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1.
Am J Orthod Dentofacial Orthop ; 159(2): 234-245, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33546828

RESUMO

Autotransplantation of a mature premolar in adults can be a treatment of choice for tooth replacement when combined with well-planned orthodontic treatment. This case report describes the successful treatment of a 39-year-old patient with severe crowding and a hopelessly fractured tooth on the maxillary left side. Maxillary dental crowding was relieved by extraction of a premolar on the right side, and this extracted tooth was autotransplanted to replace the fractured tooth. A mandibular incisor was extracted to correct anterior crossbite. The total treatment period was 20 months. The treatment results showed a good long-term prognosis after transplantation of a mature premolar with normal surrounding alveolar bone level for over 6 years of follow-up. Occlusion and periodontal health were excellent in the long term.


Assuntos
Fraturas dos Dentes , Adulto , Dente Pré-Molar/cirurgia , Humanos , Incisivo , Mandíbula , Maxila , Fraturas dos Dentes/diagnóstico por imagem , Fraturas dos Dentes/cirurgia , Transplante Autólogo
2.
Am J Orthod Dentofacial Orthop ; 159(3): 333-342, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33541786

RESUMO

INTRODUCTION: The purpose of this study was to evaluate the effects of 2 extraction patterns on incisor and molar movements in patients with growing Class II Division 1. METHODS: The sample included 54 patients 10-17 years of age treated by 2 private practice orthodontists using Tweed directional force mechanics, 4 premolar extractions, J-hook headgears, and Class II elastics or Saif springs. The sample was divided on the basis of having maxillary and mandibular first premolars (4/4) or maxillary first and mandibular second premolars (4/5) extracted. Each group included 27 patients. Treatment lasted 2.8 ± 0.60 years and 2.6 ± 0.54 years for the 4/4 and 4/5 groups, respectively. Pretreatment (T1) and posttreatment lateral cephalograms and dental casts were evaluated. Cranial base, mandibular, and maxillary superimpositions were performed to quantify tooth movements and displacements. RESULTS: There were no statistically significant T1 between-group differences in crowding or in the SNA, SNB, ANB, and MPA angles. Analyses of covariance, controlling for statistically significant (P <0.05) differences in T1 mandibular incisor position, showed that mandibular first premolars extractions produced greater (1.6 mm) mandibular incisor retraction than second premolar extractions. The mandibular first molars were protracted significantly more (0.7 mm) after the second premolar than the first premolar extractions. Within-group changes of the MPA, between-group differences in the changes in MPA, and the amount of vertical eruption of the maxillary and mandibular molars were not significantly different between the 2 extraction patterns. CONCLUSIONS: Extraction of mandibular second premolars enhances Class II molar correction, with greater mesial first molar movement and less distal incisor movement. Neither extraction pattern has an effect on the MPA or the vertical dimension (ie, there was no "wedge effect").


Assuntos
Má Oclusão de Angle Classe II , Mandíbula , Dente Pré-Molar/cirurgia , Cefalometria , Humanos , Má Oclusão de Angle Classe II/terapia , Maxila , Dente Molar , Extração Dentária , Técnicas de Movimentação Dentária
3.
Angle Orthod ; 90(3): 457-466, 2020 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378438

RESUMO

Maxillary canine and first premolar transposition is a complicated dental anomaly to treat, especially if the clinician's goal is to orthodontically move the canine into its normal position. Early diagnosis with cone-beam computed tomography simplifies the treatment of this pathology. This case report describes a patient with bilateral transposition, one complete and the other incomplete, involving the maxillary canine and the first premolar (Mx.C.1P). The orthodontic treatment involved the correction of both transpositions. In the complete transposition, the traction was mesial and upward to move the canine into a more apical position with a wider dentoalveolar process for easier crown interchange.


Assuntos
Erupção Ectópica de Dente , Dente Pré-Molar/diagnóstico por imagem , Dente Pré-Molar/cirurgia , Tomografia Computadorizada de Feixe Cônico , Dente Canino/diagnóstico por imagem , Humanos , Maxila/diagnóstico por imagem , Erupção Ectópica de Dente/diagnóstico por imagem , Erupção Ectópica de Dente/terapia
4.
Angle Orthod ; 90(5): 648-654, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378476

