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1.
Oral Maxillofac Surg Clin North Am ; 32(1): 15-26, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31685344

RESUMO

Impacted teeth occur in a significant number of patients. Their management requires coordinated efforts of orthodontists and oral and maxillofacial surgeons. Specifically, optimal results require a prompt orthodontic diagnosis and treatment plan with execution of either closed or open exposure of impacted teeth by the oral and maxillofacial surgeon. Failure to consider orthodontic mechanics and proper surgical technique can lead to suboptimal results. Thus, orthodontist/oral and maxillofacial surgeon communication is essential for success and patient education and shared decision-making is mandatory before initiating treatment.


Assuntos
Procedimentos de Ancoragem Ortodôntica , Planejamento de Assistência ao Paciente , Técnicas de Movimentação Dentária/métodos , Dente Impactado/cirurgia , Humanos , Cirurgiões Bucomaxilofaciais
2.
Oral Maxillofac Surg Clin North Am ; 32(1): 27-37, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31685345

RESUMO

As orthodontic treatment has advanced in complexity and in frequency, more recent techniques, using temporary skeletal anchorage, were developed to help correct more severe occlusal and dentofacial discrepancies that were treated with orthognathic surgery alone previously. These techniques have allowed the orthodontist to move teeth against a rigid fixation, allowing for more focused movements of teeth and for orthopedic growth modification. These types of treatments using rigid fixation have allowed for greater interaction between the orthodontist and the oral and maxillofacial surgeon, and have vastly enhanced the treatment planning for the orthodontist in today's society.


Assuntos
Procedimentos de Ancoragem Ortodôntica , Procedimentos Cirúrgicos Ortognáticos/métodos , Planejamento de Assistência ao Paciente , Técnicas de Movimentação Dentária/métodos , Humanos , Desenho de Aparelho Ortodôntico
3.
Oral Maxillofac Surg Clin North Am ; 32(1): 83-88, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31685346

RESUMO

Patients and orthodontists seek to reduce treatment time in braces. Rapid canine retraction through dentoalveolar distraction osteogenesis is one of several treatment approaches to reduce treatment in braces. This article provides an overview of technique of dentoalveolar distraction osteogenesis to accomplish rapid canine retraction and associated outcomes. When this treatment protocol is implemented well, rapid canine retraction is achieved predictably with minimal side effects. Although current evidence suggests that adverse sequelae, such as root resorptions and pulp devitalization, are rare, prospective clinical studies that are adequately powered and documenting long-term follow-up of these outcomes are lacking.


Assuntos
Procedimentos Cirúrgicos Bucais/métodos , Procedimentos de Ancoragem Ortodôntica , Desenho de Aparelho Ortodôntico , Osteogênese por Distração/métodos , Osteotomia/métodos , Técnicas de Movimentação Dentária/métodos , Humanos , Maxila , Procedimentos de Ancoragem Ortodôntica/efeitos adversos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Aparelhos Ortodônticos , Procedimentos Cirúrgicos Ortognáticos , Estudos Prospectivos , Resultado do Tratamento
4.
Am J Orthod Dentofacial Orthop ; 156(4): 453-463, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31582117

RESUMO

INTRODUCTION: Extraction of one mandibular incisor in adolescents and adults can simplify orthodontic treatment in 2 major circumstances: (1) severe crowding of the mandibular but not the maxillary incisors, and (2) mild anterior crossbite with good alignment in both arches. Despite its potential advantages, this method has had limited use in most practices. There have been 3 major objections: (1) the possibility of unsightly black triangles because of loss of interdental papilla height, (2) a possible tooth size discrepancy that would affect occlusal relationships, and (3) patient concerns about a visible extraction site. All 3 objections now can be overcome. METHODS: For 37 consecutively treated single-incisor-extraction patients, preparation of the extraction site for the tooth to be extracted was done by tipping it lingually while simultaneously closing the space in front of it. Treatment outcomes and the effect of age at the time of treatment were evaluated. RESULTS: In patients below age 20, this approach eliminated post-treatment black triangles and almost eliminated partial loss of the interdental papilla. It reduced the previously reported prevalence of these problems in patients aged 20-40 years and did not seem to be helpful in those aged over 40 years. This positive effect was achieved because of maintenance of alveolar crest height that supports the interdental papillae. Tooth size discrepancy caused by incisor extraction was largely compensated by the different labio-lingual orientation of maxillary and mandibular anterior teeth. The extraction space quickly disappeared during extraction site preparation. CONCLUSIONS: The new procedure of extraction site preparation described in this paper offers more favorable outcomes for post-treatment prevalence of black triangles in younger patients but shows limited efficacy in older patients. Camouflage of a mild skeletal Class III problem is the major indication for this extraction pattern. About 3% of Icelandic orthodontic patients appear to be good candidates for this treatment, and this finding should be reasonably generalizable to other populations of European descent.


