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1.
Am J Orthod Dentofacial Orthop ; 159(5): e389-e397, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33931225

RESUMO

INTRODUCTION: Determination of improvement in orthodontic treatment may depend on the measurement method used and the purpose. METHODS: Improvement after orthodontic treatment (from T1 to T2 [beginning to end of treatment]) was assessed 3 ways from a set of 98 patient records: (1) calculated by subtracting judges' assessments at T2 from T1 for records presented in random order, (2) judged as a holistic impression viewing T1 and T2 records side by side, and (3) determined from proxies (American Board of Orthodontics Discrepancy Index, the American Board of Orthodontics Objective Grading System, and the Peer Assessment Rating index). RESULTS: High levels of intramethod consistency were observed, with intraclass correlation coefficient clustering around an intraclass correlation coefficient of 0.900, and distributions were normal. Calculated and judged improvements correlated at r = 0.606. Calculated or judged improvements were correlated at a lower level with proxies. Calculated improvement was significantly associated with "challenge" (T1) scores and judged improvement associated with "results" (T2) scores. Common method bias was observed, with higher correlations among similar indexes than among indexes at the same time that used various methods. Relative to differences in Peer Assessment Rating scores, calculated improvement overestimated low scores and underestimated high ones. The same effect, but statistically greater, was observed using direct judgment of improvement. CONCLUSIONS: These findings are consistent with decision science and measurement theory. In some circumstances, such as third-party reimbursement and research, operationally defined measures of occlusion are appropriate. In practice, the determination of occlusion and improvement are best performed by judgment that naturally corrects for biases in proxies and incorporates background information.


Assuntos
Má Oclusão , Ortodontia , Assistência Odontológica , Oclusão Dentária , Humanos , Julgamento , Má Oclusão/terapia , Ortodontia Corretiva , Resultado do Tratamento
2.
Am J Orthod Dentofacial Orthop ; 159(4): 512-521, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33795092

RESUMO

INTRODUCTION: This study aimed to evaluate the efficiency of a newly constructed computer-based decision support system (DSS) on the basis of artificial intelligence technology and designed to plan treatment for patients with a deep overbite. METHODS: With the help of information technology, a DSS was developed specifically for treatment planning of deepbite malocclusion. The program inputs were the components and the contributing factors used commonly by the orthodontic clinicians in deepbite diagnosis. The program outputs were the treatment planning options for deepbite treatment. A total of 357 decisions made by the algorithm were evaluated for accuracy by comparing them to the actual treatment changes of 51 patients with a well-treated deepbite. RESULTS: The decisions made by the algorithm were precise, with 94.4% having a very good agreement with actual treatment changes determined using Cohen's kappa coefficient. CONCLUSIONS: The constructed DSS was shown to be an efficient tool for planning treatment of deep overbite malocclusion in the permanent dentition; thus, the artificial intelligence could be used to formulate a customized plan for orthodontic clinicians.


Assuntos
Inteligência Artificial , Má Oclusão , Algoritmos , Cefalometria , Dentição Permanente , Humanos , Má Oclusão/terapia , Mandíbula
3.
Artigo em Inglês | MEDLINE | ID: mdl-33805172

RESUMO

Facial soft tissue esthetics is a priority in orthodontic treatment, and emerging of the digital technologies can offer new methods to help the orthodontist toward an esthetic outcome. This prospective study aimed to assess the soft tissue changes of the face after six months of retention following Rapid Maxillary Expansion (RME). The sample consisted of 25 patients (13 females, 12 males, mean age: 11.6 years) who presented with unilateral or bilateral posterior crossbite requiring RME, which was performed with a Hyrax expander. 3D facial images were obtained before treatment (T0) and at the end of a six-month retention period after the treatment (T1) using a structured-light 3D handheld scanner. Linear and angular measurements were performed and 3D deviation analyses were done for six morphological regions of the face. Significant changes in various areas of the nasal and the upper lip regions were observed. Based on the results of the study and within the limitations of the study, RME with a Hyrax expander results in significant morphological changes of the face after a six-month retention period.