RESUMO

OBJECTIVES: To compare the amount of en-masse retraction with or without piezocision corticotomy, to assess the type of tooth movement, to evaluate root integrity after retraction, and to record reported pain levels. MATERIALS AND METHODS: This randomized, controlled clinical trial included 26 orthodontic patients requiring premolar extraction. The patients were divided into two groups: (1) an extraction with piezocision corticotomy group (PCG) and (2) an extraction-only group, which served as the control group (CG). Cone-beam computed tomography images were acquired before and 4 months after the initiation of en-masse retraction utilizing miniscrews. The following variables were assessed: the amount of en-masse retraction, incisor inclination, incisor and canine root resorption, and patient-reported pain. RESULTS: Twelve and 11 participants completed the entire study in the PCG and CG, respectively. The amount of en-masse retraction was significantly greater in the PCG compared to the CG (mean = 4.8 ± 0.57 mm vs 2.4 ± 0.33 mm, respectively [P < .001]). There was also significantly less tipping and root resorption of incisors in the PCG (P < .05). The reported pain was significantly higher on the first day in the PCG compared to the CG (P < .001); however, it became similar between the groups after 24 hours. CONCLUSIONS: Piezocision corticotomy enhanced the amount of en-masse retraction two times more with less root resorption. However, future studies are required to assess the long-term effects of this technique.


Assuntos
Procedimentos de Ancoragem Ortodôntica , Reabsorção da Raiz , Dente Pré-Molar/diagnóstico por imagem , Dente Pré-Molar/cirurgia , Humanos , Incisivo , Reabsorção da Raiz/diagnóstico por imagem , Reabsorção da Raiz/etiologia , Técnicas de Movimentação Dentária
5.
Angle Orthod ; 90(5): 634-639, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378478

RESUMO

OBJECTIVES: To examine the effect of micro-osteoperforation (MOP) on the space closure rate using passive self-ligating or conventional brackets. MATERIALS AND METHODS: This was a two-arm parallel randomized controlled trial undertaken at the outpatient department of a dental college. There were 60 participants (30 women and 30 men) who fulfilled the inclusion criteria. Both the study and control groups were subjected to MOPs throughout the period of space closure. MOPs were repeated every 28 days. The experimental group (mean age 19.5 ± 1.66 years) was bonded with passive self-ligating brackets while the control group (mean age 19.9 ± 1.13 years) was bonded with conventional brackets. Both groups were examined and compared for rate of space closure. An evaluation was conducted for both groups until the entire extraction space was closed and confirmed by evaluation of a tight contact between the canine and the second premolar using a piece of dental floss. RESULTS: Before the initiation of retraction, all initial criteria were similar between the two groups (P > .05). No difference was observed between the two groups in the rate of space closure (P > .05). CONCLUSIONS: MOP in conjunction with passive self-ligation does not increase the rate of orthodontic space closure when compared with MOP used with conventional brackets.


Assuntos
Braquetes Ortodônticos , Fechamento de Espaço Ortodôntico , Adolescente , Adulto , Dente Pré-Molar/cirurgia , Feminino , Humanos , Masculino , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos Fixos , Fios Ortodônticos , Técnicas de Movimentação Dentária , Adulto Jovem
6.
Dental Press J Orthod ; 25(5): 66-84, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33206831

RESUMO

INTRODUCTION: Moderate and severe bimaxillary protrusion impair the passive lip sealing and the facial and smile esthetics. The extraction of premolars can be avoided by the use of skeletal anchorage to retract both dental arches. This approach brings many advantages such as: prevents premolars extraction; simplifies orthodontic mechanics; there is no volume reduction of a premolar when smiling; control of overbite and gingival exposure. The utilization of this therapeutic approach, when associated with self-ligating brackets, can bring the possibility of spacing the appointments without damage to the treatment efficiency, and allows selection of the most appropriate torque prescriptions for each case. The intra-alveolar miniscrews are indicated for mild cases of bimaxillary protrusion, while extra-alveolar miniscrews may also be indicated for more severe cases. OBJECTIVE: To report the treatment of three cases of mild, moderate and severe bimaxillary protrusion, in which intra- and extra-alveolar miniscrews were used, according to the retraction required. CONCLUSION: The retraction of both upper and lower dental arches using orthodontic intra- and extra-alveolar miniscrews, associated with self-ligating brackets, is an excellent tool to correct mild to severe bimaxillary protrusion, thus reducing the need of premolar extraction and simplifying the orthodontic management.


