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1.
Medicine (Baltimore) ; 100(13): e25181, 2021 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-33787598

RESUMO

ABSTRACT: This retrospective study aimed to explore the effect of orthodontic treatment (ODT) on anterior tooth displacement (ATD) caused by periodontal disease (PD).A total of 72 patients were selected and were divided into a control group (n = 36) and an experimental group (n = 36). Patients in both groups received conventional periodontal treatment. In addition, patients in the experimental group also received ODT. Outcomes include probing depth, percentage of bleeding sites, clinical attachment loss, clinical crown length, tooth root length, and periodontal tissue of the affected tooth (alveolar bone height, periodontal pocket depth, bleeding index).After treatment, the patients in the experimental group achieved more improvements in probing depth (P < .01), percentage of bleeding sites (P < .01), clinical attachment loss (P < .01), clinical crown length (P = .04), and periodontal tissue of the affected tooth (periodontal pocket depth (P < .01), and bleeding index (P < .01)), than those of patients in the control group.This study suggests that ODT is beneficial for ATD caused by PD. Future studies are still needed to verify the findings of this study.


Assuntos
Ortodontia Corretiva/métodos , Doenças Periodontais/complicações , Migração de Dente/terapia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice Periodontal , Estudos Retrospectivos , Migração de Dente/etiologia , Resultado do Tratamento
2.
Medicine (Baltimore) ; 99(50): e23221, 2020 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-33327241

RESUMO

BACKGROUND: Angle class II malocclusion is clinically complex and common malocclusion type, which affects beauty. Conventional treatment has the disadvantages of long course of treatment, high cost, easy recurrence and limited curative effect. Clinical practice shows that micro-implant anchorage has certain advantages in the treatment of Angle II malocclusion, but lacks the evidence of evidence-based medicine. This study systematically evaluates the efficacy and safety of micro-implant anchorage in the treatment of Angle class II malocclusion. METHODS: A systematic search was performed by retrieving on English databases (PubMed, Embase, Web of Science, and the Cochrane Library) and Chinese databases (CNKI, Wanfang, Weipu [VIP], CBM). Besides, manually search for Google and Baidu academic of micro-implant anchorage in the treatment of Angle class II malocclusion in randomized controlled clinical research. The retrieval time limit was from the establishment of the database to September 2020. Two researchers independently extracted and evaluated the quality of the data in the included study. A meta-analysis was performed using RevMan5.3 software. RESULTS: In this study, the efficacy and safety of micro-implant anchorage against Angle class II malocclusion were evaluated by SNA, BNA, ANB, NLA°, Adverse reaction. CONCLUSIONS: This study will provide reliable evidence-based evidence for the clinical application of micro-implant anchorage in the treatment of Angle class II malocclusion. ETHICS AND DISSEMINATION: Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval was not required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.OSF Registration number: DOI 10.17605/OSF.IO/UPBR8.


Assuntos
Implantes Dentários , Má Oclusão Classe II de Angle/terapia , Procedimentos de Ancoragem Ortodôntica/métodos , Ortodontia Corretiva/métodos , Implantes Dentários/efeitos adversos , Humanos , Procedimentos de Ancoragem Ortodôntica/efeitos adversos , Ortodontia Corretiva/efeitos adversos
3.
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
4.
Cient. dent. (Ed. impr.) ; 17(2): 139-146, mayo-ago. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-195102

RESUMO

Hablamos de sonrisa gingival cuando se altera la armonía establecida entre los dientes, labios y encía, exponiendo más allá de 2 mm de encía coronal a los incisivos maxilares, una circunstancia que, en ocasiones, genera un problema estético para algunos pacientes. La etiopatogenia de dicha condición se resume en tres facetas: dentoperiodontal (erupción pasiva alterada y erupción activa alterada), ósea (esquelética y/o dentoalveolar) y muscular (labio superior corto e hipermovilidad labial).Una condición multifactorial como la sonrisa gingival precisa un abordaje multidisciplinar: cirugía plástica periodontal, ortodoncia, cirugía ortognática, reposición labial, infiltración de toxina botulínica y tratamiento estético complementario


