Root resorption in relation to a modified piezocision technique.

OBJECTIVES: To evaluate root resorption of lower incisors and canines quantitatively in a group of patients who underwent orthodontic treatment with piezocision and/or a collagen reinforcement technique with a fully resorbable three-dimensional (3D) collagen xenograft matrix compared with a control group. MATERIALS AND METHODS: The study sample of this secondary analysis consisted of 32 periodontally healthy patients with angle Class I malocclusion or mild Class II or III malocclusion and moderate irregularity index scores who underwent orthodontic treatment and had before (T0) and after treatment (T1) cone-beam computed tomography scans. Root resorption of lower incisors and canines was assessed quantitatively in the following four groups: the control group received orthodontic treatment without piezocision, experimental group 1 received orthodontic treatment with piezocision, experimental group 2 received orthodontic treatment with piezocision and a 3D collagen matrix, and experimental group 3 received orthodontic treatment with a 3D collagen matrix. RESULTS: An overall statistically significant decrease in root length from T0 to T1 for all groups was observed (P < .05). However, there was no significant difference among the groups in the amount of root length decrease from T0 to T1. CONCLUSIONS: Orthodontic treatment combined with piezocision does not increase the risk of root resorption of lower incisors and canines when compared with orthodontic treatment without acceleration techniques. More studies with larger samples should be undertaken to confirm these results.

Effect of Conventional Versus Passive Self-Ligating Vestibular Appliances on Torque, Tip and Transverse Dental Changes in Patients Affected by Class I Malocclusion: A Retrospective Study

ABSTRACT Objective: To evaluate the effects of passive self-ligating appliances (PSLAs) and conventional ligating appliances (CLAs) during orthodontic treatment regarding torque, tip, and transversal dental changes. Material and Methods: Dental parameters were digitally acquired from pre- and post-treatment models of each subject belonging to two groups of patients treated with PSLAs (23 patients; 11 females and 12 males with a mean age of 14.2 ± 1.6 years) and CLAs (18 patients; 10 females and 8 males with a mean age of 14.3 ± 1.9 years), respectively. All subjects had Class I or slight Class II malocclusion (= 2mm), permanent dentition and no previous orthodontic treatment. After normality of data was assumed, a paired sample t-test rejected any side differences at T0 and, therefore, the data were grouped by tooth group. Statistical analyses were performed using a linear mixed-effect framework, assuming the appliance, time, and interactions as fixed effects and the tooth type as random effects. Finally, post-hoc effect analysis was used to contrast modeled marginal effects (p<0.05). Results: For both appliances, there is a general increase of both torque and transverse values at T1, especially for PSLAs. Tip shows a general reduction in the lateral sectors for both appliances is registered. The only significant statistical difference referred to appliances' efficacy is located to mandibular intermolar width. Conclusion: Both appliances have an expansive potential for both torque and transverse dental changes. No evident differences are detectable between appliances except for the rate of the mandibular intermolar width increase.

Papillon-Léage and psaume syndrome patient with multiple dental and orofacial anomalies.

Papillon-Léage-Psaume Syndrome, also known as oral-facial-digital syndrome (OFDS) type I, describes a group of neurodevelopmental disorders that are characterized by anomalies of the oral cavity, facial features, and the digits. Central nervous system (CNS) anomalies and visceral organ abnormalities such as kidney, pancreas, and ovarian cysts can also be seen in these patients. Among 13 potential types, female-inherited OFDS type I is the most common and it has been reported to be lethal in males. After the identification of the genetic relation of OFDS in 2001, it is now known that, except X-linked OFDS Type I and VIII, generally all types of OFDSs are autosomal recessive. The dentist's knowledge about the syndrome can reduce the development of physical and dental anomalies by facilitating early diagnosis. This article presents a patient with Papillon-Léage-Psaume Syndrome (Oral-Facial-Digital Syndrome Type I).

Dental anomalies in different growth and skeletal malocclusion patterns.

OBJECTIVES: To evaluate prevalence, distribution, and sexual dimorphism of dental anomalies (DA) among different skeletal malocclusions (SM) and growth patterns (GP) under the hypothesis that specific clinical patterns exist and may indicate common etiological roots. MATERIALS AND METHODS: A total of 1047 orthodontic records of patients older than 8 years were evaluated. The SN-GoGn angle was used to classify GP (hypodivergent, normal, and hyperdivergent), and the ANB angle was used to verify SM (Angle Classes I, II, and III). These assessments were done from lateral cephalometric radiographs. DA were diagnosed using panoramic radiographs by one calibrated investigator. Odds ratios, chi-square, and Student's t-tests were used. RESULTS: Of the subjects, 56.7% were female, with mean age of 16.41 (±10.61) years. The prevalence of DA was 15.7%. Impaction and tooth agenesis were the most prevalent DA, with relative frequencies of 14.4% and 9.7%, respectively. DA were most prevalent in Class III SM (80.8%) and in hypodivergent GP (82.5%), although this was not statistically significant. Tooth agenesis ( P < .01) and microdontia ( P = .025) were significantly more common among hypodivergent GP and Class III SM, respectively. CONCLUSIONS: The results of this study support the idea that DA are preferentially associated with certain patterns of malocclusion.