Assuntos
Má Oclusão de Angle Classe II , Má Oclusão , Procedimentos de Ancoragem Ortodôntica , Sobremordida , Dente Pré-Molar/cirurgia , Estética Dentária , Humanos , Técnicas de Movimentação Dentária
7.
Am J Orthod Dentofacial Orthop ; 158(6): e111-e120, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33158633

RESUMO

INTRODUCTION: This single-centered, parallel-groups trial aimed to evaluate the efficacy of traditional corticotomy vs flapless corticotomy in accelerating en-masse retraction. In addition, to assess the skeletal, dental, and soft-tissue variables, as well as the external apical root resorption (EARR) of the maxillary anterior teeth. METHODS: Forty patients with Class II Division 1 malocclusion aged >18 years at the beginning of treatment, requiring maxillary first premolar extractions, were randomly distributed into 2 groups (n = 20 each): 1 group was treated using traditional corticotomy, and the other group was treated with flapless corticotomy in en-masse retraction with anchorage based on miniscrews placed between maxillary second premolars and first molars bilaterally. Randomization was implemented with a computer-generated list of random numbers; allocation was concealed in sequentially numbered, opaque, sealed envelopes. The study was single-blinded (outcomes' assessor). The primary outcome was the en-masse retraction duration. Secondary outcomes were the skeletal, dental, and soft-tissue changes on lateral cephalometric and the EARR of maxillary anterior teeth on digital panoramic radiographs. RESULTS: The en-masse retraction duration in the flapless corticotomy group was longer than the traditional corticotomy group. The average retraction duration was 4.04 ± 1.10 months for the flapless corticotomy group and 3.75 ± 2.14 months for the traditional corticotomy group, with no significant difference between the 2 groups (95% confidence interval [CI], -0.81 to 1.39; P = 0.59). No significant differences were observed between the 2 groups regarding changes in several lateral cephalometric variables (eg, SNA angle [95% CI, -2.55° to 1.66°; P = 0.67], SN-U1 angle [95% CI, -1.70° to 1.32°; P = 0.80], and UL-E [95% CI: -1.33 to 1.00 mm; P = 0.78]) or in the amount of EARR in the maxillary anterior teeth (P = 0.31). The proportion of the observed EARR ranged from 1% to 6% of root length in both corticotomy groups. No serious harms were observed in both groups. CONCLUSIONS: No significant differences between the flapless and traditional corticotomies were found in terms of the skeletal, dental, and soft-tissue variables as well as in the amount of EARR. Corticotomy-assisted en-masse retraction led to improvements in skeletal structures and facial profile and resulted in sufficient retraction of maxillary anterior teeth, slight distal movement of maxillary first molars, and an intrusion movement for both anterior and posterior teeth. Both corticotomy techniques did not cause significant EARR. REGISTRATION: ClinicalTrials.gov (Identifier: NCT03279042). PROTOCOL: The protocol was not published before the trial commencement.


Assuntos
Má Oclusão de Angle Classe II , Procedimentos de Ancoragem Ortodôntica , Adolescente , Dente Pré-Molar/cirurgia , Cefalometria , Humanos , Má Oclusão de Angle Classe II/cirurgia , Maxila/diagnóstico por imagem , Maxila/cirurgia , Técnicas de Movimentação Dentária
8.
Orthod Fr ; 91(3): 191-195, 2020 10 01.
Artigo em Francês | MEDLINE | ID: mdl-33146614

RESUMO

Studies about orthodontic relapse have always confirmed the occurrence of some occlusal changes after orthodontic treatment. The reopening of premolar extraction spaces is one of the most frequently observed movements and would have several origins : gingival folds, root proximities, muscular imbalance... and particularly unstable end of treatment occlusion. The aim of this systematic review was to study the correlation between quality of the occlusal finishing after orthodontic treatment with premolars extraction and reopening of extraction spaces. The review was undertaken according to PRISMA recommendations from the Cochrane Handbook through an electronic consultation of the PubMed database to identify clinical trials that responded to the PICO research question. Five studies met all the inclusion criteria. Three studies used the Peer Assessment Rating (PAR) in assessing the quality of the occlusal finishing. For two of these studies, there is a correlation between poor occlusal finishing and reopening of extraction space. For the other three studies, no cause-and-effect relationship between these two factors has been proven. The divergence of the published results was explained by the fact that the stability of an orthodontic treatment depends on multiple parameters. Further controlled clinical studies should be conducted to objectively evaluate, without interfering with other parameters, the role of occlusal finishing in the long-term stability of orthodontic treatment.