Assuntos
Incisivo/cirurgia , Mandíbula/cirurgia , Extração Dentária/métodos , Técnicas de Movimentação Dentária/métodos , Adolescente , Adulto , Idoso , Cefalometria/métodos , Criança , Estética Dentária , Feminino , Humanos , Islândia , Incisivo/diagnóstico por imagem , Masculino , Má Oclusão de Angle Classe III/terapia , Mandíbula/diagnóstico por imagem , Pessoa de Meia-Idade , Fotografação , Resultado do Tratamento
5.
Am J Orthod Dentofacial Orthop ; 156(4): 512-521.e6, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31582123

RESUMO

INTRODUCTION: This prospective cohort study aimed to evaluate canine substitution supported by skeletal anchorage as a viable treatment protocol for patients with maxillary lateral incisor agenesis (MLIA) and skeletal Class I or Class III. METHODS: Patients (n = 30) who met the following criteria were recruited: (1) bilateral MLIA or unilateral MLIA with a riziform contralateral incisor with a planned extraction; (2) skeletal Class I or Class III; and (3) dentoalveolar discrepancy in the mandible <5 mm. The archwire sequence routine was administered, combined with a rapid palatal expander, temporary intraoral skeletal anchorage device, and intermaxillary traction with Class III elastics. The results of the cephalometric analyses, peer assessment rating indexes, and the patient's smile self-evaluation using the visual analog scale were compared between initial and final treatments. RESULTS: This study indicated that closing the space in patients with Class I or Class III malocclusion by using temporary intraoral skeletal anchorage devices in the mandible, along with Class III elastics, yielded satisfactory outcomes. Proper occlusion was established by mesialization of the maxillary teeth and correction of the intermaxillary discrepancy, thereby yielding beneficial and significant cephalometric changes after the treatment. The soft tissue profile was maintained when it was harmonious before the treatment and improved posttreatment in patients in whom the profile was initially inharmonious. All occlusions improved, as evidenced by the peer assessment rating index. Smile esthetics were also enhanced after orthodontic treatment for all patients. CONCLUSIONS: Canine substitution may be safely offered to patients with Class I and Class III skeletal pattern and MLIA.


Assuntos
Anodontia/terapia , Dente Canino , Má Oclusão de Angle Classe III/terapia , Má Oclusão de Angle Classe I/terapia , Procedimentos de Ancoragem Ortodôntica/métodos , Técnicas de Movimentação Dentária/métodos , Adolescente , Cefalometria , Criança , Terapia Combinada , Estética Dentária , Aparelhos de Tração Extrabucal , Feminino , Humanos , Masculino , Técnica de Expansão Palatina , Estudos Prospectivos , Resultado do Tratamento , Escala Visual Analógica , Adulto Jovem
6.
Am J Orthod Dentofacial Orthop ; 156(3): 326-336, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474262

RESUMO

INTRODUCTION: Orthodontic mini-implants aid in the correction of distocclusions via direct anchorage (pull from mini-implant to teeth) and indirect anchorage (teeth pulled against other teeth anchored by the mini-implant). The aim of this study was to compare stress levels on the periodontal ligament (PDL) of maxillary buccal teeth in direct and indirect distalization against orthodontic mini-implants and accounting for individual variation in maxillary anatomy and biomechanical characteristics of the compact bone. METHODS: A 3D model of the maxilla containing the different components (teeth, PDL, trabecular and cortical bones) was generated from a computed tomographic scan. Cortical bone was divided into several areas according to previously defined zones. Bone stiffness and thickness data, obtained from 11 and 12 cadavers, respectively, were incorporated into the initial model to simulate the individual cortical bone variation at the different locations. Subsequently, a finite element analysis was used to simulate the distalization modalities. RESULTS: Stresses at the buccal, palatal, mesial, and distal surfaces were significantly different between adjacent teeth under stiffness but not thickness variation. In both distalization modalities, low or no significant correlations were found between stress values and corresponding cortical bone thicknesses. High significant and inverted correlations were observed at the first molar between stress amounts and cortical bone stiffness (direct modality: -0.68 < r < -0.72; indirect modality: -0.80 < r < -0.82; P <0.05). CONCLUSIONS: With the use of a novel finite element approach that integrated human data on variations in bone properties, findings suggested that cortical bone stiffness may influence tooth movement more than bone thickness. Significant clinical implications could be related to these findings.