Assuntos
Má Oclusão , Técnica de Expansão Palatina , Criança , Face/diagnóstico por imagem , Feminino , Humanos , Masculino , Má Oclusão/diagnóstico por imagem , Má Oclusão/terapia , Nariz , Estudos Prospectivos
4.
Am J Orthod Dentofacial Orthop ; 159(6): 750-757, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33888377

RESUMO

INTRODUCTION: Maxillary anterior crowding (MxAC) has been considered to be an esthetically favorable characteristic of young women in Japan. It has been hypothesized that laypeople and orthodontists have different esthetic preferences; however, to date, this has not been investigated in detail. Therefore, the present study compared the facial attractiveness of women with MxAC and the interpretation of MxAC among orthodontists and laypeople with and without orthodontic treatment experience in Japan. METHODS: Thirty-eight orthodontists, 42 laypeople with orthodontics (patients), and 43 laypeople without orthodontics (laypeople) evaluated the attractiveness of resting and smiling frontal images of 12 women with MxAC (MxAC models; mean age, 21.7 ± 2.6 years) and 12 women with normal occlusion (normal models; mean age, 20.1 ± 0.7 years) using a visual analog scale. In addition, they responded to a questionnaire that asked them to select the terms most closely associated with MxAC. All evaluators and models were Japanese. RESULTS: For all evaluator groups, the facial attractiveness of the MxAC models was significantly lower than that of the normal models for both the resting and smiling images. For MxAC models, orthodontists evaluated resting images more attractive than smiling images, whereas laypeople evaluated smiling images more attractive than resting images. Significantly more patients and laypeople than orthodontists selected "cute" as the term most closely associated with MxAC (P <0.05). CONCLUSIONS: The orthodontists, patients, and laypeople showed a different tendency in their facial attractiveness preferences. Regardless of their orthodontic experience, the laypeople showed more positive interpretations of MxAC than orthodontists. This finding seems to be influenced by Japanese culture, which values irregularity in nature as one form of beauty.


Assuntos
Má Oclusão , Ortodontistas , Adulto , Atitude do Pessoal de Saúde , Estética Dentária , Feminino , Humanos , Japão , Má Oclusão/terapia , Sorriso , Adulto Jovem
5.
West Afr J Med ; 38(3): 201-205, 2021 03 22.
Artigo em Inglês | MEDLINE | ID: mdl-33764558

RESUMO

BACKGROUND: The aim of this study was to determine the retention practices following orthodontic treatment in a tertiary health institution in Nigeria. METHODS: A retrospective study conducted in the Orthodontic Clinic of the Lagos University Teaching Hospital over a 3-year-period. Data on the type of retainers used and the retention practices in the upper and lower arches were obtained from case files of patients who had completed orthodontic treatment in the institution. Statistical analysis was performed using IBM SPSS software version 23. RESULTS: The demographic variables comprised of 136 subjects; 93 females (68.4%) and 43 males (31.6%). Their ages ranged from 9-44 years with a mean age of 18.96 ± 6.75. Class I malocclusion was the most common malocclusion pattern (84.6%), followed by Class II (10.3%) and Class III (5.1%). Removable retainers were more commonly used and accounted for retention carried out in 85.3% of the study population. There was a preference for the use of removable retainers in the upper arch; the Hawley retainer being the most used (79.4%). In the lower arch however, no form of retention was carried out for majority of the patients after orthodontic treatment (86.8%). However, when done, the fixed lingual retainer was the most frequently used (13.2%). CONCLUSION: The Hawley retainer was the predominant retainer in this study. The fixed lingual retainer was the most frequently used in the lower arch. Longitudinal studies are required to determine efficacy of different types of retention following orthodontic treatment.


