The periodontal status of removable appliances vs fixed appliances: A comparative meta-analysis.

BACKGROUND: Although several researchers have analyzed the dental identity of patients experience with corrective methods using fixed and removable appliances, the consequences stay debatable. This meta-analysis intended to verify whether the periodontal status of removable appliances is similar to that of the conventional fixed appliances. METHODS: Relevant literature was retrieved from the database of Cochrane library, PubMed, EMBASE, and CNKI until December 2019, without time or language restrictions. Comparative clinical studies assessing periodontal conditions between removable appliances and fixed appliances were included for analysis. The data was analyzed using the Stata 12.0 software. RESULTS: A total of 13 articles involving 598 subjects were selected for this meta-analysis. We found that the plaque index (PLI) identity of the removable appliances group was significantly lower compared to the fixed appliances group at 3 months (OR = -0.57, 95% CI: -0.98 to -0.16, P = .006) and 6 months (OR = -1.10, 95% CI: -1.60 to -0.61, P = .000). The gingival index (GI) of the removable appliances group was lower at 6 months (OR = -1.14, 95% CI: -1.95 to -0.34, P = .005), but the difference was not statistically significant at 3 months (OR = -0.20, 95% CI: -0.50 to 0.10, P = .185) when compared with that of the fixed appliances group. The sulcus probing depth (SPD) of the removable appliances group was lower compared to the fixed appliances group at 3 months (OR = -0.26, 95% CI: -0.52 to -0.01, P = .047) and 6 months (OR = -0.42, 95% CI: -0.83 to -0.01, P = .045). The shape of the funnel plot was symmetrical, indicating no obvious publication bias in the Begg test (P = .174); the Egger test also indicated no obvious publication bias (P = .1). CONCLUSION: Our meta-analysis demonstrated that malocclusion patients treated with the removable appliances demonstrated a better periodontal status as compared with those treated with fixed orthodontic appliances. However, the analyses of more numbers of clinical trials are warranted to confirm this conclusion.

[Adult orthodontics for a better prosthesis]. / L'orthodontie adulte pour une meilleure prothèse.

INTRODUCTION: Adult patients are seen more frequently in our orthodontic offices. Unlike the adolescent, the adult patient will often need a multidisciplinary approach due to tooth migrations secondary to extractions or periodontal disease. MATERIALS AND METHODS: This article will address the indications and orthodontic solutions to various restorative problems relative to the adult patient. Specific orthodontic mechanics aimed at facilitating and improving the prosthetic outcomes will be described and illustrated with clinical cases.

Lingual Orthodontics: The future?

The increase in demand for adult orthodontics has been mirrored by an increased availability and demand of cosmetic appliances. This article focuses on one type of cosmetic appliance--the lingual appliance. Factors to consider in case selection as well as the advantages and disadvantages of lingual appliances are discussed. This paper also outlines the sequence of treatment using these appliances by way of two treated cases.

Fabrication of lingual orthodontic appliances: past, present and future.

Lingual orthodontics is increasing in popularity, with more adults receiving orthodontic treatment and opting for truly invisible appliances that do not have any limitations on the type of tooth movement they can achieve. In addition, there are a growing number of children receiving lingual appliances as they have been shown to significantly reduce the incidence of decalcification. Combining this growth in popularity with advances in computer technology, it is possible to treatment plan, design the appliance and have it custom made all with the click of a button. This article highlights the different methods that have been utilized in the fabrication of lingual appliances.

LinguaJet: combinação de bráquetes customizados com a técnica do arco reto / LinguaJet: combination of customized brackets and straight wire technique for lingual orthodontics

O sistema LingualJet representa uma opção técnica paraa Ortodontia lingual com a proposta de se trabalhar com arcos retos, bráquetes customizados e set up digital combinado a recursos deimagem para a previsibilidade de resultados. Este método baseou-seem características anteriormente descritas na literatura, mesclandocaracterísticas do sistema Orapix (arco reto, set up digital) e do sistemaIncognito (bráquetes customizadosl. Oferece precisão e praticidade nabusca pela qualidade de resultados clínicos. O presente artigo tevea proposição de apresentar a técnica, assim como suas vantagens.

The Lingua/Jet System presents a technical option tolingual orthodontics with the proposal to working without bends in thearchwires, customized brackets and digital set up combined to theimaging resources for the results'previsibility. This method is based incharacteristics previously described in the literature, with influence ofthe Orapix System (straight wire, virtual set up) and Incognito System(customized brackets). It offers precision and predictibility, looking forthe high quality for the clinical results. This paper has the objective ofintroduce a new technique and its advantages.

Evaluation of retention protocols among members of the American Association of Orthodontists in the United States.

INTRODUCTION: Little research has been conducted to evaluate protocols and trends in orthodontic retention. The purpose of this study was to identify the general retention protocols used by orthodontists in the United States. Additionally, our goal was to identify trends in these orthodontic retention protocols by evaluating how they have changed over the past 5 years and how they might continue to change in the next 5 years. METHODS: The study was conducted via a 36-question electronic survey (REDCap, Nashville, Tenn) with branching logic on certain questions. The survey was sent to all 9143 practicing members of the American Association of Orthodontists in the United States, and 1632 (18%) responded. RESULTS AND CONCLUSIONS: Mean retention protocols of the surveyed population showed predominant use of Hawley or vacuum-formed retainers in the maxillary arch and fixed retention in the mandibular arch. For both arches, there is a current shift away from Hawley retainers and toward vacuum-formed retainers and fixed retention. Respondents who extract fewer teeth reported increased use of fixed retention in the maxillary (P = 0.041) and mandibular (P = 0.003) arches. Respondents who extract fewer teeth and use removable retainers were more likely to tell their patients to wear their retainers at night for the rest of their lives (P = 1.63 × 10(-6)).

