed. Implants were placed in the canine site through a flapless guided surgery, and cantilevered temporary bridges were delivered. Final prosthetic rehabilitation included veneers for the central incisors and zirconia-ceramic cantilevered bridges for the canine and lateral incisors. After 36 months of active treatment, the patient showed an Angle Class I molar and canine relationship and an ideal overbite and overjet. His profile had improved, lips were competent, and gingival levels were acceptable. The lateral radiograph and cephalometric analysis showed a good balance of the skeletal pattern, a good profile of the soft tissue, and proper inclinations of the maxillary and mandibular incisors in relation to maxilla and mandible. After 2 years of follow-up, the patient had a pleasant smile and no relapse, or joint or muscular pain.


Asunto(s)
Anodoncia/complicaciones , Maloclusión de Angle Clase III/terapia , Diseño de Aparato Ortodóncico/instrumentación , Diseño de Aparato Ortodóncico/métodos , Aparatos Ortodóncicos , Adulto , Cefalometría , Diente Canino , Implantación Dental Endoósea , Implantes Dentales , Modelos Dentales , Diastema/cirugía , Diastema/terapia , Estética Dental , Humanos , Incisivo , Labio , Masculino , Maloclusión de Angle Clase I/complicaciones , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/rehabilitación , Maloclusión de Angle Clase III/cirugía , Mandíbula/cirugía , Maxilar/cirugía , Diente Molar , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Soportes Ortodóncicos , Alambres para Ortodoncia , Osteotomía , Sobremordida/terapia , Radiografía Panorámica , Técnicas de Movimiento Dental/instrumentación , Técnicas de Movimiento Dental/métodos , Adulto Joven
17.
Am J Orthod Dentofacial Orthop ; 156(2): 203-209, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375230

RESUMEN

INTRODUCTION: The objective of this clinical prospective study was to evaluate the effect of the 2 treatment strategies, translation or controlled tipping, followed by root correction on canine retraction efficiency, specifically canine movement rate. METHODS: Twenty-one patients who needed bilateral maxillary canine retraction to close extraction space as part of their treatment plan were selected for this study. Segmental T-loops designed for controlled tipping or for translation were applied randomly to each side. Two digital maxillary dental casts (taken before and after treatment) were used to measure the tooth displacements of each patient. The coordinate system located at the center of canine crown on the pretreatment model with the 3 axes defined in the mesial-distal (M-D), buccal-lingual, and occlusal-gingival directions was used to express the 6 tooth displacement components. The movement rates on the occlusal plane and in the M-D direction were computed. Movement rates were calculated by dividing the M-D displacements or the resultant displacement on the occlusal plane with the corresponding treatment time. RESULTS: T-Loops for controlled tipping moved canines faster (33.3% on occlusal plane and 38.5% in the M-D direction) than T-loops for translation. The differences were statistically significant (P = 0.041 on the occlusal plane and 0.020 in the M-D direction). CONCLUSIONS: Moment-to-force ratio (M/F) affects the canine movement rate in a maxillary canine retraction treatment with the use of a segmented T-loop mechanism. Within the neighborhood of the ratio for translation, lower M/F moves the canine faster than higher M/F both on the occlusal plane and in the M-D direction.


Asunto(s)
Diente Canino , Estrés Mecánico , Técnicas de Movimiento Dental/métodos , Adolescente , Adulto , Fenómenos Biomecánicos , Diente Canino/anatomía & histología , Femenino , Análisis de Elementos Finitos , Humanos , Masculino , Maxilar , Diseño de Aparato Ortodóncico , Estudios Prospectivos , Corona del Diente , Adulto Joven
18.
Am J Orthod Dentofacial Orthop ; 156(2): 210-219, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375231

RESUMEN

INTRODUCTION: More patients are choosing customized orthodontic appliances because of their excellent esthetics. It is essential that clinicians understand the biomechanics of the tooth movement tendency in customized lingual orthodontics. This study aimed to evaluate the tooth movement tendency during space closure in maxillary anterior teeth with the use of miniscrew anchorage in customized lingual orthodontics with various power arm locations. METHODS: Three-dimensional finite element models of the maxilla were created with miniscrews and power arms; the positions were varied to change the force directions. A retraction force (1.5 N) was applied from the top of the miniscrews to the selected points on the power arm, and the initial displacements of the reference nodes of the maxillary teeth were analyzed. RESULTS: After applying force in different directions, power arms located at the distal side of the canines led to larger initial lingual crown tipping and occlusal crown extrusion of the maxillary incisors compared with power arms located at the midpoint between the lateral incisors and canines, and caused a decreasing trend of the intercanine width. CONCLUSIONS: In customized lingual orthodontic treatment, power arms located at the distal side of the canines are unfavorable for anterior teeth torque control and intercanine width control. Power arms located at the midpoint between the lateral incisors and canines can get better torque control, but still cannot achieve excepted torque without extra torque control methods, no matter whether its force application point is higher than, lower than, or equal to the level of the top of the miniscrews.