Assuntos
Má Oclusão , Contenções Ortodônticas , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Má Oclusão/terapia , Nigéria , Ortodontia Corretiva , Estudos Retrospectivos , Adulto Jovem
8.
J Med Life ; 14(1): 21-31, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33767781

RESUMO

Patients whose with facial appearance involves dental anomalies and malocclusion face an increased prevalence of various psychosocial problems such as a high level of social anxiety, social avoidance, and low quality of life. This study investigates the patients with craniofacial anomalies and their psychological adjustment concerning the facial and dental appearance. It also evaluates the expectations of this patient group from the orthodontic treatment. Two steps were done in this study. In the first step, translation and validation of the Derriford Appearance Scale (DAS59), The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), and Patient Expectation from the Orthodontic Treatment (PEOTQ) questionnaires into Maithili were done, and then the main study was conducted using these valid questionnaires. This was a cross-sectional study conducted on the patients with congenital craniofacial anomalies visiting the orthodontics department of Patna Dental College and Hospital, Patna (Bihar). All the patients received the Maithili DAS, Maithili PIDAQ and Patients' Expectation from the orthodontic treatment questionnaires. The Maithili version of DAS59, PIDAQ and PEOTQ were developed with outstanding reliability and validity. A significant difference between PIDAQ (p<0.001) and DAS59 scores (p<0.001) was found. In females, the total PIDAQ score was significantly higher as compared to males, but there was no association of DAS scores with gender. Place of residence showed no association with PIDAQ and DAS59 scores in patients. Patients and controls had significant differences between various items, and a comparison was made in terms of expectation from the orthodontic treatment. Altered facial and dental appearance in patients with craniofacial anomalies showed a significant psychological impact.


Assuntos
Má Oclusão/psicologia , Anormalidades Maxilofaciais/psicologia , Ortodontia , Adolescente , Adulto , Estudos de Casos e Controles , Estudos Transversais , Escolaridade , Estética Dentária , Feminino , Seguimentos , Humanos , Masculino , Má Oclusão/terapia , Reprodutibilidade dos Testes , Inquéritos e Questionários , Adulto Jovem
9.
J. oral res. (Impresa) ; 10(1): 1-9, feb. 24, 2021. ilus, graf, tab
Artigo em Inglês | LILACS | ID: biblio-1178774

RESUMO

Background: To correlate the need for orthodontic treatment between the self-perception of Chilean adolescents from 14 to 18 years old with the observation of a dentist using the same assessment scale, as well as to determine if covariates such as gender, age and type of school influence the self-perception of the adolescent and the examiner. Material and Methods: Cross-sectional descriptive study of adolescents aged 14 to 18 years from public, subsidized and private schools in Temuco, Chile. The probability sample is stratified by course, from first to fourth year, a total of 414 students participated, according to the eligibility criteria. The photographic score of the aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN) was used. The statistical analysis of the data was performed with the SPSS Statistics program v.23. Results: 94.9% of the adolescents perceived themselves as having good aesthetics. The examiner considered that 77% presented this condition, p<0.00. Males perceived themselves better than females. At age 15, 1.7% of students considered themselves to have poor aesthetics, p<0.01. From the examiner's perspective, aesthetics are related to type of school, p<0.00. Conclusion: Adolescents perceive themselves better aesthetically than do the evaluators. The school type factor, according to the IOTN-AC examiner, shows a higher proportion of students with no need for orthodontic treatment in private schools, and a threshold need in municipal and subsidized institutions.


Correlacionar la necesidad de tratamiento ortodóncico, entre la autopercepción de adolescentes con el diagnóstico de un evaluador odontólogo, utilizando la misma escala de valoración, así también determinar si las variables como el género, la edad y la dependencia educacional influyen en la autopercepción del adolescente y la observación del examinador. Material y Métodos: Estudio descriptivo de corte transversal, en adolescentes de 14 a 18 años de escuelas públicas, subvencionadas y privadas de Temuco-Chile. Muestreo probabilístico estratificado por cursos, de primero a cuarto medio con una muestra de 414 estudiantes, según los criterios de elegibilidad. Se utilizó el score fotográfico del componente estético (AC) del Índice de Necesidad de Tratamiento de Ortodoncia (INTO). El análisis estadístico de los datos fue realizado con el programa SPSS Statistics v.23. Resultados: El 94,9% de los adolescentes se autoperciben con una buena estética, el examinador considera que un 77% presenta esta condición, p<0,00. Los varones se perciben mejor que las damas. Los adolescentes de 15 años un 1,7% considera tener mala estética, p<0,01. Desde la perspectiva del examinador la estética se relaciona con la dependencia educacional, <0,01. Conclusión: Los adolescentes se autoperciben mejor estéticamente que lo diagnosticado por evaluadores odontólogos. El factor dependencia educacional según INTO-AC examinador, muestra mayor proporción de estudiantes sin necesidad de tratamiento ortodóncico en los establecimientos privados, y necesidad límite en los públicos y subvencionados.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Autoimagem , Estudantes/psicologia , Estética Dentária , Ortodontia Corretiva/psicologia , Chile , Saúde Bucal , Epidemiologia Descritiva , Determinação de Necessidades de Cuidados de Saúde , Índice de Necessidade de Tratamento Ortodôntico , Má Oclusão/psicologia , Má Oclusão/terapia
10.
Head Face Med ; 17(1): 4, 2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33546715