The excessive gingival display when a patient smiles (from 2 mm or more) is known as gummy smile. When the harmony established between the teeth, lips and gum is altered, exhibiting short clinical crown of the maxillary anterior teeth, in occasions generates an aesthetic problem for some patients.There are different etiologies of gummy smile, it concludes in three facets: dentoperiodontal (Altered Passive Eruption and Altered Active Eruption), bone defect (excessive vertical bone growth, dentoalveolar extrution) and muscular (short upper lip and upper lip hyperactivity), and the combination of some of these factors.A multifactorial condition requires a multidisciplinary boarding: plastic periodontal surgery, orthodontic, orthognathic surgery, lip reduction, infiltration of Botulinum toxin and complementary aesthetic treatment


Assuntos
Humanos , Técnicas Cosméticas , Sorriso/fisiologia , Músculos Faciais/anatomia & histologia , Músculos Faciais/fisiologia , Dimensão Vertical , Crescimento Excessivo da Gengiva/cirurgia , Ortodontia/métodos , Ortodontia Corretiva/métodos , Periodontia , Cirurgia Ortognática
5.
Niger J Clin Pract ; 23(5): 589-595, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32367863

RESUMO

Background: The prevalence of white spot lesions/tooth demineralization during orthodontic fixed appliance therapy ranges widely from 2 to 96% of patients. The purpose of this study was to evaluate measures used by orthodontists practicing in Nigeria to manage demineralization during and after fixed orthodontic treatment and how it compares with the available evidence-based information. Method: Study group comprised of 60 practitioners (21 orthodontists and 39 orthodontic residents) in Nigeria. Self-administered questionnaires were used to obtain information on the measures they use to prevent the occurrence of demineralization at the onset and during orthodontic treatment, as well as the management of its occurrence at treatment completion. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 17.0. Descriptive statistics were used. Level of significance was set at P < 0.05. Results: Responses obtained showed that 96.7% of orthodontic practitioners routinely advised their patients on tooth cleaning methods; the use of manual orthodontic toothbrush (78.3%) and dental floss (51.7%) being popularly recommended methods. However, 51.7% used a specific demineralization preventive protocol at the start of treatment. Oral hygiene instruction was observed to be the most commonly adopted protocol (51.7%), followed by fluoride rinses (41.7%) (considered relatively ineffective). Extraoral hygiene instruction was the most common treatment protocol used when tooth demineralization occurred during and after treatment (56.7% and 73.3% respectively). Approximately 92% of the orthodontists agreed on the need for the development of a basic protocol to prevent demineralization. Conclusion: The demineralization preventive measures used by Nigerian orthodontists and orthodontic residents are inconsistent and not based on evidence-based information. The development of standardized demineralization prevention protocol was therefore recommended.


Assuntos
Cárie Dentária/prevenção & controle , Higiene Bucal/métodos , Aparelhos Ortodônticos/efeitos adversos , Ortodontia Corretiva/métodos , Ortodontistas , Padrões de Prática Odontológica , Desmineralização do Dente/prevenção & controle , Adulto , Cariostáticos/uso terapêutico , Odontologia Baseada em Evidências/métodos , Feminino , Fluoretos/uso terapêutico , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Braquetes Ortodônticos/efeitos adversos , Inquéritos e Questionários , Escovação Dentária
6.
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 Classe II de Angle/patologia , Má Oclusão Classe II de Angle/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
7.
BMC Oral Health ; 20(1): 22, 2020 01 28.
Artigo em Inglês | MEDLINE | ID: mdl-31992277

RESUMO

BACKGROUND: Periodontally accelerated osteogenic orthodontics (PAOO) is a treatment for bone defects associated with a lack of bone graft stability, especially in coronal locations. This study aimed to compare a modified technique of membrane fixation that utilizes periosteal sutures (using a pouch design) with the traditional approach, which does not use membrane fixation. METHODS: Twenty-eight patients with a total of 168 teeth treated were divided into two groups: 1-A, in which patients were treated using the modified technique (with membrane fixation), and group 2-B, in which patients were treated using the traditional technique (without membrane fixation). The postoperative bone thickness was evaluated via radiographic examination. RESULTS: Postoperative improvements in bone augmentation were detected in both groups. At 12 months, the values of the CHBT (measured from the midpoint of the coronal third to the labial cortical surface, 0.84 ± 0.33 mm) and the values of VBL (measured from the alveolar crest to the cemento-enamel junction, - 2.35 ± 0.80 mm)were significantly greater in the modified technique group than those in the traditional technique group (CHBT:0.12 ± 0.21 mm and VBL:-1.39 ± 0.99 mm; P = 0.00 and P = 0.01). CONCLUSIONS: This study shows that compared to the traditional technique, the modified PAOO technique with membrane fixation using periosteal sutures provides improved graft stabilization, superior coronal augmentation and satisfactory vertical volume.