Assuntos
Análise do Estresse Dentário/métodos , Análise de Elementos Finitos , Técnicas de Movimentação Dentária/métodos , Fenômenos Biomecânicos , Parafusos Ósseos , Simulação por Computador , Implantes Dentários , Humanos , Imagem Tridimensional/métodos , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Modelos Anatômicos , Dente Molar , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Desenho de Aparelho Ortodôntico , Ligamento Periodontal , Estresse Mecânico , Técnicas de Movimentação Dentária/instrumentação , Torção Mecânica
7.
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
8.
Am J Orthod Dentofacial Orthop ; 156(3): 355-364, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474265

RESUMO

INTRODUCTION: The aim of this work was to analyze data of patients with failed or delayed eruption of first and second permanent molars, to assess the effectiveness of the treatment methods used. METHODS: Epidemiologic and clinical data of 125 patients (mean age 14.08 ± 4.04 years) with 197 affected molars (30 first and 167 second molars) were retrospectively analyzed. The treatment outcome was known in 161 molars after patient drop-out (20 patients with 36 molars). The cases were categorized into 8 groups according to the choice of treatment: orthodontic uprighting, surgical-orthodontic uprighting, surgical uprighting, surgical repositioning, surgical exposure, first or second molar extraction, third molar extraction, or removal of pathologic conditions. RESULTS: The overall treatment outcome was positive in 141 molars (87.6%). It was positive in all cases treated with orthodontic uprighting (7 molars), surgical exposure (10 molars), surgical uprighting (38 molars), and surgical repositioning (8 molars), but it was significantly lower for surgical-orthodontic uprighting (34/48 molars, 70.8%). The positive outcome was significantly lower for inclusion (52/68 molars, 76.5%) than for early-diagnosed condition (11/11 molars, 100%) and retention (78/82 molars, 95.1%), and for total bone crown coverage (21/28 molars, 75.0%) than for osteomucosal or mucosal crown coverage (120/133 molars, 90.2%). CONCLUSIONS: This study demonstrates that an early diagnosis results in a better outcome regardless of the treatment used, with the number of cases with a positive outcome being higher in younger patients.


Assuntos
Dente Molar/patologia , Anormalidades Dentárias , Erupção Dentária , Técnicas de Movimentação Dentária/métodos , Dente Impactado/terapia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Itália , Modelos Logísticos , Masculino , Dente Molar/cirurgia , Dente Serotino/cirurgia , Estudos Retrospectivos , Dente Impactado/diagnóstico , Dente Impactado/cirurgia , Resultado do Tratamento , Adulto Jovem
9.
Am J Orthod Dentofacial Orthop ; 156(3): 401-411, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474270

RESUMO

A 24-year-old man presented with a severe skeletal class III malocclusion, associated with an anterior and posterior crossbite in the left side, upper and lower lip eversion, skeletal asymmetry, midline discrepancy, diastemas in the maxillary and mandibular dental arches, and agenesis of maxillary lateral incisors and canines with retained deciduous teeth. Treatment was performed with the use of the Win Lingual System. When the 0.016 × 0.022-inch NiTi archiwire was applied, the deciduous teeth were extracted and replaced with temporary crowns connected to the appliance. After the aligning, leveling, and diastema closure phases, a modified Le Fort II osteotomy, a mandibular setback with a bilateral sagittal split osteotomy and a genioplasty were performed. Implants were placed in the canine site through a flapless guided surgery, and cantilevered temporary bridges were delivered. Final prosthetic rehabilitation included veneers for the central incisors and zirconia-ceramic cantilevered bridges for the canine and lateral incisors. After 36 months of active treatment, the patient showed an Angle Class I molar and canine relationship and an ideal overbite and overjet. His profile had improved, lips were competent, and gingival levels were acceptable. The lateral radiograph and cephalometric analysis showed a good balance of the skeletal pattern, a good profile of the soft tissue, and proper inclinations of the maxillary and mandibular incisors in relation to maxilla and mandible. After 2 years of follow-up, the patient had a pleasant smile and no relapse, or joint or muscular pain.