RESUMO

BACKGROUND: The purpose of this study was to analyze the relationship between body posture and sagittal dental overjet in children before and after early orthodontic treatment with removable functional orthodontic appliances. METHODS: Angle Class II patients (mean age 8.2 ± 1.2 years; 29 males and 25 females) with a distinctly enlarged overjet (> 9 mm) were retrospectively examined regarding body posture parameters before and after early orthodontic treatment. In addition, changes in overjet were investigated with the aid of plaster models. Forms of transverse dysgnathism (crossbite, lateral malocclusions) and open bite cases were excluded. Body posture parameters kyphosis, lordosis, surface rotation, pelvic tilt, pelvic torsion and trunk imbalance were analyzed by means of rasterstereographical photogrammetry to determine, if the orthodontic overjet correction is associated with specific changes in posture patterns. RESULTS: In nearly all patients an overjet correction and an improvement regarding all body posture and back parameters could be noted after early orthodontic treatment. Overjet reduction (- 3.9 mm ± 2.1 mm) and pelvic torsion (- 1.28° ± 0,44°) were significantly (p < 0.05) and moderately correlated (R = 0.338) with no significant associations found for the other posture and back parameters (p > 0.05). CONCLUSION: Overjet reduction during early orthodontic treatment may be associated with a detectable effect on pelvic torsion.


Assuntos
Má Oclusão Classe II de Angle , Má Oclusão , Aparelhos Ortodônticos Funcionais , Criança , Feminino , Humanos , Masculino , Má Oclusão/diagnóstico por imagem , Má Oclusão/terapia , Má Oclusão Classe II de Angle/diagnóstico por imagem , Má Oclusão Classe II de Angle/terapia , Postura , Estudos Retrospectivos
11.
Am J Orthod Dentofacial Orthop ; 159(4): 453-459, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33573897

RESUMO

INTRODUCTION: The effects of Invisalign clear aligner treatment with and without Dental Monitoring (DM) were compared for treatment duration, number of appointments, refinements and refinement aligners, and accuracy of Invisalign in achieving predicted tooth positions (aligner tracking). The null hypothesis was that there are no differences between Invisalign with and without DM in these parameters. METHODS: A sample of 90 consecutively treated Invisalign patients (45 control, 45 DM) fitted the inclusion and exclusion criteria. Treatment duration, number of refinements, number of refinement aligners, time to first refinement, number of appointments, number of emergency visits, and accuracy of predicted tooth movement were observed for differences. RESULTS: The 2 groups were homogeneous (P >0.05) for sample size, age, gender, Angle classification, maxillary and mandibular irregularity index, and the number of initial aligners. There was a significant (P = 0.001) reduction in the number of appointments by 3.5 visits (33.1%) in the DM group. There was also a significant (P = 0.001) reduction in the time to the first refinement (1.7 months) in the DM group. Compared with Invisalign predicted tooth positions, actual tooth positions were statistically (P <0.05) more accurate for the DM group for the maxillary anterior dentition in rotational movements and mandibular anterior dentition for buccal-lingual linear movement. Invisalign therapy without DM was closer to predicted tooth positions for the maxillary posterior dentition for the tip. None of these differences surpassed the clinically significant thresholds (>0.5 mm or >2°); however, the DM group achieved this in 1.7 fewer months. CONCLUSIONS: DM with Invisalign therapy resulted in a reduced number of appointments by 3.5 visits (33.1%). The DM group also achieved a clinically similar accuracy in obtaining predicted tooth movements compared with the control group in 1.7 fewer months, indicating improved aligner tracking in the DM group.