Assuntos
Processo Alveolar/cirurgia , Transplante Ósseo/métodos , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Osteogênese/fisiologia , Osteotomia/métodos , Aumento do Rebordo Alveolar/métodos , Humanos , Ortodontia Corretiva/instrumentação , Técnicas de Movimentação Dentária/métodos , Resultado do Tratamento
8.
J Pediatr Hematol Oncol ; 42(3): 198-203, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31851070

RESUMO

Rapid blood cell turnover and bone marrow expansion caused by beta-thalassemia (ßT) result in craniofacial and dentoalveolar anomalies. This report presents a systematic review of the literature over the past 50 years on orthodontic and surgical considerations in the management of ßT-affected patients. Seventeen publications encompassed 24 patients, 11 male individuals and 13 female individuals, 7 to 43 years of age. Eleven patients underwent only surgical treatment, eleven combined orthodontic-surgical treatment, and 2 orthodontic treatment. Surgical treatment primarily addressed typical maxillary overgrowth by maxillary reshaping, premaxillary segmental repositioning, or complete Le Fort I impaction and set back osteotomy. In severe maxilla-mandibular discrepancy and/or increased lower facial height, a bilateral sagittal split mandibular osteotomy is the treatment of choice. Although surgery involves risks of excessive bleeding, morbidity, and impaired nasal esthetics, little attention is given to the orthodontic modality. In conclusion, the current literature recommends early interceptive orthodontics aimed to decrease dentoskeletal deformities, severe malocclusion, and soft tissue imbalance. Treatment includes maxillo-mandibular orthopedic and functional manipulation with dentoalveolar treatment, which might either prevent orthosurgical procedures later or reduce its extent. This suggested a multidisciplinary approach comprising a hematologist, a pediatrician, a pediatric dentist, and an orthodontist, which might also significantly improve the patient's quality of life.


Assuntos
Anormalidades Craniofaciais/etiologia , Anormalidades Craniofaciais/terapia , Ortodontia Corretiva/métodos , Procedimentos Ortopédicos/métodos , Talassemia beta/complicações , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Má Oclusão/etiologia , Má Oclusão/terapia , Adulto Jovem
9.
Oral Maxillofac Surg Clin North Am ; 32(1): 71-82, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31744601

RESUMO

Complications in orthognathic surgery are commonly a result of inadequate preoperative planning and communication between the surgeon and orthodontist. Unfavorable outcomes can often be avoided when overall treatment goals along with a surgical and orthodontic plan are developed and agreed upon by the orthodontist, surgeon, and patient before the start of active tooth movement or any surgical procedures. Continuous evaluation of the patient's progress throughout treatment and subsequent communication between the surgeon and orthodontist are recommended to prevent frequent errors, such as inadequate dental decompensation, poor appliance selection or management, and occasional contraindicated orthodontic elastic traction or tooth movements.


Assuntos
Má Oclusão , Ortodontia Corretiva/métodos , Ortodontia , Cirurgia Ortognática/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Planejamento de Assistência ao Paciente , Humanos , Equipe de Assistência ao Paciente , Complicações Pós-Operatórias
10.
Acta Odontol Scand ; 78(4): 297-302, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31833442

RESUMO

Objective: To evaluate the influence of mandibular third molars on relapse of mandibular anterior crowding in orthodontically treated patients.Material and Methods: Sample included orthodontic records of 108 patients: Group 1: 72 patients (39 female; 33 male) with third molars present in the postretention evaluation stage. Group 2: 36 patients (18 female; 18 male) who did not present the third molars in the postretention evaluation stage. Panoramic radiographs and dental models were evaluated at three different stages: pre-treatment; posttreatment and postretention. Panoramic radiographs showed the presence or absence of third molars in the 3 evaluated stages and on the dental models, overbite and mandibular anterior crowding was measured by the Little Irregularity Index. For intergroup comparisons, t-tests and a multifactorial regression analysis were used.Results: There was no statistically significant difference in the relapse of mandibular anterior crowding among the groups with and without mandibular third molars at the postretention stage.Conclusion: The presence or absence of mandibular third molars did not influence the relapse of mandibular anterior crowding in orthodontically treated patients.


