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1.
Prog Orthod ; 22(1): 5, 2021 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-33523325

RESUMO

BACKGROUND: The influence of different biological agents on the rate of orthodontic tooth movement (OTM) has been extensively reviewed in animal studies with conflicting results. These findings cannot be extrapolated from animals to humans. Therefore, we aimed to systematically investigate the most up-to-date available evidence of human studies regarding the effect of the administration of different biological substances on the rate of orthodontic tooth movement. METHODS: A total of 8 databases were searched until the 16th of June 2020 without restrictions. Controlled randomized and non-randomized human clinical studies assessing the effect of biological substances on the rate of OTM were included. ROBINS-I and the Cochrane Risk of Bias tools were used. Reporting of this review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: A total of 11 studies (6 randomized clinical trials and 5 prospective clinical trials) were identified for inclusion. Local injections of prostaglandin E1 and vitamin C exerted a positive influence on the rate of OTM; vitamin D showed variable effects. The use of platelet-rich plasma and its derivatives showed inconsistent results, while the local use of human relaxin hormone showed no significant effects on the rate of OTM. LIMITATIONS: The limited and variable observation periods after the administration of the biological substances, the high and medium risk of bias assessment for some included studies, the variable concentrations of the assessed biological agents, the different experimental designs and teeth evaluated, and the variety of measurement tools have hampered the quantitative assessment of the results as originally planned. CONCLUSIONS AND IMPLICATIONS: Despite the methodological limitations of the included studies, this systematic review provides an important overview of the effects of a variety of biological agents on the rate of tooth movement and elucidates the deficiencies in the clinical studies that have been conducted so far to evaluate the effectiveness of these agents in humans, providing some guidelines for future robust research. TRIAL REGISTRATION: PROSPERO ( CRD42020168481 , www.crd.york.ac.uk/prospero ).


Assuntos
Técnicas de Movimentação Dentária , Dente , Animais , Fatores Biológicos , Humanos , Estudos Prospectivos , Projetos de Pesquisa
3.
Am J Orthod Dentofacial Orthop ; 158(3): 426-442, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32862937

RESUMO

Progressive improvements in digital technology and surgical techniques have synergized the speed, predictability, and favorable outcomes for patients undergoing surgical-orthodontic treatment with handicapping dentofacial deformities. This case report will demonstrate the management of a patient with severe mandibular hypoplasia, condylar hypoplasia, and mandibular asymmetry. The dentofacial deformity, and consequently, the unaesthetic facial appearance, led to psychosocial stress, symptoms of excessive daytime sleepiness, and functional limitations, especially related to mandibular movements. A modified surgery-first approach was used, which was successfully performed using computer-assisted surgical planning. Postsurgical orthodontics was accomplished with the aid of temporary skeletal anchorage mini-plates. An additional alloplastic enhancement of the chin addressed the severe microgenia, which the osseous advancement could not achieve. This resulted in a total advancement of the pogonion by 26 mm yielding a remarkable improvement in the patient's facial esthetics. Furthermore, a considerable improvement in mandibular function and reduction in daytime sleepiness occurred. The severe malocclusion with a discrepancy index value of 47 was treated to a successful final occlusion in 21 months of treatment time.


Assuntos
Assimetria Facial , Má Oclusão , Queixo , Estética Dentária , Humanos , Mandíbula
4.
Prog Orthod ; 21(1): 23, 2020 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-32830306

RESUMO

OBJECTIVES: To evaluate the dental and skeletal effects that occur in the correction of anterior open bite with clear aligners. MATERIALS AND METHOD: In this single-center retrospective study, the mechanism of anterior open bite closure using clear aligners (Invisalign, Align Technology, Santa Clara, CA, USA) was evaluated by cephalometric superimposition based on records of patients consecutively treated by a single, experienced Invisalign provider. Inclusion criteria consisted of anterior open bite (overbite < 0.5 mm), adult patients (18+) at the beginning of treatment, consecutive records, and good quality pre- and post-treatment records, where the required landmarks were clearly visible. RESULTS: A total of 45 patients were included for data analysis with a mean age of 30.73 ± 8.0 years and initial open bite of - 1.21 ± 1.15 mm. During treatment, the upper incisors showed significant (p < 0.05) retraction [U1-SN'(°) = - 10.91 ± 6.95°], [U1-SN'perp(mm) = - 2.57 ± 1.75 mm] and extrusion [U1-SN'(mm) = 1.45 ± 0.89 mm]. The lower incisors also showed significant retraction [IMPA(°) = - 3.73 ± 4.91°), (ΔL1-MP'perp (mm) = - 1.08 ± 1.59] and extrusion (ΔL1-MP'(mm) = 0.53 ± 0.74). Regarding molar position, no significant changes were noted in the anteroposterior position of the upper [ΔU6-SN'perp(mm) = 0.01 ± 1.08 mm] and lower molar [ΔL6-MP'perp(mm) = 0.03 ± 0.87 mm]; however, there was a statistically significant intrusion of the upper [ΔU6-SN'(mm) = - 0.47 ± 0.59 mm] and lower molar [ΔL6-MP'(mm) = - 0.39 ± 0.76 mm]. CONCLUSION: Open bite closure with clear aligners occurred due to a combination of maxillary and mandibular incisor extrusion and maxillary and mandibular molar intrusion, with slight mandibular auto rotation. Significant retraction of maxillary and mandibular incisors was also observed with treatment. Clear aligners are effective in reducing/controlling the vertical dimension in open bite patients.