Assuntos
Má Oclusão , Aparelhos Ortodônticos Removíveis , Humanos , Má Oclusão/terapia , Mandíbula , Estudos Retrospectivos , Técnicas de Movimentação Dentária
12.
Am J Orthod Dentofacial Orthop ; 159(4): e363-e375, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33573898

RESUMO

INTRODUCTION: Rapid palatal expansion is a common therapy during orthodontic treatment and could be a preliminary step for correcting different malocclusions; furthermore, this treatment could be necessary at any age. Different anchorage approaches have been proposed to obtain an effective skeletal result, although every device produces both dental and skeletal effects. This study aimed to compare the dentoskeletal effects of a bone-borne palatal expander considering 2 groups of patients of different ages. METHODS: Twenty-four patients consecutively treated were included in the study; patients were divided into 2 groups according to their age: group 1 with age ≤16 years and group 2 patients >16 years. All patients had a preexpansion cone-beam computed tomography scan; a second scan was required at the end of activations. All patients received a bone-borne appliance anchored on 4 miniscrews. RESULTS: Significant intragroup differences were found for maxillary width and dental diameters. No significant differences were found between groups with regard to longitudinal changes, except for the maxillary right plane. CONCLUSIONS: The use of bone-borne maxillary expansion was effective in generating palatal widening both in growing and young adult patients. No significant skeletal or dental differences were found between groups.


Assuntos
Má Oclusão , Técnica de Expansão Palatina , Adolescente , Tomografia Computadorizada de Feixe Cônico , Humanos , Má Oclusão/diagnóstico por imagem , Má Oclusão/terapia , Maxila/diagnóstico por imagem , Desenho de Aparelho Ortodôntico , Adulto Jovem
13.
Am J Orthod Dentofacial Orthop ; 159(2): e179-e185, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33483219

RESUMO

INTRODUCTION: The study investigated which patient and orthodontic treatment factors act as predictors for the conclusion of the ongoing treatment in a dental clinic of a specialization program in Orthodontics. METHODS: Data were collected from the records of patients treated from 1997 to 2015. Potential predictors for treatment conclusion were investigated: patient-related factors (PRFs) and treatment-related factors (TRFs). PRFs were sex, age, face balance, Angle malocclusion classification, open bite, denture, facial pattern, facial profile, buccal corridor, crossbite, maxillary deficiency, and sagittal mandibular behavior; and TRFs were therapeutic approaches, treatment modality, extractions, and Bolton discrepancy. The initial and final treatment dates were collected. Descriptive data analysis, univariate, and multivariate logistic regression were performed (5% significance). RESULTS: Of the 903 records, 561 patients were included in the study. It was demonstrated that starting the treatment at a young age (PRF) and the presence of crossbite (TRF) are predictive factors for the treatment conclusion. A vertical facial pattern (dolichofacial or brachyfacial) and a greater number of extractions for orthodontic reasons may contribute positively to the conclusion of the treatment. The frequency of treatment inconclusion was higher during the first 2 years of treatment (more than 50% of the patients that initiated the treatment). CONCLUSIONS: Young age at the beginning of treatment and the presence of crossbite malocclusion can increase the chance of treatment conclusion.