Assuntos
Oclusão Dentária , Extração Dentária , Dente Pré-Molar/cirurgia
9.
Am J Orthod Dentofacial Orthop ; 158(5): 684-693, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33010980

RESUMO

INTRODUCTION: This retrospective pilot study assessed the pre- and posttreatment lip profile changes among adult patients with Class II Division 1 malocclusion of varied growth patterns and compared these changes with patients with a skeletal Class I relationship, to identify the dental, skeletal, and soft tissue cephalometric variables that altered the posttreatment lip profile. METHODS: A total of 33 digital cephalograms were divided into 4 study groups based on the mandibular plane (Mp-SN) angle: group 1 (control, skeletal Class I; mean angle = 21.5°) (n = 8), group 2 (Class II Division 1 malocclusion; low angle = <26°) (n = 8), group 3 (Class II Division 1 malocclusion; intermediate angle = 26°-38°) (n = 9), and group 4 (Class II Division 1 malocclusion; high angle = >38°) (n = 8). RESULTS: We observed a significant decrease in SNA, ANB, maxillary incisor to NA (degrees and millimeters), and soft tissue parameters, especially lip strain and lower lip to E line and upper lip to E line. Posttreatment intergroup comparison showed a significant increase of Mp-SN, and this increase was greater in group 3, followed by group 4 as compared with group 1. In addition, statistically significant differences in SNA, ANB, mandibular incisor to NB (degrees) and IMPA, and H angle in groups 2-4 were observed. CONCLUSIONS: Patients with Class II Division 1 malocclusion showed a significant decrease in SNA, ANB, maxillary incisor to NA, and all soft tissue parameters in posttreatment compared with group 1. Thus, the soft tissue changes resulted in a similar profile to patients in group 1, who are considered to have an aesthetically pleasing posttreatment profile.


Assuntos
Lábio , Má Oclusão de Angle Classe II , Adulto , Dente Pré-Molar/cirurgia , Cefalometria , Humanos , Lábio/anatomia & histologia , Lábio/diagnóstico por imagem , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Projetos Piloto , Estudos Retrospectivos
10.
Niger J Clin Pract ; 23(8): 1110-1119, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32788489

RESUMO

Background: Bimaxillary protrusion is a condition wherein esthetic concerns are the main reason behind seeking orthodontic treatment. Aim: The aim of this retrospective cephalometric study was to evaluate the soft tissue profile and dental changes among female Saudi bimaxillary protrusion patients treated with extraction of all second premolars followed by retraction of the anterior teeth. Subjects and Methods: Pre and posttreatment cephalometric radiographs of adult female patients (ages 18-30 years) who underwent orthodontic therapy for Class I bimaxillary protrusion were obtained. Data were analyzed with SPSS® software. A paired t-test and Pearson's correlation coefficients were conducted with the statistical significance set at 95% (P value < 0.05). Results: At posttreatment, there was an overall decrease in the mean values among the majority of the soft tissue and dental cephalometric angles and linear measurements. Among soft tissue variables, there was a marginal increase in the upper lip length by 1.49 mm (P < 0.001), and the nasolabial angle increased markedly by 7.64° (P < 0.001). Similarly, a marked increase in retroclination by 5.95° (P < 0.001) was observed among the dental variables. Conversely, no significant changes were noted in the lower incisors. Pearson's correlation analysis revealed a significant correlation between all the different dental variables. Within the soft tissue variables, there was a significant positive correlation between changes in the upper lip protrusion, lower lip protrusion, upper lip thickness, and the distance from the upper and lower lips to the S-line.


Assuntos
Dente Pré-Molar/cirurgia , Incisivo , Lábio , Má Oclusão/terapia , Adolescente , Adulto , Cefalometria/estatística & dados numéricos , Estética , Feminino , Humanos , Incisivo/patologia , Lábio/anatomia & histologia , Lábio/patologia , Masculino , Ortodontia Corretiva/métodos , Radiografia , Estudos Retrospectivos , Extração Dentária , Resultado do Tratamento , Adulto Jovem
11.
Am J Orthod Dentofacial Orthop ; 158(4): e5-e15, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32843251