Assuntos
Má Oclusão de Angle Classe II , Mordida Aberta , Aparelhos Ortodônticos Removíveis , Adulto , Cefalometria , Humanos , Estudos Retrospectivos , Técnicas de Movimentação Dentária , Adulto Jovem
5.
Eur J Orthod ; 42(4): 378-386, 2020 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-32572439

RESUMO

INTRODUCTION: The aim of this study was to investigate the effect of supplemental vibratory force on biomarkers of bone remodelling during orthodontic tooth movement, the rate of mandibular anterior alignment (RMAA), and compliance with a vibration device. DESIGN, SETTINGS, AND PARTICIPANTS: Forty patients between the ages 15-35 undergoing fixed appliance treatment that presented to a university orthodontic clinic were randomly allocated to supplemental use of an intraoral vibrational device (n = 20, AcceleDent®) or fixed appliance only (n = 20). Salivary multiplex assay was completed to analyse the concentration of selected biomarkers of bone remodelling before treatment (T0) and at three following time points (T1, T2, T3), 4-6 weeks apart. Irregularity of the mandibular anterior teeth and compliance was assessed at the same trial time points. Data were analysed blindly on an intention-to-treat basis with descriptive statistics, Mann-Whitney U-test, Wilcoxon signed-rank test, and linear mixed effects regression modelling. RESULTS: No difference in the changes in salivary biomarkers of bone remodelling and RMAA between groups at any time point over the trial duration was observed. No correlation was found between changes in irregularity and biomarker level from baseline to another time point. Lastly, there was no association between RMAA and compliance with the AcceleDent® device. CONCLUSIONS: Supplemental vibratory force during orthodontic treatment with fixed appliances does not affect biomarkers of bone remodelling or the RMAA. LIMITATIONS: The main limitation of the study was the small sample size and the large variability in the salivary biomarkers. HARMS: No harms were observed during the duration of the trial. PROTOCOL: The protocol was not published prior to trial commencement. REGISTRATION: The study was registered in Clinical Trials.gov (NCT02119455) first posted on April 2014.


Assuntos
Aparelhos Ortodônticos Fixos , Técnicas de Movimentação Dentária , Vibração , Adolescente , Adulto , Biomarcadores , Humanos , Aparelhos Ortodônticos , Projetos Piloto , Adulto Jovem
6.
Oral Maxillofac Surg Clin North Am ; 32(2): 297-307, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32151372

RESUMO

Orthodontic treatment of patients with unilateral and bilateral cleft palate requires an extensive interdisciplinary approach to achieve optimal functional and esthetic rehabilitation. Intervention is divided into 3 main stages: early mixed, late mixed, and permanent dentition. Treatment modalities can vary according to developmental stage, severity of cleft, and presence of other dentofacial abnormalities. This article describes the use and efficacy of different orthodontic, orthopedic, and surgical approaches at each developmental stage of unilateral and bilateral clefts, whereby the orthodontist plays a pivotal role in the different phases of growth and development of the cleft lip and the patient.


Assuntos
Fenda Labial/cirurgia , Fissura Palatina/cirurgia , Ortodontia , Estética Dentária , Humanos
7.
Am J Orthod Dentofacial Orthop ; 157(2): 228-239, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32005475