Assuntos
Má Oclusão , Mordida Aberta , Estudos de Coortes , Face , Humanos , Má Oclusão/terapia , Mandíbula , Mordida Aberta/terapia , Ortodontia Corretiva
14.
Angle Orthod ; 91(2): 164-170, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-33434276

RESUMO

OBJECTIVES: To investigate the skeletal and dentoalveolar effects of Invisalign's G5 protocol with virtual bite ramps in the treatment of adults with skeletal deep bites. MATERIALS AND METHODS: This retrospective study was conducted on consecutively treated adults presenting with skeletal deep bites as defined by the Overbite Depth Indicator (ODI). Subjects were divided into 2 groups: Invisalign group (n = 24) treated with the Invisalign G5 protocol and a full fixed appliance (FFA) group (n = 24) treated with edgewise FFAs and matched to the Invisalign group by ODI, sex, type of malocclusion, and non-extraction treatment. Pretreatment (T1) and post-comprehensive treatment (T2) lateral cephalograms were obtained and analyzed. RESULTS: Both the Invisalign and FFA groups showed significant changes from T1 to T2 in ODI and other skeletal and dentoalveolar measurements. The mean change in ODI was -1.5° (P < .001) for the Invisalign group and -2.0° (P < .001) for the FFA group. The mean decrease in overbite was 1.3 mm (P < .001) and 2.0 mm (P < .001) for the Invisalign and FFA groups, respectively. The mean increase in mandibular plane angle (Sn-GoGn) was 0.65° (P = .003) for the Invisalign group and 1.15° (P < .001) for the FFA group. When the groups were compared with each other, both ODI (P = .03) and overbite (P = .003) were significantly different in addition to other measurements. CONCLUSIONS: Although FFA treatment had more apparent skeletal changes for deep bite adult patients when compared with Invisalign, both systems were effective in opening deep bites at dentoalveolar and skeletal levels.


Assuntos
Má Oclusão Classe II de Angle , Má Oclusão , Aparelhos Ortodônticos Removíveis , Sobremordida , Adulto , Cefalometria , Humanos , Má Oclusão/diagnóstico por imagem , Má Oclusão/terapia , Mandíbula , Estudos Retrospectivos
15.
BMC Oral Health ; 21(1): 36, 2021 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-33478458

RESUMO

BACKGROUND: The effectiveness of anterior crossbite treatment in preschool-aged children depends on the treatment design and patient compliance. Common early treatment appliances with steel wires and acrylic resin can bring about numerous problems, such as toothache, sore gums and mucous membrane injury. The aim of this study was to propose a new clear removable appliance to provide preschool-age children with an improved experience of early occlusal interference treatment. METHODS: Appliances were designed with the help of 3-dimensional (3D) digital reconstruction oral models and fabricated using 3D printing technology and the pressed film method. Then, the mechanical properties of the original dental coping sheet and thermoformed aligners were assessed in a simulated intraoral environment. Preschool-age participants who displayed anterior crossbite were recruited in this study. Records (photographs and impressions) were taken before the treatment (T1), during the treatment (T2) and at the end of the treatment (T3). The effects of treatment were evaluated by clinical examination and questionnaires. RESULTS: Normal degrees of overbite and overjet in the primary dentition were achieved using this new appliance. Dental and soft tissue relationships were improved. Questionnaires showed that the safety evaluation, degree of comfort and convenience grades of the appliance were all relatively high. CONCLUSION: This explorative study demonstrates that our new clear removable appliance is able to correct early-stage anterior crossbite in a safe, comfortable, convenient and efficient way. Thus, it is a promising method to correct a certain type of malocclusion, and its clinical use should be promoted in the future.


Assuntos
Má Oclusão , Aparelhos Ortodônticos Removíveis , Sobremordida , Criança , Pré-Escolar , Dentição Mista , Humanos , Má Oclusão/terapia , Placas Oclusais
16.
J Clin Pediatr Dent ; 44(6): 459-463, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378471