Assuntos
Má Oclusão/terapia , Mandíbula/patologia , Dente Serotino , Ortodontia Corretiva/métodos , Cefalometria , Feminino , Humanos , Masculino , Recidiva
11.
Rio de Janeiro; s.n; 2020. 149 p. ilus.
Tese em Inglês, Português | BBO - Odontologia | ID: biblio-1177549

RESUMO

O objetivo deste estudo foi realizar uma revisão de literatura abordando os aspectos da etiologia, prevalência, diagnóstico, alternativas de tratamento ortodôntico, prognóstico e parâmetros periodontais de incisivos centrais superiores impactados com dilaceração radicular. Evidências científicas relacionadas ao tema foram coletadas e apresentadas por meio de uma descrição narrativa. A dilaceração radicular resulta em um desvio abrupto do longo eixo do dente. Está muitas vezes relacionada ao trauma dentário na dentição decídua, sendo os incisivos centrais superiores permanentes os dentes mais afetados, que geralmente não erupcionam espontaneamente nestas situações. Para um correto diagnóstico, a tomografia computadorizada de feixe cônico é o exame mais indicado. A modalidade de tratamento ortodôntico-cirúrgico é utilizada, na maioria dos casos. O prognóstico é bom, quando considerados cuidadosamente os fatores que podem afetar o resultado do tratamento. É possível tracionar dentes dilacerados e obter ótimos resultados periodontais, embora uma leve perda de fixação periodontal e uma pequena redução no suporte ósseo possa ocorrer nas estruturas adjacentes aos dentes tratados. (AU)


The aim of this study was to review the literature addressing aspects of etiology, prevalence, diagnosis, orthodontic treatment alternatives, prognosis and periodontal parameters of maxillary central incisors impacted with root dilaceration. Scientific evidence related to the theme was collected and presented through a narrative description. Root laceration results in an abrupt deviation of the long axis of the tooth. It is often related to dental trauma in the primary dentition, with the permanent upper central incisors being the most affected teeth, which generally do not erupt spontaneously in these situations. For a correct diagnosis, cone beam computed tomography is the most suitable exam. The orthodontic-surgical treatment modality is used in most cases. The prognosis is good, when carefully considering the factors that can affect the treatment outcome. It is possible to force eruption of dilacerated teeth with excellent periodontal results, although a slight loss of periodontal support and a small reduction in bone support may occur around the treated teeth.(AU)


Assuntos
Humanos , Criança , Ortodontia Corretiva/métodos , Dente Impactado , Técnicas de Movimentação Dentária , Incisivo/anormalidades , Dente não Erupcionado
12.
Rev. esp. cir. oral maxilofac ; 41(4): 178-182, oct.-dic. 2019. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-191803

RESUMO

OBJETIVOS: Comparar la variación de la dimensión del espacio orofaríngeo (EO) en el prequirúrgico, postquirúrgico inmediato y postquirúrgico de 5 a 24 meses después de la cirugía de retroceso mandibular (CRM). MATERIALES Y MÉTODOS: Se evaluaron las radiografías cefalométricas prequirúrgicas, postquirúrgicas inmediatas y postquirúrgicas de 5 a 24 meses de 20 pacientes con CRM del Servicio de Cirugía Oral y Maxilofacial de dos instituciones. Se cuantificó la dimensión del EO en diferentes momentos. RESULTADOS: No se encontraron diferencias de significación entre la cantidad de retroceso mandibular y la variación de la dimensión del EO. CONCLUSIONES: Existe una leve disminución de la dimensión del EO después de la CRM. No son estadísticamente significantes entre los momentos de evaluación. No se encontró correlación entre el retroceso mandibular y la disminución del EO