RESUMO

INTRODUCTION: The objective of this study was to assess the reproducibility of cervical vertebral maturation (CVM) method based on the type of radiographic image and the level of experience and level of training of the evaluator. METHODS: Ten evaluators (5 orthodontic residents and 5 faculty members) were randomly divided into 2 groups: trained and untrained. All participants evaluated 80 radiographic images previously acquired in 4 different formats: (1) 2-dimensional (2D) digital (2D-digital), (2) 2D digitized hard copy from the Iowa Facial Growth Study (American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection), (3) 2D digital reconstructed from a 3-dimensional (3D) radiograph (2D-from 3D), and (4) 3D cone-beam computerized tomographic (3D-CBCT) images. Agreement among evaluators on the morphology of the cervical vertebrae (CV) and the CVM stage of each radiographic image was assessed using Randolph's kappa statistic and Kendall's W coefficient of concordance. RESULTS: Interobserver agreement on the determination of a curvature on the inferior border of the CV was substantial to perfect, whereas agreement on shape was fair to moderate. Overall, the level training in all image types, except 3D-CBCTs, but not the level of experience affected the agreement for shape and curvature of the CVs. Interobserver agreement on CVM staging for all combined images was substantial at 0.72. Faculty had a higher level of agreement than residents except for 2D-digital and 3D-CBCT images, whereas trained evaluators had an overall higher level of agreement than untrained evaluators except for 3D-CBCT images. CONCLUSIONS: Interobserver agreement in determining CVM stage was substantial for all images evaluated; experience and training resulted in higher level of agreement for some image types. The 3D-CBCT images did not provide increased interobserver agreement over current 2D-digital lateral cephalograms in determining CVM staging or shape of the CV. The highest agreement in CVM staging was obtained on 2D-digital lateral cephalograms with training.


Assuntos
Cefalometria , Vértebras Cervicais , Tomografia Computadorizada de Feixe Cônico , Ortodontia/educação , Vértebras Cervicais/diagnóstico por imagem , Competência Clínica , Humanos , Imageamento Tridimensional , Iowa , Variações Dependentes do Observador , Reprodutibilidade dos Testes
8.
Oral Maxillofac Surg Clin North Am ; 32(1): 153-165, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31685342

RESUMO

Many of the aesthetic facial procedures can be performed simultaneously at the time of initial orthognathic surgery. Correction of any residual deformities after surgery, such as mandibular notching, malar asymmetry, labiomental crease, and any camouflage treatment, should be performed as a delayed procedure, when the outcome is more predictable. Additionally, these procedures could be used to enhance the orthodontic result, without the need of osteotomies to reposition the bones.


Assuntos
Estética Dentária , Face/cirurgia , Lipectomia , Ortodontia , Procedimentos Cirúrgicos Ortognáticos/métodos , Rinoplastia , Toxinas Botulínicas Tipo A/uso terapêutico , Objetivos , Humanos , Cirurgia Ortognática
9.
Oral Maxillofac Surg Clin North Am ; 32(1): 89-103, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31685343

RESUMO

The surgery-first approach (SFA) has become a recent alternative to the conventional 3-stage approach to orthognathic surgery. Skeletal anchorage in orthodontics has facilitated the resurgence of this treatment sequence. By eliminating the presurgical phase of orthodontic treatment, patients have immediate resolution to their facial deformity. Treatment duration has been shown to be reduced; the difference with the conventional approach being approximately 5 months. Patient satisfaction with this approach is very high as measured by quality-of-life surveys. This article describes the indications and step-by-step approach of this technique in conjunction with virtual surgical planning.


Assuntos
Procedimentos de Ancoragem Ortodôntica , Ortodontia Corretiva , Procedimentos Cirúrgicos Ortognáticos , Planejamento de Assistência ao Paciente , Humanos , Satisfação do Paciente , Qualidade de Vida , Inquéritos e Questionários
11.
Orthod Craniofac Res ; 22(1): 32-37, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30451366

RESUMO

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.


Assuntos
Reabsorção da Raiz/etiologia , Ápice Dentário/anormalidades , Técnicas de Movimentação Dentária/efeitos adversos , Estudos de Casos e Controles , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Masculino , Estudos Retrospectivos , Fatores de Risco , Reabsorção da Raiz/diagnóstico por imagem , Ápice Dentário/diagnóstico por imagem , Adulto Jovem
13.
Case Rep Dent ; 2018: 3542792, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29721340

RESUMO

This case report describes orthodontic camouflage treatment for a 32-year-old African American male patient with Class III malocclusion. The treatment included nonextraction, nonsurgical orthodontic camouflage by en masse distalization of the mandibular teeth using skeletal anchorage devices. The total treatment time was 23 months. Normal overjet and overbite with Class I occlusion were obtained despite the compensated dentition to the skeletal malocclusion. His smile esthetics was significantly improved at the completion of his treatment.

14.
Korean J Orthod ; 48(2): 125-130, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29564222

RESUMO

Traumatic dental injury is considered a public dental health problem because of a high childhood incidence, high treatment costs, and prolonged treatment time. Although management guidelines for traumatized teeth have been outlined, tooth loss following trauma is occasionally unavoidable. Here, we describe the successful interdisciplinary management of a traumatized central incisor in an 11-year old boy that was extracted because of a poor prognosis and restored by the autotransplantation of an immature donor tooth into the site. The patient underwent orthodontic treatment in order to close the donor site space and bring the autotransplanted tooth to an ideal position. Postorthodontic treatment radiographs and photographs revealed an esthetic and functional natural tooth replacing the lost tooth. The findings from this case suggest that autotransplantation offers unique advantages as a treatment modality for the restoration of missing teeth, particularly in growing children.