Longitudinal investigation of relationship between developmental changes in sagittal occlusion and caries in lower first permanent molars.

The aim of the present study was to investigate the relationship between developmental changes in sagittal occlusion and the presence of caries on the occlusal surface of the lower first permanent molars. Dental casts were taken from 60 children at 2-monthly dental examinations after the emergence of the lower first molars through to when they reached 22 years of age. Data on the state of the occlusal surfaces of 120 lower first permanent molars were collected from these examinations and each occlusal surface classified into one of the following two categories: (1) sound, or (2) caries (filled). Sagittal occlusion of the first permanent molars was classified as Angle Class I, II, or III at each developmental stage. The data were analyzed to assess the relationship between changes in the occlusal characteristics and the presence of caries (fillings) in the lower first permanent molars. Of a total of 120 lower first permanent molars, 36 (30.0%) were filled by the end of the study period. Occlusal caries attacks occurred most commonly between 24 and 72 months after emergence of first permanent molars. New occlusal caries continued to occur thereafter, however, even though the teeth had already erupted for as long as 14 and 16 years. A Class II occlusal relationships in the lower permanent molars throughout the study period showed a significantly stronger correlation with caries than when it changed from Class II to Class I. With a Class II occlusal relationship, the percentage of teeth with fillings showed a continual increase, even though those teeth had already been erupted for between 10 and 16 years by the end of the study. These results suggest that occlusal sealing is still indicated for 3 or more years after eruption when the lower first permanent molars occlude in a Class II relationship as their risk for caries remains relatively high.

Mandibular anterior bony support and incisor crowding: Is there a relationship?

INTRODUCTION: The aim of this study was to test the null hypothesis that increased irregularity of the mandibular incisors is associated with a reduction in the alveolar support on cone-beam computed tomographic sections. METHODS: From a sample of 1100 digital volumetric tomographs, 125 tomographs of subjects with Class I malocclusion (mean age, 21.6 ± 4.8 years) were selected for this study. An irregularity index was used to categorize these tomographs as having mild, moderate, or severe crowding. All tomographs were taken by using an iCAT (Imaging Sciences International, Hatfield, Pa) imaging device. The following parameters were measured on the sections corresponding to the 4 mandibular incisors with the iCAT software: height, thickness, and area of the entire symphysis; height, thickness, and area of the cancellous bone of the symphysis; and distance between the vestibular and lingual cortices. For the statistical evaluation, independent samples t test, analysis of variance, and the Tukey HSD test were used at an alpha level 0.05. The Pearson correlation coefficient and a simple linear regression were calculated to determine the relationship between mandibular anterior bony support and incisor crowding. RESULTS: Almost all mandibular anterior bone measurements were greater in the male subjects than in the female subjects (height of the mandibular symphysis, P <0.001; cancellous bone height, P <0.001). Female subjects with mild crowding had higher values for cancellous bone height (P = 0.025) and vestibular cancellous bone thickness (P = 0.004) than did those with severe crowding. However, no differences were detected in the male subjects. Additionally, significant correlations were determined between incisor crowding and thickness of the mandibular symphysis, cancellous bone thickness, and the vestibular part of cancellous bone thickness in female subjects. CONCLUSIONS: Significant relationships were found between the measures of mandibular incisor crowding and basal bone dimensions in female subjects. Except for the vestibular part of cancellous bone thickness, all mandibular incisor bone measurements were greater in the male subjects than in the female subjects.

Etiology and treatment of anterior open bite / Etiologia e tratamento da mordida aberta anterior

The term anterior open bite, which means no contact between anterior teeth, stands out in current orthodontic by the complexity of the treatment, associated with high levels of instability and recurrence. The purpose of this study is to emphasize that early etiological diagnosis is essential to the successful outcome of the technical intervention. The bibliographical study shows that, once the malocclusion in deciduous and mixed dentition is diagnosed, it simplifies the aparatology that is used, decreases the treatment time and conditions are created for a possible self-correction. In the permanent dentition, the authors recommend the removal of the etiological factor and the control of the vertical growth. The diversity of causes requires a multidisciplinary therapeutic approach.