OBJECTIVE: The aim of this study was to compare the variation in the size of the oropharyngeal space (OS) in the preoperative, immediate postoperative and post-operative 5 to 24 months according to the amount of mandibular setback. MATERIAL AND METHOD: Variation were evaluated on cephalometric radiographs taken few days before the surgery (Rx1), immediate postoperative (Rx2) and postoperative long time (5 to 24 months) (Rx3). The subjects were 20 patients (18 - 36 years) in whom dentofacial deformity class III was corrected by bilateral sagittal split ramus osteotomy setback. Surgery was done in two Oral and Maxillofacial specialized institutions, since 2003 to 2010. We examined the size of the oropharyngeal space at different times before and after mandibular setback surgery. RESULTS: These shows no significant difference between the amount of mandibular setback and decrease the size of the oropharyngeal space. It was determined that the oropharyngeal space immediately after surgery increases and decreases over time as a result of soft and hard tissue adaptation. CONCLUSIONS: We conclude that there is a slight decreased in the anteroposterior dimension of oropharynx after mandibular setback surgery, however the variations is no statistically significant difference between the moments of evaluation (the amount of mandibular recoil and the decrease in OS)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Osteotomia Mandibular/métodos , Boca/anatomia & histologia , Reconstrução Mandibular/métodos , Má Oclusão Classe III de Angle/cirurgia , Estudos Retrospectivos , Complicações Pós-Operatórias , Síndromes da Apneia do Sono/epidemiologia , Resultado do Tratamento , Ortodontia Corretiva/métodos , Osteotomia Mandibular/estatística & dados numéricos , Anormalidades da Boca/cirurgia , Reconstrução Mandibular/efeitos adversos , Cefalometria/métodos
13.
Georgian Med News ; (294): 62-68, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31687951

RESUMO

Recently, there has been a tendency for the growth of dentognathic deformities of various origins, accompanied by phonetic abnormalities. Aim - to increase the effectiveness of orthodontic treatment of dentognathic deformities, accompanied by phonetic disorders, by developing and justifying a set of diagnostic and therapeutic measures based on a multidisciplinary approach. The influence of the state of ENT organs on the formation of dentognathic deformities and phonetic disturbances is studied in 155 children. A clinical dental examination and orthodontic treatment is performed in 82 patients aged 6-12 years. Individual corrective speech therapy work has been carried out to overcome the defects of the phonological side of speech. A certain pathological "chain" of cause-effect relationships of dentognathic deformities with phonetic disorders and diseases of the ENT organs became the basis for a multidisciplinary approach to solving the problems identified. The qualitative and quantitative dependence of sound deterioration on the type of orthognathic deformities is established. A complex of diagnostic and therapeutic measures for patients with dental deformities accompanied by phonetic disorders, consisting of motivational, diagnostic and therapeutic blocks, has been developed and introduced into practice. The proposed complex of diagnostic and treatment measures made it possible to increase the efficiency of orthodontic treatment of children with dentognathic deformities with disturbances of sound pronunciation depending on the type of bite by means of a multidisciplinary approach involving an otolaryngologist, speech therapist, children's therapist and surgeon, which was confirmed in 86.6% of patients by the improvement of electromyography, anthropometric measurements of scanned models of jaws, cephalometry; the analysis of cone-beam computed tomography data showed a significant increase in the upper respiratory tract volume by 53.8±4.2%.


Assuntos
Anormalidades Maxilofaciais/diagnóstico , Anormalidades Maxilofaciais/cirurgia , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Fonética , Prognatismo/cirurgia , Distúrbios da Fala/cirurgia , Cefalometria , Criança , Humanos , Imageamento Tridimensional , Prognatismo/diagnóstico por imagem , Reprodutibilidade dos Testes , Distúrbios da Fala/diagnóstico , Resultado do Tratamento
14.
Am J Orthod Dentofacial Orthop ; 156(4): 531-544, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31582125

RESUMO

Progressive condylar resorption, also known as idiopathic condylar resorption, is an uncommon, aggressive, degenerative disease of the temporomandibular joint (TMJ) seen mostly in adolescent girls and young women. This condition leads to loss of condylar bone mass, decrease of mandibular ramal height, steep mandibular and occlusal plane angles, and an anterior open bite. In 3 case reports, we review the pathogenesis of TMJ degenerative disease and the clinical management of TMJ arthrosis. We emphasize that TMJ arthritic disease should be discussed in dental circles as a pathologic entity in the same way that orthodontists discuss arthritic disease in orthopedic circles. Regarding the degenerative pathology of the TMJ, treatment goals include restored function and pain reduction. The treatment methods used to achieve these goals can range from noninvasive therapy to minimally invasive and invasive surgery. Most patients can be treated noninvasively, and the importance of disease prevention and conservative management in the overall treatment of TMJ disease must be acknowledged. The decision to manage TMJ osteoarthrosis surgically must be based on evaluation of the patient's response to noninvasive treatments, mandibular form and function, and effect of the condition on his or her quality of life.