Assuntos
Anodontia/complicações , Má Oclusão de Angle Classe III/terapia , Desenho de Aparelho Ortodôntico/instrumentação , Desenho de Aparelho Ortodôntico/métodos , Aparelhos Ortodônticos , Adulto , Cefalometria , Dente Canino , Implantação Dentária Endo-Óssea , Implantes Dentários , Modelos Dentários , Diastema/cirurgia , Diastema/terapia , Estética Dentária , Humanos , Incisivo , Lábio , Masculino , Má Oclusão de Angle Classe I/complicações , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/reabilitação , Má Oclusão de Angle Classe III/cirurgia , Mandíbula/cirurgia , Maxila/cirurgia , Dente Molar , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Braquetes Ortodônticos , Fios Ortodônticos , Osteotomia , Sobremordida/terapia , Radiografia Panorâmica , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Adulto Jovem
10.
Am J Orthod Dentofacial Orthop ; 156(2): 203-209, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375230

RESUMO

INTRODUCTION: The objective of this clinical prospective study was to evaluate the effect of the 2 treatment strategies, translation or controlled tipping, followed by root correction on canine retraction efficiency, specifically canine movement rate. METHODS: Twenty-one patients who needed bilateral maxillary canine retraction to close extraction space as part of their treatment plan were selected for this study. Segmental T-loops designed for controlled tipping or for translation were applied randomly to each side. Two digital maxillary dental casts (taken before and after treatment) were used to measure the tooth displacements of each patient. The coordinate system located at the center of canine crown on the pretreatment model with the 3 axes defined in the mesial-distal (M-D), buccal-lingual, and occlusal-gingival directions was used to express the 6 tooth displacement components. The movement rates on the occlusal plane and in the M-D direction were computed. Movement rates were calculated by dividing the M-D displacements or the resultant displacement on the occlusal plane with the corresponding treatment time. RESULTS: T-Loops for controlled tipping moved canines faster (33.3% on occlusal plane and 38.5% in the M-D direction) than T-loops for translation. The differences were statistically significant (P = 0.041 on the occlusal plane and 0.020 in the M-D direction). CONCLUSIONS: Moment-to-force ratio (M/F) affects the canine movement rate in a maxillary canine retraction treatment with the use of a segmented T-loop mechanism. Within the neighborhood of the ratio for translation, lower M/F moves the canine faster than higher M/F both on the occlusal plane and in the M-D direction.


Assuntos
Dente Canino , Estresse Mecânico , Técnicas de Movimentação Dentária/métodos , Adolescente , Adulto , Fenômenos Biomecânicos , Dente Canino/anatomia & histologia , Feminino , Análise de Elementos Finitos , Humanos , Masculino , Maxila , Desenho de Aparelho Ortodôntico , Estudos Prospectivos , Coroa do Dente , Adulto Jovem
11.
Am J Orthod Dentofacial Orthop ; 156(2): 210-219, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375231

RESUMO

INTRODUCTION: More patients are choosing customized orthodontic appliances because of their excellent esthetics. It is essential that clinicians understand the biomechanics of the tooth movement tendency in customized lingual orthodontics. This study aimed to evaluate the tooth movement tendency during space closure in maxillary anterior teeth with the use of miniscrew anchorage in customized lingual orthodontics with various power arm locations. METHODS: Three-dimensional finite element models of the maxilla were created with miniscrews and power arms; the positions were varied to change the force directions. A retraction force (1.5 N) was applied from the top of the miniscrews to the selected points on the power arm, and the initial displacements of the reference nodes of the maxillary teeth were analyzed. RESULTS: After applying force in different directions, power arms located at the distal side of the canines led to larger initial lingual crown tipping and occlusal crown extrusion of the maxillary incisors compared with power arms located at the midpoint between the lateral incisors and canines, and caused a decreasing trend of the intercanine width. CONCLUSIONS: In customized lingual orthodontic treatment, power arms located at the distal side of the canines are unfavorable for anterior teeth torque control and intercanine width control. Power arms located at the midpoint between the lateral incisors and canines can get better torque control, but still cannot achieve excepted torque without extra torque control methods, no matter whether its force application point is higher than, lower than, or equal to the level of the top of the miniscrews.