Asunto(s)
Tornillos Óseos , Análisis de Elementos Finitos , Métodos de Anclaje en Ortodoncia/instrumentación , Métodos de Anclaje en Ortodoncia/métodos , Cierre del Espacio Ortodóncico , Técnicas de Movimiento Dental/instrumentación , Técnicas de Movimiento Dental/métodos , Adulto , Fenómenos Biomecánicos , Simulación por Computador , Diente Canino/patología , Humanos , Imagenología Tridimensional/métodos , Incisivo/patología , Maxilar , Modelos Biológicos , Diseño de Aparato Ortodóncico , Aparatos Ortodóncicos , Soportes Ortodóncicos , Cierre del Espacio Ortodóncico/instrumentación , Cierre del Espacio Ortodóncico/métodos , Alambres para Ortodoncia , Planificación de Atención al Paciente , Estrés Mecánico , Corona del Diente , Torque , Resultado del Tratamiento
19.
Am J Orthod Dentofacial Orthop ; 156(2): 266-274, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375237

RESUMEN

Adult orthodontic treatment involving maxillary transverse deficiency is a challenge for an interdisciplinary team. Surgically assisted rapid palatal expansion to segment the maxilla was once the treatment of choice, but the invasiveness, bone deficiency, and gingival recession hindered its acceptance. Corticotomy-assisted rapid maxillary arch expansion with ridge augmentation has the advantage of augmenting alveolar bony housing to accommodate and facilitate tooth movement. This approach was used to correct a severely constricted maxilla with bilateral posterior crossbite and anterior crowding in a 46-year-old man. Treatment time was 14 months. The accelerated arch expansion overcame the crossbite in 7 months, increasing intercanine distance by 5.2 mm and intermolar distance by 9.8 mm. Subsequent implant prosthesis was able to be restored in a functional normal occlusion. Satisfactory and stable clinical outcome was followed for 7 years. Corticotomy-assisted rapid maxillary arch expansion with alveolar bone augmentation is a novel and effective interdisciplinary approach for correcting adult maxillary transverse deficiency. Well controlled prospective clinical trails are warranted for further investigation.


Asunto(s)
Aumento de la Cresta Alveolar/métodos , Maloclusión/terapia , Técnica de Expansión Palatina , Técnicas de Movimiento Dental/métodos , Cefalometría , Modelos Dentales , Oclusión Dental , Estudios de Seguimiento , Humanos , Masculino , Maloclusión/diagnóstico por imagen , Maloclusión/patología , Maloclusión/cirugía , Maloclusión de Angle Clase II/diagnóstico por imagen , Maloclusión de Angle Clase II/patología , Maloclusión de Angle Clase II/cirugía , Maloclusión de Angle Clase II/terapia , Maloclusión de Angle Clase III/diagnóstico por imagen , Maloclusión de Angle Clase III/patología , Maloclusión de Angle Clase III/cirugía , Maloclusión de Angle Clase III/terapia , Maxilar/anomalías , Maxilar/patología , Maxilar/cirugía , Persona de Mediana Edad , Aparatos Ortodóncicos , Soportes Ortodóncicos , Alambres para Ortodoncia , Paladar (Hueso)/cirugía , Planificación de Atención al Paciente , Estudios Prospectivos , Resultado del Tratamiento
20.
Am J Orthod Dentofacial Orthop ; 156(2): 275-282, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31375238

RESUMEN

This case report describes the interdisciplinary treatment of an ectopic horizontally placed maxillary right central incisor with severe root dilaceration. The root was distally angulated and entrapped by the root of the maxillary right lateral incisor. The initial force system was aimed at an occlusal displacement and applied to the crown. During the second phase, a button was cemented onto the apex of the impacted tooth. A force from the apex to a temporary anchorage device in the palate moved the root toward the midline. Finally, a root canal and an apectomy were performed and the central incisor could be moved to its ideal position. The treatment generated a normal height of the alveolar bone and an ideal occlusion with a healthy periodontium.


Asunto(s)
Incisivo/cirugía , Técnicas de Movimiento Dental/métodos , Raíz del Diente/cirugía , Diente Impactado/cirugía , Diente Impactado/terapia , Fenómenos Biomecánicos , Niño , Tomografía Computarizada de Haz Cónico/métodos , Cavidad Pulpar , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador/métodos , Imagenología Tridimensional , Maloclusión de Angle Clase I/terapia , Maxilar/anatomía & histología , Maxilar/diagnóstico por imagen , Maxilar/cirugía , Aparatos Ortodóncicos Fijos , Extrusión Ortodóncica/métodos , Planificación de Atención al Paciente , Tratamiento del Conducto Radicular , Corona del Diente , Diente Impactado/diagnóstico por imagen , Resultado del Tratamiento
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