Assuntos
Reabsorção Óssea/diagnóstico por imagem , Reabsorção Óssea/cirurgia , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos/métodos , Osteoartrite/diagnóstico por imagem , Osteoartrite/cirurgia , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/terapia , Adulto , Reabsorção Óssea/patologia , Criança , Terapia Combinada , Progressão da Doença , Feminino , Humanos , Côndilo Mandibular/patologia , Côndilo Mandibular/cirurgia , Osteoartrite/patologia , Qualidade de Vida , Transtornos da Articulação Temporomandibular/patologia , Resultado do Tratamento
15.
Am J Orthod Dentofacial Orthop ; 156(4): 555-565, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31582127

RESUMO

A common dilemma when treating anterior open bite is understanding its etiology. Idiopathic condylar resorption (ICR) can cause open bite in affected individuals. Although it is prudent to not treat patients with ICR until active resorption has ceased, orthodontists may begin treating them because anterior open bite from ICR may not appear before or during their orthodontic treatment. This article reports a 12-year-old female who was diagnosed with ICR 10 months after completion of her orthodontic treatment for a Class II Division 1 malocclusion. When a young patient with a high mandibular angle and previous skeletal or dental Class II malocclusion returns with an open bite during the retention phase, the patient's condyles must be carefully examined to determine whether any temporomandibular joint disorder, such as ICR, is present. Currently, the controversy over the cause and the cure for ICR is continuing to challenge orthodontists in diagnoses and treatments. Orthodontists should closely monitor and offer informed treatment options to patients with risk factors for ICR or signs of its pathology that might develop at any stage of orthodontic treatment, including the retention period.


Assuntos
Reabsorção Óssea/complicações , Reabsorção Óssea/terapia , Má Oclusão Classe II de Angle/terapia , Côndilo Mandibular/patologia , Doenças Mandibulares/patologia , Doenças Mandibulares/terapia , Mordida Aberta/etiologia , Mordida Aberta/terapia , Ortodontia Corretiva/métodos , Transtornos da Articulação Temporomandibular/terapia , Reabsorção Óssea/diagnóstico por imagem , Cefalometria , Criança , Terapia Combinada , Estética Dentária , Feminino , Humanos , Má Oclusão Classe II de Angle/diagnóstico por imagem , Doenças Mandibulares/diagnóstico por imagem , Mordida Aberta/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Resultado do Tratamento
16.
Am J Orthod Dentofacial Orthop ; 156(3): 312-325, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474261

RESUMO

INTRODUCTION: This aim of this paper is to describe and identify the practitioner and patient characteristics that are associated with treatment recommendations for adult anterior open bite patients across the United States. METHODS: Practitioners and patients were recruited within the framework of the National Dental Practice-Based Research Network. Practitioners were asked about their demographic characteristics and their treatment recommendations for these patients. The practitioners also reported on their patients' dentofacial characteristics and provided initial cephalometric scans and intraoral photographs. Patients were asked about their demographic characteristics, previous orthodontic treatment, and goals for treatment. Four main treatment groups were evaluated: aligners, fixed appliances, temporary anchorage devices (TADs), and orthognathic surgery. Extractions were also investigated. Predictive multivariable models were created comparing various categories of treatment as well as extraction/nonextraction decisions. RESULTS: Ninety-one practitioners (mostly orthodontists) and 347 patients were recruited from October 2015 to December 2016. Increased aligner recommendations were associated with white and Asian patients, the presence of tongue habits, and female practitioners. TADs were recommended more often in academic settings. Recommendations for orthognathic surgery were associated with demographic factors, such as availability of insurance coverage and practitioner race/ethnicity, and dentofacial characteristics, such as anteroposterior discrepancies, more severe open bites, and steeper mandibular plane angles. Extraction recommendations were largely associated with severe crowding and incisor proclination. CONCLUSIONS: Both doctor and patient demographic factors, as well as dentofacial characteristics, were significantly associated with treatment recommendations for adult anterior open bite patients.