RESUMO

OBJECTIVE: The aim of this study was to evaluate changes in the mandibular dental arch and incisor alignment induced by combined bonded Rapid Maxillary Expansion (RME) and Face Mask (FM) therapy in the mixed dentition stage in which leeway space was used throughout the treatment. STUDY DESIGN: This retrospective study evaluates pretreatment (T0) and posttreatment (T1) cephalometric radiographs and orthodontic models of 25 patients (mean age: 10.75±2.64), in mixed dentition, having skeletal Class 3 anomaly (ANB<0) with maxillary retrognatism (SNA=77.2±0.68) and bilateral posterior crossbite treated with bonded Hyrax RME-FM. Mean treatment duration was 10.4 months. Dental model measurements were performed using the 3Shape OrthoAnalyzerTM 2013-1 program. Changes in the mandibular incisor and first molar positions were determined on cephalometric radiographs. Statistical evaluation was done with a paired t-test. RESULTS: A significant increase of 1.2 mm was found in intermolar width (p<0.001) in the mandibular dental arch. There was a significant decrease (1.4 mm) (p<0.001) in arch depth and an increase in arch length discrepancy (1.7mm)(p<0.01). There was a significant increase (0.8mm) (p<0.05) in the incisors' irregularity score (LII). IMPA showed a significant decrease (p<0.05). CONCLUSION: Clinicians should be aware that mandibular crowding tends to increase during this type of combined therapy.


Assuntos
Má Oclusão , Máscaras , Adolescente , Cefalometria , Criança , Arco Dental/diagnóstico por imagem , Dentição Mista , Humanos , Má Oclusão/terapia , Maxila , Técnica de Expansão Palatina , Estudos Retrospectivos
17.
Medicine (Baltimore) ; 99(50): e23165, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327234

RESUMO

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.


Assuntos
Má Oclusão/terapia , Aparelhos Ortodônticos Fixos/efeitos adversos , Aparelhos Ortodônticos Removíveis/efeitos adversos , Doenças Periodontais/etiologia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Má Oclusão/classificação , Má Oclusão/diagnóstico , Pessoa de Meia-Idade , Desenho de Aparelho Ortodôntico/tendências , Aparelhos Ortodônticos/provisão & distribuição , Avaliação de Resultados em Cuidados de Saúde , Doenças Periodontais/epidemiologia , Índice Periodontal , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
Angle Orthod ; 90(5): 665-671, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378477

RESUMO

OBJECTIVE: To investigate the value-addition of obtaining lateral cephalometric radiographs during the treatment planning phase of orthodontic treatment. MATERIALS AND METHODS: The records of 100 orthodontic patients were presented to seven scorers during two phases that were 6 weeks apart. In the first phase, scorers completed a seven-question survey with questions regarding treatment planning. They were given various diagnostic records that did not include a lateral cephalometric radiograph. Six weeks later, the same scorers completed the same survey for the same patient cases with the same diagnostic records that additionally included a lateral cephalometric radiograph. Correlation coefficients were used to calculate intrarater agreement and inter-rater agreement within the study. RESULTS: Cohen's kappa values showed moderate to almost perfect agreement for the majority of survey questions. Intrarater agreement ranged between 0.430 and 1. Cronbach's alpha reliability statistics showed good interrater agreement for all questions in the survey. Agreement ranged from 0.710 to 0.913 across the survey questions. Diagnosing Angle classification of occlusion had the highest level of agreement and differentiating between skeletal and dental malocclusion had the lowest level of agreement. CONCLUSIONS: The lateral cephalometric radiograph is not a necessary diagnostic tool for most cases in orthodontic diagnosis and treatment planning. Weighing the usefulness of a lateral cephalometric on a case-by-case basis should be recommended to align with the principle of ALARA (as low as reasonably achievable), especially in a primarily pediatric population.


Assuntos
Má Oclusão , Cefalometria , Criança , Humanos , Má Oclusão/diagnóstico por imagem , Má Oclusão/terapia , Planejamento de Assistência ao Paciente , Radiografia , Reprodutibilidade dos Testes
19.
Angle Orthod ; 90(4): 485-490, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-33378505