RESUMO

INTRODUCTION: The objective of this research was to evaluate the anterior tooth alignment and dental arch dimension changes after orthodontic treatments with and without premolar extractions in the long-term. METHODS: Fifty-seven patients with Class I and Class II malocclusion were divided into 2 groups. Group 1 included 16 patients treated with nonextraction therapy, with mean initial (T1), final (T2), and long-term follow-up (T3) ages of 13.20 years, 15.07 years, and 50.32 years, respectively. The mean treatment (T2 - T1) and long-term follow-up (T3 - T2) times were 1.86 years and 35.25 years, respectively. Group 2 included 41 patients treated with extraction of 4 first premolars, with T1, T2, and T3 ages of 13.31 years, 15.63 years, and 53.60 years, respectively. The mean treatment and long-term follow-up times were 2.32 years and 37.96 years, respectively. The mean retention time was 2.26 years for both groups. The dental casts were obtained and digitized at T1, T2, and T3 stages. The following measurements were obtained: Little irregularity index, arch length, perimeter, and intercanine, interpremolar, and intermolar widths. Intragroup and intergroup comparisons were performed with repeated measures analysis of variance and t tests, respectively. RESULTS: Anterior tooth irregularity index increased at T3 in both groups. In addition, all arch dimensions, except the intercanine width, were significantly smaller in the extraction group at T3. Both groups showed similar arch dimension changes at T3, except for the mandibular arch perimeter. The percentage of mandibular anterior tooth alignment change was significantly greater in the nonextraction than in the extraction group. CONCLUSIONS: There was no difference in the changes of anterior alignment and transverse arch dimensions in patients treated with and without premolar extraction at T3, but the percentage of mandibular anterior tooth alignment changes was higher in the nonextraction than in the extraction patients at T3. The mandibular arch perimeter showed more of a decrease at T3 in extraction patients.


Assuntos
Arco Dental/diagnóstico por imagem , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Adolescente , Dente Pré-Molar/cirurgia , Cefalometria , Seguimentos , Humanos , Extração Dentária
12.
Dent Med Probl ; 57(2): 157-163, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32633105

RESUMO

BACKGROUND: Class II malocclusion is routinely observed in orthodontics. Its treatment usually revolves around the growth modification or the extractions of the teeth. Identifying treatment that leads to the greatest improvement can aid clinicians in providing the desired smile esthetics. OBJECTIVES: The aim of the study was to compare smile esthetics between treatment groups by measuring various smile variables and the esthetic perceptions of 3 panels of raters. MATERIAL AND METHODS: A cross-sectional study was performed on 66 patients equally divided into the functional appliance (FA) and upper first premolar extraction (UPE) groups. Eight smile variables were measured on post-treatment photographs using the Adobe Photoshop® software. Ten orthodontic residents, general dentists and laypersons performed the subjective evaluations of smiles using the visual analog scale (VAS). The Mann-Whitney U-test was applied to compare smile variables between the groups. The Kruskal-Wallis test was used to compare esthetic scores (ES) among the raters. The simple linear regression analysis, followed by the multiple linear regression analysis was applied to determine the smile variables associated with the ES values. RESULTS: Statistically significant differences were found between the FA and UPE groups for the buccal corridor ratio (BCR) (p = 0.046), the visible dentition width ratio (VDWR) (p = 0.019) and the arch form index (AFI) (p < 0.001). The Kruskal-Wallis test showed significant differences in ES among the raters for the FA (p < 0.001) and UPE (p = 0.004) groups. The simple linear regression analysis showed significant associations between ES and the patient's age (p = 0.002), BCR (p = 0.020) and VDWR (p = 0.006). The multiple linear regression analysis showed that age (p = 0.008) and VDWR (p = 0.021) were significantly associated with the ES values. CONCLUSIONS: The FA group had narrower buccal corridor spaces, a greater visible dentition width and a wider arch form in their smiles. The UPE group showed an increase in the buccal corridor width. Each panel rated the FA appliance group as superior.


Assuntos
Estética Dentária , Ortodontia , Dente Pré-Molar/cirurgia , Estudos Transversais , Humanos , Sorriso
13.
Braz Oral Res ; 34: e003, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32022222

RESUMO

This retrospective study evaluated facial profile pleasantness determined by two protocols of Class II treatment. The sample comprised facial profile silhouettes obtained retrospectively from the pretreatment (T1) and posttreatment (T2) cephalograms of 60 patients (42 males and 18 females) divided into two groups. One group of 30 patients (mean age of 12.84 years) was treated with the extraction of maxillary first premolars (mean treatment time of 2.7 years), and the other group of 30 patients (mean age of 12.81 years) was treated with a mandibular advancement appliance (Forsus) (mean treatment time of 2.49 years). The facial profile silhouettes (T1 and T2) were randomly distributed in an album containing one patient per sheet. The examiners consisted of 60 orthodontists and 60 lay individuals, who analyzed the profiles in regard to facial pleasantness, using the Likert scale. A comparison between stages T1 and T2 of the two treatment protocols and between the examiners was performed by mixed-design analysis of variance at a significance level of 5%. The results demonstrated a significant difference between T1 and T2 (greater scores for T2 compared to T1), and between lay individuals and orthodontists (orthodontists assigned higher scores), but with no significant difference between the treatment protocols. Both protocols produced positive effects on the facial profile esthetics, from the standpoint of lay individuals and orthodontists.