Assuntos
Mordida Aberta/terapia , Ortodontia Corretiva/estatística & dados numéricos , Ortodontistas/estatística & dados numéricos , Padrões de Prática Odontológica/estatística & dados numéricos , Idoso , Cefalometria , Feminino , Humanos , Incisivo , Masculino , Mandíbula , Pessoa de Meia-Idade , Mordida Aberta/diagnóstico por imagem , Mordida Aberta/epidemiologia , Aparelhos Ortodônticos/estatística & dados numéricos , Ortodontia Corretiva/instrumentação , Ortodontia Corretiva/métodos , Procedimentos Cirúrgicos Ortognáticos , Inquéritos e Questionários , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Técnicas de Movimentação Dentária/estatística & dados numéricos , Estados Unidos/epidemiologia
17.
Am J Orthod Dentofacial Orthop ; 156(3): 375-382, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474267

RESUMO

INTRODUCTION: The aim of this work was to compare the skeletal and dental outcomes of 1- versus 2-phase treatment in Class II subjects with difficult-to-treat high-angle severe Class II malocclusions. METHODS: The sample of 120 cases was collected from the private offices of 3 experienced clinicians. The following selection criteria were used: (1) ANB ≥6°, (2) SN-GoGn ≥37° or mandibular plane to Frankfort horizontal plane ≥30°; and (3) overjet ≥6 mm. Patients were classified into either the early or the late treatment group according to dental age (early Tx: ≥5 primary teeth; late Tx: otherwise). Thirty-four angular, linear, and proportional measurements were determined for each patient. Statistical significance was assessed with the use of a 2-tailed t test, analysis of covariance test, and chi-square test. RESULTS: The results showed that early 2-phase treatment for severe Class II high-angle patients offered no skeletal anteroposterior advantages over late 1-phase treatment. Severe high-angle Class II patients also showed similar dental anteroposterior outcomes with the use of both approaches. Vertically there was a higher frequency of increased mandibular plane angles and extrusion of upper incisors and lower molars in the late treatment group. CONCLUSIONS: Early 2-phase treatment for severe Class II high-angle patients offered no skeletal or dental advantage over late 1-phase treatment.


Assuntos
Má Oclusão Classe II de Angle/terapia , Ortodontia Corretiva/métodos , Adolescente , Cefalometria/métodos , Criança , Feminino , Humanos , Incisivo , Masculino , Mandíbula , Maxila , Dente Molar , Sobremordida/terapia , Fatores de Tempo , Resultado do Tratamento
18.
Am J Orthod Dentofacial Orthop ; 156(3): 391-400, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474269

RESUMO

INTRODUCTION: Orthodontic traction of a maxillary impacted canine (MIC) increases the orthodontic treatment time. Therefore, the objective of this study was to evaluate the influence of MIC characteristics and factors associated with orthodontic treatment on the duration of active orthodontic traction. METHODS: This follow-up and retrospective study included 45 MICs orthodontically tractioned into the occlusal plane with the use of a standardized protocol. MIC characteristics, including type, sector, side, location, height, and complexity of impaction, as well as α and ß angles and canine root length and area were measured. Likewise, factors associated with orthodontic treatment, including sex, age, malocclusion, premolar extractions, previous incisor root resorption, ANB, APDI, and SNA angles, and PNS-ANS distance were also evaluated. The statistical analysis included multiple linear regressions to estimate the influence of all variables on the duration of traction (α = 0.05). RESULTS: Sex had significant influence (P = 0.027) on the time of traction; in female patients, the time was 2.05 months more than in male patients. Bilateral impaction treatment increased the time by 2.74 months compared with unilateral cases (P = 0.001). Traction of bicortically centered impacted canines increased the duration of traction by 2.85 months (P = 0.001). Finally, the traction time increased in 2.35 months (P = 0.046) when the impaction sectors were 4 or 5 (close to the midline). CONCLUSIONS: The duration of active orthodontic traction of MIC is mainly influenced by sex, bilateral type, bicortically centered location, or when MIC is located in sector 4 or 5 close to midline, increasing the traction time by some months.