Assuntos
Parafusos Ósseos , Análise de Elementos Finitos , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Fechamento de Espaço Ortodôntico , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Adulto , Fenômenos Biomecânicos , Simulação por Computador , Dente Canino/patologia , Humanos , Imagem Tridimensional/métodos , Incisivo/patologia , Maxila , Modelos Biológicos , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos , Braquetes Ortodônticos , Fechamento de Espaço Ortodôntico/instrumentação , Fechamento de Espaço Ortodôntico/métodos , Fios Ortodônticos , Planejamento de Assistência ao Paciente , Estresse Mecânico , Coroa do Dente , Torque , Resultado do Tratamento
12.
Am J Orthod Dentofacial Orthop ; 156(2): 266-274, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375237

RESUMO

Adult orthodontic treatment involving maxillary transverse deficiency is a challenge for an interdisciplinary team. Surgically assisted rapid palatal expansion to segment the maxilla was once the treatment of choice, but the invasiveness, bone deficiency, and gingival recession hindered its acceptance. Corticotomy-assisted rapid maxillary arch expansion with ridge augmentation has the advantage of augmenting alveolar bony housing to accommodate and facilitate tooth movement. This approach was used to correct a severely constricted maxilla with bilateral posterior crossbite and anterior crowding in a 46-year-old man. Treatment time was 14 months. The accelerated arch expansion overcame the crossbite in 7 months, increasing intercanine distance by 5.2 mm and intermolar distance by 9.8 mm. Subsequent implant prosthesis was able to be restored in a functional normal occlusion. Satisfactory and stable clinical outcome was followed for 7 years. Corticotomy-assisted rapid maxillary arch expansion with alveolar bone augmentation is a novel and effective interdisciplinary approach for correcting adult maxillary transverse deficiency. Well controlled prospective clinical trails are warranted for further investigation.


Assuntos
Aumento do Rebordo Alveolar/métodos , Má Oclusão/terapia , Técnica de Expansão Palatina , Técnicas de Movimentação Dentária/métodos , Cefalometria , Modelos Dentários , Oclusão Dentária , Seguimentos , Humanos , Masculino , Má Oclusão/diagnóstico por imagem , Má Oclusão/patologia , Má Oclusão/cirurgia , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/patologia , Má Oclusão de Angle Classe II/cirurgia , Má Oclusão de Angle Classe II/terapia , Má Oclusão de Angle Classe III/diagnóstico por imagem , Má Oclusão de Angle Classe III/patologia , Má Oclusão de Angle Classe III/cirurgia , Má Oclusão de Angle Classe III/terapia , Maxila/anormalidades , Maxila/patologia , Maxila/cirurgia , Pessoa de Meia-Idade , Aparelhos Ortodônticos , Braquetes Ortodônticos , Fios Ortodônticos , Palato/cirurgia , Planejamento de Assistência ao Paciente , Estudos Prospectivos , Resultado do Tratamento
13.
Am J Orthod Dentofacial Orthop ; 156(2): 275-282, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31375238

RESUMO

This case report describes the interdisciplinary treatment of an ectopic horizontally placed maxillary right central incisor with severe root dilaceration. The root was distally angulated and entrapped by the root of the maxillary right lateral incisor. The initial force system was aimed at an occlusal displacement and applied to the crown. During the second phase, a button was cemented onto the apex of the impacted tooth. A force from the apex to a temporary anchorage device in the palate moved the root toward the midline. Finally, a root canal and an apectomy were performed and the central incisor could be moved to its ideal position. The treatment generated a normal height of the alveolar bone and an ideal occlusion with a healthy periodontium.