A expressão mordida aberta anterior, que designa ausência de contato entre os dentes anteriores, destaca-se na ortodontia atual pela complexidade do tratamento, associada a altos níveis de instabilidade e recidiva. O objetivo deste trabalho é enfatizar que o diagnóstico etiológico precoce é fundamental para o bom resultado da intervenção técnica. O estudo bibliográfico mostra que, diagnosticada a maloclusão na dentadura decídua e mista, simplifica-se a aparatologia utilizada, diminui-se o tempo de tratamento e criam-se condições para uma possível autocorreção. Na dentadura permanente, os autores recomendam a remoção do fator etiológico e o controle do crescimento vertical. A diversidade de causas requer abordagem terapêutica multidisciplinar.

Má oclusão Classe I de Angle, com mordida aberta anterior, tratada com extração de dentes permanentes / Angle Class I malocclusion, with anterior open bite, treated with extraction of permanent teeth

A mordida aberta é uma anomalia com características distintas que, além da complexidade dos múltiplos fatores etiológicos, traz consequências estéticas e funcionais. Muitas alternativas têm sido utilizadas em seu tratamento, entre elas a grade palatina, forças ortopédicas, ajuste oclusal, camuflagem com ou sem exodontias, mini-implantes ou miniplacas e cirurgia ortognática. O diagnóstico preciso e a determinação da etiologia permitem estabelecer os objetivos e o plano de tratamento ideal para essa má oclusão. O presente relato descreve o tratamento de uma má oclusão Classe I de Angle, com padrão esquelético de Classe II e mordida aberta anterior, realizado em duas fases e que foi apresentado à diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), representando a categoria 2, como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.

Open bite is an anomaly with distinct characteristics which, in addition to involving complex, multiple etiologic factors, entails aesthetic and functional consequences. Many alternative approaches have been employed to treat open bite, including palatal crib, orthopedic forces, occlusal adjustment, camouflage with or without extractions, mini-implants or mini-plates, and orthognathic surgery. By determining accurate diagnosis and etiology professionals can set the goals and ideal treatment plan for this malocclusion. This report, describing the two stages treatment of a Angle Class I malocclusion with Class II skeletal pattern and anterior open bite, was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO), representative of category 2, as partial fulfillment of the requirements for obtaining the title of BBO Diplomate.

Prevalence of malocclusion traits and sucking habits among 3-year-old children.

The aim of the present study was to evaluate the prevalence of malocclusion traits and sucking habits among 3-year-old children. A sample of 457 3-year-old children (234 girls and 223 boys) was obtained from three Public Dental Health clinics in Orebro County Council, Sweden. Data from clinical examination and a questionnaire were used to determine malocclusion traits, sucking habits, snoring and breathing pattern including nocturnal breathing disturbances. The results showed that 70% had one or more malocclusion traits at 3 years of age. The most common malocclusion traits were anterior open bite (50%), Class II occlusion (26%), increased overjet (23%) and posterior crossbite (19%). The prevalence of sucking habit was 66% and dummy sucking was dominating and in connection with more malocclusion traits than finger/thumb sucking. A significant association was found between the sucking habits and the most prevalent malocclusions, anterior open bite, Class II occlusion, increased overjet and posterior crossbite. In conclusion, the prevalence of malocclusion traits in 3-year-old children was high. Sucking habits was highly prevalent and dummy sucking resulted in more malocclusion traits than finger/thumb sucking did.

Mia-assisted orthodontic treatment for dental malocclusion secondary to periodontal disease.

In contemporary dental care, an increasing number of adult patients with periodontal disease are seeking orthodontic treatment. Achieving optimal results in such adult patients is difficult because decreased posterior tooth anchorage is risky. This case report demonstrates the use of miniscrew implant anchorage (MIA) in a Chinese male 21 years 5 months of age with maxillary and mandibular anterior dental spacing, bimaxillary protrusion, and severe bone loss caused by periodontal disease. Prior to orthodontic treatment, the patient underwent treatment to control his periodontitis. The patient was treated with 0.022-in straight-wire orthodontic appliances. After 17 months of active orthodontic treatment, the patient had healthier periodontal tissue with increased bone support, as well as improved facial esthetics and a functional occlusion. The results demonstrate that MIA is useful in enhancing anchorage in patients with bone loss associated with severe periodontal disease.

Ankylosing spondylitis associated with craniomandibular disorder--a combined orthodontic and prosthodontic therapeutic approach.