Assuntos
Dente Canino/cirurgia , Maxila/cirurgia , Ortodontia Corretiva/métodos , Dente Impactado/complicações , Dente Impactado/terapia , Adolescente , Dente Canino/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Incisivo , Masculino , Má Oclusão/classificação , Má Oclusão/terapia , Maxila/diagnóstico por imagem , Procedimentos Cirúrgicos Bucais , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Aparelhos Ortodônticos Fixos , Ortodontia Corretiva/instrumentação , Avaliação de Processos e Resultados em Cuidados de Saúde , Planejamento de Assistência ao Paciente , Radiografia Dentária , Estudos Retrospectivos , Reabsorção da Raiz/complicações , Fatores Sexuais , Fatores de Tempo , Erupção Dentária , Raiz Dentária/anatomia & histologia , Raiz Dentária/diagnóstico por imagem , Dente Impactado/diagnóstico por imagem , Dente Impactado/cirurgia , Tração , Resultado do Tratamento
19.
Saudi Med J ; 40(9): 954-957, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31522225

RESUMO

OBJECTIVES: To investigated the diagnostic performance of circumpubertal eruption stages which identify skeletal maturity stages using the cervical vertebral maturation (CVM) method in a Saudi population. METHODS: This is a retrospective cross-sectional study. Lateral cephalograms, panoramic radiographs, and intraoral pictures of 600 orthodontic patients (284 boys, 316 girls) who met inclusion criteria were assessed. Records were retrieved between January 2016 and April 2018. The diagnostic performance of eruption stages for identifying skeletal maturity was tested with positive likelihood ratios (LHR+). RESULTS: Prevalence of each CVM stage in the eruption stages was reported. For every eruption stage, LHR+ was reported in order to identify every CVM stage. The majority of the LHR+ values were ≤3.5, with a significant value of ≥10 for the identification of the post-pubertal growth stage. The other eruptions stages did not strongly predict skeletal maturity. CONCLUSION: In treatment planning for cases that require identifying the growth peak, the use of eruption stages is not recommended as an indicator of skeletal maturity except for the early permanent dentition stage where strong diagnostic performance for identifying post-pubertal skeletal growth stage has been shown.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Desenvolvimento Ósseo/fisiologia , Vértebras Cervicais/diagnóstico por imagem , Dentição Permanente , Erupção Dentária/fisiologia , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Ortodontia Corretiva/métodos , Radiografia Panorâmica , Estudos Retrospectivos
20.
Int Orthod ; 17(4): 667-677, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31492602

RESUMO

OBJECTIVE: Pharyngeal airway obstruction can facilitate some forms of sleep disorder breathing (SDB) in susceptible children, especially in those having class II malocclusion. Changes in the anatomic areas surrounding the pharyngeal region during orthodontic treatment could hypothetically impact the pharyngeal airway dimensions. Management of a class II malocclusion on a growing individual with either intermaxillary elastics or different removable or fixed class II appliance designs have been proposed over the last century. The objective of this retrospective exploratory cohort study is to investigate to what extent the class II malocclusion treatment with either intermaxillary elastics (IME) or Forsus® fatigue resistance device (FFRD) leads to changes in oropharyngeal airway dimensions. MATERIALS AND METHODS: Twenty-nine patients diagnosed as class II with an average age of 12.7years were included in this study, (11 males, 18 females). The sample was divided into group 1: IME and group 2: FFRD. CBCT's scans before (T1) and after treatment (T2) were obtained and analysed using Dolphin software. Reliability was obtained using Intraclass Correlation Coefficient (ICC). Descriptive statistics, ANOVA and paired t-test were used for analysis. RESULTS: Intra-rater reliability test was excellent in all measurements for both groups. There were no statistically significant differences in pharyngeal airway dimensions between both groups (P=0.919). A statistically significant correlation was found for sex, where male patients had the highest increase in oro-space area (ORS), and in oropharyngeal volume. Children under 14-year-old in IME group showed statistically negative correlation for sub-mandibular (SM) and for ORS, meaning the younger the greatest increase. Additionally, individuals younger than 14years had a statistically significant increase in the vertical dimension. CONCLUSIONS: Both orthodontic treatment approaches appear to be associated with a similar increase in oropharyngeal airway dimensions. Male patients under 14-year-old had a greater significant increase compared to female patients and older children. Normal pharyngeal dimensions changes were not accounted for.


Assuntos
Má Oclusão Classe II de Angle/complicações , Má Oclusão Classe II de Angle/terapia , Ortodontia Corretiva/métodos , Faringe/anatomia & histologia , Adolescente , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Má Oclusão Classe II de Angle/reabilitação , Mandíbula , Orofaringe/anatomia & histologia , Aparelhos Ortodônticos , Ortodontia Corretiva/efeitos adversos , Reprodutibilidade dos Testes , Estudos Retrospectivos , Software , Adulto Jovem
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