Assuntos
Incisivo/cirurgia , Técnicas de Movimentação Dentária/métodos , Raiz Dentária/cirurgia , Dente Impactado/cirurgia , Dente Impactado/terapia , Fenômenos Biomecânicos , Criança , Tomografia Computadorizada de Feixe Cônico/métodos , Cavidade Pulpar , Feminino , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imagem Tridimensional , Má Oclusão de Angle Classe I/terapia , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Maxila/cirurgia , Aparelhos Ortodônticos Fixos , Extrusão Ortodôntica/métodos , Planejamento de Assistência ao Paciente , Tratamento do Canal Radicular , Coroa do Dente , Dente Impactado/diagnóstico por imagem , Resultado do Tratamento
14.
J Med Case Rep ; 13(1): 207, 2019 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-31279335

RESUMO

BACKGROUND: Little information is available on the treatment of open bite with temporomandibular joint disorder by intrusion of molars using miniscrews. CASE PRESENTATION: This case report describes a 42-year-old Japanese woman with a skeletal class II severe anterior open bite and temporomandibular joint disorder. The pretreatment magnetic resonance imaging of both temporomandibular joints revealed osteoarthritis and anterior disc displacement without reduction in both temporomandibular joints. A stabilization splint was used before orthodontic treatment and bilateral upper and lower premolars were extracted. Miniscrews were inserted into the palatal region to intrude the maxillary molars and avoid loss of anchorage. The maxillary left first molar was also extracted to improve the molar relationship and the dental midline. Normal overjet and overbite with Angle class I molar relationship were achieved, and the upper and lower midlines coincided. Our patient's teeth continued to be stable and her temporomandibular joint was asymptomatic after a retention period of 2 years. CONCLUSIONS: Intrusion of molars by miniscrews is available for skeletal class II severe open bite.


Assuntos
Sobremordida/terapia , Transtornos da Articulação Temporomandibular/terapia , Técnicas de Movimentação Dentária/métodos , Adulto , Parafusos Ósseos , Feminino , Humanos , Imagem por Ressonância Magnética , Dente Molar/cirurgia , Sobremordida/complicações , Sobremordida/diagnóstico por imagem , Transtornos da Articulação Temporomandibular/complicações , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Extração Dentária
15.
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
16.
Am J Orthod Dentofacial Orthop ; 156(1): 148-156, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256828

RESUMO

This article reports on the technical aspects of using a computer-aided design-computer-aided manufacturing (CAD-CAM) insertion guide for the placement of orthodontic mini-implants used for the purpose of providing anchorage support for maxillary molar distalization. A 10-year-old girl presented with a bilateral full-step Angle Class II molar relationship in the permanent dentition, with anterior arch-length insufficiency and blocked out maxillary canine teeth. The primary treatment objective was to provide an esthetic and functional occlusal outcome, and secondarily to avoid the removal of multiple premolar teeth. The patient was initially treated with an implant-supported distalization device, and the occlusion was subsequently detailed with preadjusted fixed orthodontic appliances. The CAD-CAM procedure facilitates the safe and precise insertion of mini-implants in the anterior palate, potentially broadening the scope of use of palatal mini-implants for less experienced clinicians. The illustrated protocol allows for the insertion of mini-implants and fitting of a prefabricated appliance in a single office appointment.


Assuntos
Parafusos Ósseos , Projeto Auxiliado por Computador , Implantes Dentários , Má Oclusão de Angle Classe II/terapia , Procedimentos de Ancoragem Ortodôntica/métodos , Desenho de Aparelho Ortodôntico/métodos , Técnicas de Movimentação Dentária/métodos , Dente Pré-Molar , Cefalometria/métodos , Criança , Dente Canino , Modelos Dentários , Dentição Permanente , Estética Dentária , Feminino , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/cirurgia , Maxila/diagnóstico por imagem , Maxila/cirurgia , Dente Molar , Procedimentos de Ancoragem Ortodôntica/instrumentação , Desenho de Aparelho Ortodôntico/instrumentação , Aparelhos Ortodônticos Fixos , Fios Ortodônticos , Palato/diagnóstico por imagem , Palato/cirurgia , Planejamento de Assistência ao Paciente , Técnicas de Movimentação Dentária/instrumentação , Resultado do Tratamento
17.
Am J Orthod Dentofacial Orthop ; 156(1): 75-86, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256844