16.
J Clin Orthod ; 51(9): 547-554, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29130913
19.
Angle Orthod ; 87(5): 717-724, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28594231

RESUMO

OBJECTIVE: To evaluate the effect of corticotomy and corticision, with and without a full mucoperiosteal flap, on the rate of tooth movement and alveolar response in a rat model. MATERIALS AND METHODS: Sixty male, 6-week-old Wistar rats were divided into five groups based on surgical procedure, as follows: control (no tooth movement), orthodontic tooth movement (OTM) only, corticotomy, corticision, and corticision with full mucoperiosteal flap (corticision + flap). A force of 10-15g was applied from the maxillary left first molar to the maxillary incisors using nickel-titanium springs. Surgery was performed at the time of appliance placement (day 0), and tooth movement occurred for 21 days. Micro-computed tomography was performed on day 21 to evaluate the amount of tooth movement and alveolar bone parameters. Histomorphometry, including tartrate-resistant acid phosphatase staining, was performed to quantify the osteoclast parameters at day 21. RESULTS: No statistical differences in the amount of OTM, bone volume fraction, and tissue density and the osteoclast parameters were found among all experimental groups. CONCLUSIONS: Corticotomy and corticision, with or without a full mucoperiosteal flap, did not show a significant effect on either the OTM magnitude or alveolar bone response.


Assuntos
Processo Alveolar/patologia , Processo Alveolar/cirurgia , Maxila/cirurgia , Dente Molar/cirurgia , Cirurgia Ortognática/métodos , Técnicas de Movimentação Dentária/métodos , Processo Alveolar/diagnóstico por imagem , Animais , Fenômenos Biomecânicos , Remodelação Óssea , Reabsorção Óssea/diagnóstico por imagem , Reabsorção Óssea/patologia , Incisivo/diagnóstico por imagem , Incisivo/cirurgia , Masculino , Maxila/diagnóstico por imagem , Modelos Animais , Dente Molar/diagnóstico por imagem , Dente Molar/patologia , Níquel , Fios Ortodônticos , Ortodontia Corretiva/métodos , Osteoclastos/patologia , Osteotomia/métodos , Ratos , Ratos Wistar , Estresse Mecânico , Retalhos Cirúrgicos , Fosfatase Ácida Resistente a Tartarato , Fatores de Tempo , Titânio , Técnicas de Movimentação Dentária/instrumentação , Raiz Dentária/diagnóstico por imagem , Raiz Dentária/patologia , Microtomografia por Raio-X/métodos
20.
Eur J Orthod ; 39(6): 595-600, 2017 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-28371882

RESUMO

Objectives: The aim of this clinical trial was to investigate the duration of mandibular-crowding alleviation with piezotome-corticision orthodontics compared with conventional orthodontics. Design: Single-centre, two-arm parallel group randomized controlled trial. Setting: Orthodontic clinic at the University of Connecticut. Ethical approval: The study was approved by the Institutional Review Board (IRB # 12-0147-2). Subjects and methods: Forty-one adult subjects from a single centre with more than 5mm of mandibular anterior crowding were randomly allocated using block randomization into experimental and control groups. The experimental group received a corticision procedure with a piezotome on the labial aspect of the mandibular incisors in conjunction to a self-ligation fixed orthodontic appliance. The control group received the self-ligation fixed orthodontic appliance and no corticision. Same archwire sequence (0.014 inch followed by 0.014 × 0.025 inch copper-nickel-titanium) was followed for both groups. Mandibular study casts taken every 4-5 weeks were used to assess changes in the irregularity index by blinded outcome assessors. Outcome measures: The time to alignment was calculated in days. Results: Twenty-nine subjects (16 experimental and 13 control) completed the study. Overall, no significant difference in the time required to correct mandibular crowding with piezotome-corticision assisted (102.1 ± 34.7 days; 95% CI, 83.6 to 120.6) and conventional orthodontics (112 ± 46.2 days; 95% CI, 84-139.9) was observed. No complications with treatment or unintended consequences were observed on any of the subjects. Limitations: A high attrition rate. Conclusions: This randomized clinical trial found no evidence that piezotome-corticision assisted orthodontics was more efficient in alleviating mandibular anterior crowding. Registration: ClinicalTrials.gov, Identifier: NCT02026258. Funding: Division of Orthodontics, University of Connecticut. Conflict of Interest: None.


Assuntos
Má Oclusão/terapia , Mandíbula/cirurgia , Piezocirurgia/métodos , Técnicas de Movimentação Dentária/métodos , Adolescente , Adulto , Ligas , Feminino , Humanos , Incisivo , Masculino , Níquel , Desenho de Aparelho Ortodôntico , Braquetes Ortodônticos , Fios Ortodônticos , Método Simples-Cego , Titânio
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