RESUMO

OBJECTIVE: To assess the efficacy and efficiency of treatment in adolescents presenting with mild malocclusions, comparing outcomes using clear aligners to fixed appliances. MATERIALS AND METHODS: Patients identified retrospectively and consecutively from one private practice had been treated with either clear aligners (Invisalign, Align Technology, Santa Clara, Calif) or fixed appliances (0.022 Damon, Ormco, Orange, Calif; n = 26/group). Assessments of occlusion were made using the American Board of Orthodontics Discrepancy Index (DI) for initial records and Cast-Radiograph Evaluation (CRE) for final records. Number of appointments, number of emergency visits, and overall treatment time were determined from chart reviews. Data were analyzed using Pearson's correlation, Wilcoxon rank tests, unpaired t-tests, and Chi-square tests, with significance set to P ≤ .05. RESULTS: Pretreatment, the aligner and fixed groups showed no significant difference in overall severity (DI: 11.9 ± 5.3 vs 11.6 ± 4.8) or in any individual DI category. Posttreatment scores showed finishes for the aligner group had fewer discrepancies from ideal relative to the fixed appliance group (CRE: 30.1 ± 8.3 vs 37.0 ± 9.3; P < .01). Patients treated with aligners had fewer appointments (13.7 ± 4.4 vs 19.3 ± 3.6; P < .0001), fewer emergency visits (0.8 ± 1.0 vs 3.6 ± 2.5; P < .0001), and shorter overall treatment time (16.9 ± 5.7 vs 23.4 ± 4.4 months; P < .0001). CONCLUSIONS: Outcomes for treatment of mild malocclusions in adolescents showed equivalent effectiveness of clear aligners compared to fixed appliances, with significantly improved results for clear aligner treatment in terms of tooth alignment, occlusal relations, and overjet. Assessment of the number of appointments, number of emergency visits, and overall treatment time showed better outcomes for treatment with clear aligners.


Assuntos
Má Oclusão , Aparelhos Ortodônticos Removíveis , Adolescente , Humanos , Má Oclusão/terapia , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos Fixos , Avaliação de Resultados em Cuidados de Saúde , Estudos Retrospectivos , Resultado do Tratamento
20.
Am J Orthod Dentofacial Orthop ; 158(6): e121-e136, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33250105

RESUMO

INTRODUCTION: This article evaluates and reports on the satisfaction of adult patients across the United States who received orthodontic treatment for anterior open bite malocclusion. The factors that influence satisfaction are also described. METHODS: Practitioners were recruited from the National Dental Practice-Based Research Network. On joining the Network, practitioner demographics and information on their practices were acquired. Practitioners enrolled their adult patients in active treatment for anterior open bite. Patient demographics, patient dentofacial characteristics, and details regarding previous and current treatment were collected through questionnaires at enrollment (T1). Pretreatment lateral cephalograms and intraoral frontal photographs were submitted. Treatment performed, and details related to treatment outcome were recorded through questionnaires at the end of active treatment (T2). Posttreatment lateral cephalograms and intraoral frontal photographs were submitted. Patient satisfaction at T2 was assessed using a 5-point Likert-type scale and open-ended responses. Predictive univariate models were developed to evaluate the factors that affect patient satisfaction. Open-ended responses were reviewed for general trends. RESULTS: T2 data were received for 260 patients, and 248 of these patients completed and returned the patient satisfaction questionnaires. High levels of satisfaction were found in this sample of adult patients receiving treatment for anterior open bite malocclusion. Specifically, 96% of the sample reported being very or somewhat satisfied. Only 10 patients (4%) were not satisfied with the treatment provided or an element of the final result. Successful open bite closure, treatment modality, and certain patient characteristics may affect patient satisfaction. However, there was insufficient power to demonstrate statistical significance because of the very low number of dissatisfied patients. Open-ended responses directly associated with patient satisfaction were received from 23 patients (9%). They relayed positive, neutral, and negative feelings about the treatment received and final results. Additional responses regarding the orthodontic treatment in general, but not specifically linked to patient satisfaction, were received from 119 patients (48%). These comments depict an overwhelmingly positive experience. CONCLUSIONS: Adult patients who received orthodontic treatment for anterior open bite malocclusion were generally satisfied with the treatment provided, as well as the final esthetic and functional results.


Assuntos
Má Oclusão , Mordida Aberta , Adulto , Estética Dentária , Humanos , Má Oclusão/terapia , Mordida Aberta/terapia , Satisfação do Paciente , Inquéritos e Questionários , Resultado do Tratamento
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