Assuntos
Estética Dentária , Face/patologia , Má Oclusão de Angle Classe II/patologia , Má Oclusão de Angle Classe II/terapia , Extração Dentária/métodos , Adolescente , Análise de Variância , Dente Pré-Molar/cirurgia , Cefalometria , Criança , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Aparelhos Ortodônticos Fixos , Ortodontia Corretiva/métodos , Ortodontistas , Percepção , Estudos Retrospectivos , Estatísticas não Paramétricas , Resultado do Tratamento
14.
J Endod ; 46(1): 29-33, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31735361

RESUMO

INTRODUCTION: Altered sensation is a rare but disturbing adverse event after mandibular premolar and molar periapical surgery procedures, and its incidence is not known. The aim of this study was to determine the incidence of altered sensation after periapical surgery procedures in mandibular premolars and molars. METHODS: This retrospective study includes patients who received periapical surgery in endodontic clinics of a university hospital in the United States. Data were obtained by review of the records for patients who met the inclusion criteria, and statistical analysis of possible predictive factors was performed using the 2-tailed Fisher exact test (α = 0.05). RESULTS: Sixty-two patients (63 teeth, 13 premolars and 50 molars) met the inclusion and exclusion criteria and were analyzed in the study. The first follow-up visit occurred 3 to 37 days after surgery. Altered sensation was observed in 9 patients. Observation of altered sensation was significantly higher (odds ratio = 7.19) after premolar surgeries (5/13) compared with molar surgeries (4/50). CONCLUSIONS: Despite the limited size and retrospective nature of this study, it was concluded that the incidence of altered sensation after periapical surgery appears to be relatively high (14%), with a higher incidence found in premolars compared with molars.


Assuntos
Dente Pré-Molar , Mandíbula , Dente Molar , Transtornos das Sensações , Dente Pré-Molar/cirurgia , Humanos , Incidência , Mandíbula/cirurgia , Dente Molar/cirurgia , Estudos Retrospectivos , Sensação , Transtornos das Sensações/etiologia
15.
J Contemp Dent Pract ; 21(10): 1182-1188, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33686044

RESUMO

AIM AND OBJECTIVE: The study aimed to compare the prospective changes in mandibular third molar angulation in high anchorage cases treated with first premolar extractions vs non-extraction orthodontic treatment. MATERIALS AND METHODS: The sample consisted of 56 nongrowing patients: Group I had 26 patients with a high anchorage requirement who underwent first premolar extractions and group II had 30 patients who underwent non-extraction treatment. Pretreatment, mid-treatment, and posttreatment panoramic radiographs were obtained for group I and pretreatment and posttreatment for group II. Angle between M2 (second molar)-horizontal reference plane (HRP), M3 (third molar)-HRP, and M2-M3 were measured bilaterally. Data were analyzed using Student t test and ANOVA test (p value < 0.05). RESULTS: Statistically significant increase was found between the pretreatment, mid-treatment, and posttreatment values of M2-M3 in group I (p value = 0.02 R and p value = 0.049 L) and between pretreatment to posttreatment values of M2-HRP in group II bilaterally (p value = 0.001). Significant increase was found in the M2-M3 angulations in group II on the right side (p value = 0.036). M3-HRP decreased in group I without reaching statistical significance. No statistically significant intergroup differences were found between the two groups in relation to M2-HRP, M3-HRP, and M2-M3 angulations. CONCLUSION: M2-M3 angulations increased significantly bilaterally in group I and on the right side in group II, indicating worsening of third molar angulation. M3-HRP worsened in group I without reaching statistical significance. Extraction therapy in high anchorage cases does not lead to an improvement in third molar angulation. CLINICAL SIGNIFICANCE: The extraction of first premolars in high anchorage cases does not lead to an improvement in the angulation of mandibular third molars; moreover, the angulation worsened with extraction therapy. Prospective orthodontic patients need to be cautioned against any improvement in mesioangular impaction of mandibular third molars in high anchorage premolar extraction cases.