Ankylosing spondylitis is a disease that causes inflammatory changes of the involved joints. Although the initial clinical signs are pain and discomfort, synovial changes progressively involve all the axial joints, including the temporomandibular joint (TMJ). Eventually, bony alterations develop (condylar erosions, flattening, sclerosis) that affect the position of the condyle, the superior joint space, and the range of movements. These symptoms correlate with the severity of the disease. Besides physiotherapy and surgery, no dental rehabilitation has been reported for these patients. This report of a female patient with ankylosing spondylitis and a TMJ disorder emphasizes dental rehabilitation. The aim of the splint, orthodontic, and prosthodontic treatment was to relieve the subjective symptoms through establishing a stable optimum occlusion. Anamnestic, laboratory, and clinical findings including pre- and postradiographic examination records are presented.

Distribution of malocclusion types among thumb suckers seeking orthodontic treatment.

UNLABELLED: The present study was conducted to evaluate the influence of thumb sucking and its duration on the type of malocclusion. A total of 410 North Indian individuals between ages 12-30 years, 161 males and 249 females were examined. A specially designed proforma was used to record the detailed history of the individual. Among the etiological factors it was found that history of thumb sucking was present in 13.9% and significantly related to Class II div 1 malocclusion. When thumb sucking exceeded 18 months, it was found statistically significant (P < 0.1) in Class II skeletal malocclusion, in open bite (P < 0.1) and in extreme overjet (P < 0.5). CONCLUSION: If thumb sucking is not treated early, it can cause skeletal Class II malocclusion, anterior open bite and excessive overjet.

Surgical and orthodontic conduct in the treatment of mesiodens: a case report.

This article reports a clinical case involving an 8-year-old boy with two mesiodentes. The supernumerary teeth caused both a functional alteration (malocclusion) and an esthetic one (interincisal diastema), both of which affected his quality of living. Surgical removal of the supernumerary teeth and orthodontic follow-up was proposed, in agreement with the treatment established in the literature. This treatment produced satisfactory results in terms of both esthetics and functionality.

Avaliação do índice de Peck Peck em pacientes portadores de maloclusão Classe I e Classe II, primeira divisão de Angle / Evaluation of Peck and Peck index in patients with Angle Class I and Class II division 1 malocclusions

Alterações no tamanho mésio-distal e vestibulo-lingual dos dentes podem significar dificuldade no correto posicionamento dos incisivos na arcada. Este estudo propôs avaliar o equilíbrio dentário através do índice de PECK PECK (1975) em pacientes leucodermas portadores de maloclusão Classe I e Classe II, 1ª divisão de Angle. Foram selecionados 100 modelos de gesso da arcada inferior com apinhamento anterior em graus variados de pacientes não tratados ortodonticamente. As dimensões mésio-distal e véstibulo-lingual dos incisivos inferiores foram mensuradas com auxílio de paquímetro digital com graduação 0,01mm. Os resultados mostraram que o Grupo I apresentou discrepância nos incisivos centrais e laterais esquerdos em 86,67 por cento dos casos, os incisivos centrais direitos apresentaram discrepância em 82,23 por cento e os incisivos laterais direitos em 84,45 por cento dos casos. O Grupo II, 1 apresentou discrepância nos incisivos centrais esquerdos em 89,10 por cento e os incisivos centrais direitos em 87,28 por cento dos casos, os incisivos laterais esquerdos apresentaram discrepância em 83,64 por cento dos casos, uma incidência menor que os incisivos laterais direitos, com 85,46 por cento. Pode-se concluir que os incisivos laterais e centrais esquerdos apresentaram maior incidência de discrepância dentária para a maioria dos casos, quando comparados aos homólogos em ambos os grupos, e houve ausência de correlação total entre homólogos em ambos os grupos.

Talon cusp: report of a case.

Talon cusp is a developmental dental anomaly, normally located on the palatal surface of the anterior teeth, that can occur in both primary and permanent dentition. The aim of this article is to relate a clinical case of talon cusp that interfered with both the occlusion and appearance of the patient. During anamnesis, the patient told of difficulty masticating. Clinical examination revealed labial inclination of the maxillary central incisors, featuring an overjet of about 5 mm, with interposition of the lower lip and an Angle Class I occlusal relationship. A treatment plan was devised in which gradual grinding of both talon cusps, the fitting of a removable orthodontic device, and clinical and radiographic follow-up were carried out.

Simultaneous maxillo-mandibular distraction osteogenesis in hemifacial microsomia: a new technique using two distractors.