Technological advances in nontraditional orthodontics.

New technological advances have helped the orthodontic profession progress in traditional and surgical methods of treatment. The profession has seen transitions from traditional braces to self-ligating brackets, lingual braces, removable aligners, and more advanced technology, which have helped to address concerns that include but are not limited to better diagnostics, anchorage control, length of treatment, and esthetics. An increase in the number of adult patients seeking orthodontic treatment and the need for a timely efficient care will continue to drive technology and the use of cone beam computed tomography, miniscrews, piezocision, distraction osteogenesis, and bioengineering.

Northcroft lecture: how has the spectrum of orthodontics changed over the past decades?

Three aspects have had a significant impact on orthodontics during the last few decades: the appliances being used, the anchorage being used and finally the distribution of patients being treated. Firstly, the marketing of appliances is increasingly leading the orthodontist to outsource important aspects of treatment such as wirebending and bracket positioning. Brackets and wires are being presented as the solution to all problems and metaphysical terms such as 'intelligent design,' 'working brackets' and 'intelligent wires' are dominating advertising and reducing the impact of evidence-based treatment approaches. Secondly, the introduction of skeletal anchorage has potentially widened the spectrum of orthodontics, allowing for treatments that could not be done with conventional appliances. Biomechanical knowledge is, however, mandatory if we agree that the system should not be abused. Thirdly, the orthodontic population comprises an increasing number of adult patients, many of whom are characterized by a degenerated dentition. The treatment of these patients requires a thorough knowledge not only of biomechanics but also of the reaction of the periodontal tissues to various types of loading. They can be treated only with custom-made appliances adapting the force systems and magnitude to the patient-specific treatment goal. In summary, the orthodontic world is being split between 'appliance-driven fast-food orthodontics' where the results to a large extent are dependent on both growth and function and 'orthodontist-driven' 'slow-food' treatments attempting to push the limits of the possible in relation to complicated problems and reversal of degeneration in adult patients. The latter treatments are performed with individualized appliances adapting the force system to the patient. This paper will attempt to summarize the bearing of these factors on present orthodontics.

Sistemas autoligables de mínima fricción: ¿la fricción imperfecta? / No disponible

Introducción: El uso de brackets autoligables ha crecido exponencialmente en la última década como respuesta a las expectativas generadas en términos de supuestos beneficios al reducir la fricción frente a las técnicas convencionales de ligado con elastómeros. A partir de la modificación de la técnica de ligado y la consiguiente disminución en la fricción clásica los ortodoncistas hemos atribuido a los brackets autoligables una serie de mejoras clínicas. Desafortunadamente gran parte de estos supuestos beneficios no presentan base científica, sino que se apoyan en publicaciones comerciales, con problemas metodológicos que conducen a conclusiones subjetivas guiadas más por el entusiasmo de sus autores y sus experiencias subjetivas, que por los criterios que marca la “ortodoncia basada en la evidencia”. Material y método: Se ha realizado una exhaustiva revisión bibliográfica en diferentes bases de datos electrónicas (Medline, PubMed y Cochrane Library) seleccionando los artículos que mencionaban fricción de autoligables comparada con brackets convencionales. Resultados: Existe una alarmante ausencia de estudios “in vivo”, frente a una gran mayoría de estudios “in vitro” que, mediante la recreación de condiciones ficticias en un laboratorio, valoran la fricción en términos de contacto entre la superficie del bracket, el arco (..) (AU)

Introduction: The use of self-ligating brackets has grown markedly in the last decade in response to the expectations of the reduced friction, supposedly offered by this system in comparision to the friction generated by conventional techniques employing elastomereligation. Based on the modification of the ligation technique with its supposed decrease in classic friction, orthodontists have creditedself-ligating brackets with a series of clinical improvements. Unfortunately, rather than as scientific evidence, most of these supposed benefits have been presented in commercial publications that are plagued by methodological problems that lead to subjective conclusions based more on the autors´s enthusiasm and expectations than on “evidence based orthodontics”. Methods: An exhaustive review of the different free electronic data bases (Medline, PubMed and Cochrane Library) selected articles comparing friction with self-ligating brackets and friction with conventional brackets systems. Results: There is an alarming paucity of “in vivo” studies. The majority of “in vitro” laboratory studies recreate frictional conditions to evaluate friction in terms of contact between bracket surface bracket surface, bracket arch and the ligating (..) (AU)

Pêndulo higiênico de Prieto / Prieto's hygienic pendulum

Dos dispositivos de cooperação mínima, o aparelho pêndulo é um dos que mais satisfaz o clínico, quando se deseja aplicar força de distalização aos molares. Um dos poucos inconvenientes deste aparelho é a necessidade de colaboração do paciente para manter higienizada a região do palato onde repousa o botão de resina acrílica e o fato de que, em alguns casos, ocorre a compressão da mucosa. Visando eliminar os inconvenientes acima citados, este artigo propôs uma forma alternativa de utilização das molas de TMA, com o objetivo de mover os molares para distal. Desta forma, apresentamos um modelo de aparelho distalizador que emprega molas de TMA removíveis, com a eliminação do botão de acrílico e constituindo a unidade de ancoragem apenas com suporte dentário.

Extraoral appliances: A twenty-first century update.

With the locations of the centers of resistance of the dentomaxillary complex having recently been defined, and with the newly acquired knowledge of the critical interplay between part-time extraoral and full-time intraoral force systems, the basic designs of all types of extraoral appliances are discussed in depth. Armed with this information, the clinician can improve the efficiency of all extraoral appliances to obtain better dentomaxillary-complex growth control and negate or enhance appliance-induced intraoral force systems.