Assuntos
Dente Serotino , Extração Dentária , Dente Pré-Molar/cirurgia , Humanos , Mandíbula , Dente Molar , Dente Serotino/diagnóstico por imagem , Dente Serotino/cirurgia , Estudos Prospectivos
16.
Niger J Clin Pract ; 22(11): 1530-1538, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31719274

RESUMO

Background: Bimaxillary protrusion is a common dentofacial condition associated with proclination of maxillary and mandibular incisors in relation to the dental and cranial bases resulting in soft tissue procumbency. The present retrospective study aimed to investigate dental and soft tissue profile changes using cephalometric analysis to evaluate bimaxillary protrusion patients after extraction of the first four premolars and subsequent retraction of the anterior teeth. Materials and Methods: Pre-treatment and post-treatment cephalometric radiographs of 46 Saudi patients (16 males and 30 females), 18-30 years of age with bimaxillary protrusion, were selected based on inclusion criteria. Dental and soft tissue landmarks were traced using the Dolphin® imaging software and statistically analyzed with SPSS® 21 software. Results: The upper and lower incisors retroclined by a mean value of 9.6° and 9.65°, respectively, and an average distance of 4.1 mm. The level of maxillary incisor exposure was reduced by approximately 1.1 mm after treatment. A mean increase of 6.6° in the nasolabial angle was also observed. Multiple regression analysis showed that retraction of both upper and lower incisors by 1 mm would result in a 0.44 mm retraction of the upper and lower lips. Conclusion: A statistically significant increase in the nasolabial angle and upper lip length was found in relation to upper and lower incisor retraction and retroclination. A significant reduction was also evident in the post treatment upper incisor exposure, facial convexity angle and mentolabial sulcus depth.


Assuntos
Cefalometria/métodos , Face/anatomia & histologia , Incisivo/anormalidades , Má Oclusão/terapia , Extração Dentária , Adolescente , Adulto , Dente Pré-Molar/cirurgia , Feminino , Humanos , Incisivo/diagnóstico por imagem , Lábio/anatomia & histologia , Masculino , Má Oclusão/etnologia , Maxila , Aparelhos Ortodônticos , Radiografia , Estudos Retrospectivos , Adulto Jovem
17.
Sci Rep ; 9(1): 14549, 2019 10 10.
Artigo em Inglês | MEDLINE | ID: mdl-31601925

RESUMO

We assessed the three-dimensional (3D) pattern of the physiologic drift of the remaining adjacent teeth after premolar extraction due to orthodontic reasons and the associated factors. Data were collected from 45 patients aged 17.04 ± 5.14 years who were scheduled to receive a fixed appliance after maxillary premolar extraction. Seventy-five drift models were obtained and digitalized via 3D scanning. The average physiologic drift duration was 81.66 ± 70.03 days. Angular and linear changes in the first molars, second premolars, and canines were measured using the 3D method. All the examined teeth had tipped and moved towards the extraction space, leading to space decreases. Posterior teeth primarily exhibited significant mesial tipping and displacement, without rotation or vertical changes. All canine variables changed, including distal inward rotation and extrusion. The physiologic drift tended to slow over time. Age had a limited negative effect on the mesial drift of posterior teeth, whereas crowding had a limited positive effect on canine drift. Thus, the mesial drift of molars after premolar extraction may lead to molar anchorage loss, particularly among younger patients. The pattern of the physiologic drift of maxillary canines can help relieve crowding and facilitate labially ectopic canine alignment, whereas canine drift is accelerated by more severe crowding.


Assuntos
Dente Pré-Molar/cirurgia , Imageamento Tridimensional , Extração Dentária , Migração de Dente , Adolescente , Adulto , Cefalometria , Criança , Feminino , Humanos , Masculino , Ortodontia , Análise de Regressão , Adulto Jovem
18.
Int Orthod ; 17(4): 817-825, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31481304

RESUMO

This case report shows the orthodontic treatment of four first premolar extractions of a 14-year-old teenager presenting a dental Class I malocclusion with a severe retrognathic mandible. It reflects conflicting views on objectives between the orthodontist who takes into account the facial balance and the patient who only desires a tooth alignment.