BACKGROUND: The goal of this study was to prospectively evaluate the use of two distractors for a simultaneous maxillo-mandibular distraction osteogenesis without the use of intermaxillary fixation in the restorative treatment of hemifacial microsomia. METHODS: The authors analyzed the clinical and radiological data of five patients with type I hemifacial microsomia (one patient), type IIa hemifacial microsomia (two patients), and Goldenhar syndrome (two patients). Follow-up examinations were performed at 1, 3, 6, and 12 months. RESULTS: All the patients had satisfactory correction of the facial asymmetry without complications. Complete horizontalization of the occlusal plane was achieved in three patients, whereas a cant of 2 degrees persisted in two patients. None of the children in this study were noncompliant with the prescribed duration of the active distraction period, nor did they experience technical problems with the two devices. CONCLUSIONS: Simultaneous maxillo-mandibular distraction osteogenesis resulted in a high rate of success in correcting facial asymmetry as well as occlusal plane cant. It offered good aesthetic satisfaction.

Early orthodontic treatment and long-term observation in a patient with Morquio syndrome.

Early orthodontic treatment and long-term observation in a patient with Morquio syndrome were demonstrated. To date, there are no case reports describing orthodontic treatment in such a patient. The patient showed spaced maxillary and mandibular arches with a tongue thrust habit at age seven years eight months. She also showed a protruded upper lip, labial inclination of the upper and lower anterior teeth, and thin enamel. The tongue thrust habit disappeared after the application of a removable orthodontic appliance. The spaced dentition in the upper and lower arches improved after treatment with a fixed appliance with closing loop arch wire (0.017 x 0.025") and bands on the upper and lower molars. We did not use an edgewise appliance because of the thin enamel. The protruded upper lip and labial inclination of the upper and lower anterior teeth were also improved after treatment, but optimal intercuspation of the teeth was not achieved. However, optimal intercuspation of the teeth was achieved after long-term observation and the masticatory function was improved. It was suggested that early orthodontic treatment could improve the malocclusion in a patient with Morquio syndrome and that improvement of masticatory function could be achieved during a long-term retention period.

[Angle class I malocclusion in primary dentition and findings in permanent dentition--a follow-up study].

The aim of the study was to examine stability and changes in Angle Class I malocclusion from deciduous to permanent dentition in 168 subjects. All the subjects had Class I malocclusion in deciduous dentition, and were examined by the same orthodontist on two occasions during deciduous and permanent dentition. None of the subjects had received orthodontic therapy in the meantime. The results showed considerable changes from primary to permanent dentition. Crowding in primary dentition was retained in permanent dentition in 45.2% cases. In 16.2% cases it changed into normocclusion and 38.6% subjects developed other types of malocclusion. Open bite was retained in permanent dentition in 17.8% cases and in 17.8% subjects transformed into normocclusion. 64.4% subjects developed other types of malocclusion. Cross bite was retained in permanent dentition in 21.4% cases and in 28.6% subjects changed to normocclusion. Other types of malocclusion in permanent dentition developed in 50% subjects. In 30.8% of cases finding of premature loss of deciduous teeth was accompanied by extraction of some permanent teeth. Normocclusion was retained in 19.2% cases while 50% of children developed some type of malocclusion. Crowding, which was retained in permanent dentition in 45.2% cases, showed the highest degree of stability. Children with this type of anomaly in primary dentition displayed the highest frequency of total malocclusions (83.3% subjects). Out of all anomalies in primary dentition, cross bite most frequently switched to normal occlusion in permanent dentition (in 28.6% cases).

Mal oclusiones clase I / Class I malocclusions

El ejercicio de la ortodoncia incluye diagnóstico, prevención, intercepción y tratamiento de todas las formas clínicas de maloclusión y anomalías óseas circundantes; además el diseño, aplicación y control de la aparatología terapéutica; cuidado, guía de la dentición y estructuras de soporte con el fin de obtener manteniendo una relaciones dentoesqueleticas óptimas en equilibrio funcional - estético con las estructuras craneofaciales. El objetivo de este trabajo es describir la maloclusión clase I, para transmitir estos conocimientos a todos los profesionales relacionado al área de ortodoncia.

The dental management of a patient with hyperimmunoglobulinemia E syndrome: a case report.

Hyperimmunoglobulinemia E recurrent infection syndrome (also known as Job's syndrome) is a rare multi-system primary immunological disorder in which non-immunological abnormalities of the dentition, bones and connective tissue are also seen. A previous study has reported the occurrence of dental abnormalities in three-quarters of individuals diagnosed as suffering from this condition. The present authors report the case of a boy whose prolonged retention of the primary dentition was associated with delayed eruption of permanent teeth. They emphasize the need for early intervention in order to help minimize later orthodontic problems.