Assuntos
Dente Pré-Molar/cirurgia , Má Oclusão de Angle Classe II/terapia , Má Oclusão de Angle Classe I/terapia , Extração Dentária , Técnicas de Movimentação Dentária/métodos , Adolescente , Pontos de Referência Anatômicos , Cefalometria , Modelos Dentários , Mentoplastia , Humanos , Masculino , Má Oclusão de Angle Classe I/diagnóstico por imagem , Má Oclusão de Angle Classe II/diagnóstico por imagem , Aparelhos Ortodônticos Fixos , Fios Ortodônticos , Osteotomia , Técnicas de Movimentação Dentária/instrumentação , Resultado do Tratamento
19.
Am J Orthod Dentofacial Orthop ; 156(1): 137-147, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256827

RESUMO

A 16-year-old patient sought orthodontic correction for profile improvement and labially inclined maxillary incisors. She had Class II malocclusion, protrusive maxillary and mandibular incisors, and increased overjet and overbite with an American Board of Orthodontics discrepancy index value of 25. She was treated with maxillary premolar extractions and miniscrew-supported en masse retraction assisted with piezoincisions. Extraction spaces (7.5 mm per side) were closed with maximum anchorage in 10 months. Total treatment time was 23 months. Twenty-seven months after debonding, a pink spot was noted at the buccocervial region of the left central incisor. Radiographic evaluation on cone-beam computed tomographic scans revealed a severe case of invasive cervical resorption on both central incisors, around which the piezosurgical cuts had been made. Treatment proceeded with a nonintervention approach and the affected teeth were reinforced with a lingual retainer.


Assuntos
Má Oclusão de Angle Classe II/terapia , Ortodontia Corretiva/métodos , Sobremordida/terapia , Piezocirurgia/efeitos adversos , Adolescente , Dente Pré-Molar/cirurgia , Parafusos Ósseos , Cefalometria , Tomografia Computadorizada de Feixe Cônico , Feminino , Humanos , Incisivo/diagnóstico por imagem , Incisivo/patologia , Incisivo/cirurgia , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/cirurgia , Mandíbula , Maxila/diagnóstico por imagem , Maxila/patologia , Maxila/cirurgia , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos , Braquetes Ortodônticos , Fios Ortodônticos , Sobremordida/diagnóstico por imagem , Sobremordida/cirurgia , Radiografia Panorâmica , Reabsorção da Raiz/etiologia , Técnicas de Movimentação Dentária/métodos , Resultado do Tratamento , Dimensão Vertical
20.
Am J Orthod Dentofacial Orthop ; 155(5): 681-692, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31053284

RESUMO

PURPOSE: The purpose of this study was to determine how micro-osteoperforations (MOPs) affect tooth movements, bone turnover, bone density, and bone volume. METHODS: A split-mouth experimental design with 7 beagle dogs was used to evaluate bone surrounding maxillary second premolars that had been retracted for 7 weeks. One month after the maxillary third premolars were extracted, 8 MOPs (1.5 mm wide and 7 mm deep) were created without flaps with the use of the Propel device (6 were placed 3 mm distal to the second premolar and 2 were placed in the premolar furcation) on one randomly chosen side. The maxillary second premolars were retracted bilaterally with the use of 200 g nickel-titanium closed coil springs. Tooth movements were measured intraorally and radiographically. Microscopic computed tomography was used to evaluate the material density and volume fraction of bone distal to the premolars. Hematoxylin and eosin-stained and fluorescent sections were used to examine the bone remodeling. RESULTS: Neither the intraoral (P = 0.866) nor radiographic (P = 0.528) measures showed statistically significant side differences in tooth movements. There also were no statistically significant differences in the density (P = 0.237) or volume fraction (P = 0.398) of bone through which the premolars were being moved. Fluorescent and histologic evaluations showed no apparent differences in osteoblasts, osteoclasts, or mineralization of bone near the teeth being moved. Bone healing was evident in and near the MOP sites, which had nearly but not completely healed after 7 weeks. Regions of acellular bone were evident extending ∼0.8 mm from the MOP sites. CONCLUSIONS: MOPs placed 3 mm away from teeth do not increase tooth movements and have limited and transitory effect on bone.


Assuntos
Prótese Dentária , Técnicas de Movimentação Dentária/instrumentação , Animais , Dente Pré-Molar/cirurgia , Densidade Óssea/fisiologia , Remodelação Óssea/fisiologia , Planejamento de Prótese Dentária , Cães , Maxila/patologia , Microtomografia por Raio-X
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