RESUMO

INTRODUCTION: Maintaining tooth anchorage during orthodontic treatment has challenged orthodontists and threatening the success of some orthodontic therapy. The objective of this study was to evaluate the effect of local administration of simvastatin on orthodontic tooth movement. METHODS: Nickel-titanium coil springs were used to induce orthodontic tooth movement in 10 white New Zealand rabbits for 21 days. A split-mouth design was implemented where one mandibular quadrant received local administration of simvastatin and the corresponding mandibular quadrant received control vehicle solution on a weekly basis. Magnitudes of tooth movement were measured on 3-dimensional models of the experimental teeth. Animals were killed at the end of the experimental period to allow histomorphometric analysis of alveolar bone modeling. RESULTS: The total magnitude of tooth movement in the quadrant receiving simvastatin was significantly less than that in the quadrant receiving control vehicle solution. Local administration of simvastatin resulted in a significant percentage of inhibition of tooth movement of 39.8 ± 22.6%. Histomorphometric analysis revealed a significant reduction in the numbers of osteoclasts and areas of active bone-resorptive lacunae hindering bone resorption processes in the quadrant receiving simvastatin. CONCLUSIONS: Local administration of simvastatin can reduce the rate and magnitude of orthodontic tooth movement. Moreover, local administration of simvastatin diminishes bone resorption processes associated with orthodontic tooth movement reducing the number of osteoclasts and the subsequent area of active bone resorption.


Assuntos
Reabsorção Óssea/patologia , Osteoclastos/efeitos dos fármacos , Sinvastatina/administração & dosagem , Sinvastatina/antagonistas & inibidores , Técnicas de Movimentação Dentária/métodos , Perda do Osso Alveolar/diagnóstico por imagem , Perda do Osso Alveolar/patologia , Animais , Remodelação Óssea/efeitos dos fármacos , Reabsorção Óssea/diagnóstico por imagem , Masculino , Mandíbula/irrigação sanguínea , Mandíbula/efeitos dos fármacos , Mandíbula/patologia , Modelos Animais , Níquel/química , Aparelhos Ortodônticos , Fios Ortodônticos , Osteoclastos/patologia , Coelhos , Titânio/química , Técnicas de Movimentação Dentária/instrumentação
18.
Am J Orthod Dentofacial Orthop ; 156(1): 87-93, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256846

RESUMO

INTRODUCTION: The aim of this study was to evaluate the effects of mechanical vibration and low-level laser therapy on orthodontic pain after placement of the initial archwire. METHODS: Sixty subjects with 3-6 mm maxillary dental crowding, a nonextraction fixed treatment plan, and no medical history were included in this study. The subjects were randomly divided into 3 groups, equally distributed by sex. In each subject, preadjusted edgewise appliances were placed in the maxillary arch from the left first molar to the right first molar, and a 0.014-inch round nickel-titanium archwire was fully engaged with elastomeric ties and cut at the end of first molar bondable tube. In group 1 (mean age 13.98 ± 2.68 y), mechanical vibration was performed 3 times: immediately, 24 hours, and 48 hours after engagement of the initial archwire. In group 2 (mean age 14.86 ± 2.06 y), low-level laser therapy was applied once: immediately after the insertion of the initial archwire. Group 3 (mean age 14.41 ± 1.78 y) served as the control group. Pain scores were determined with the use of a visual analog scale (VAS). RESULTS: Although no statistically significant differences were found among the groups (P >0.05), the mean VAS scores for the mechanical vibration group were consistently lower than those of the control and low-level laser therapy groups at all measured time points. CONCLUSIONS: The mechanical vibration group had lower, though nonsignificant, VAS scores for all measured time points. Additional clinical trials are recommended for more definitive conclusions.


Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Má Oclusão/terapia , Fios Ortodônticos , Manejo da Dor/métodos , Técnicas de Movimentação Dentária/métodos , Vibração/uso terapêutico , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Maxila , Dente Molar , Níquel , Desenho de Aparelho Ortodôntico , Dor/etiologia , Medição da Dor , Titânio , Técnicas de Movimentação Dentária/efeitos adversos , Técnicas de Movimentação Dentária/instrumentação , Adulto Jovem
19.
Am J Orthod Dentofacial Orthop ; 156(1): 94-103, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31256848

RESUMO

INTRODUCTION: Self-ligating appliances are purposed to expand the arches, but evidence on stability of the result is lacking. We measured the width of maxillary and mandibular arches and torque changes after treatment with the use of passive self-ligating appliances and assessed stability at the 2-year follow-up. METHODS: Maxillary and mandibular 3-dimensional (3D) models from 32 subjects (mean initial age 14.9 ± 0.9 years), consecutively treated with the use of self-ligating appliances, were obtained before, immediately after, and 2 years after treatment. Dental arches were examined with the use of 3D software to evaluate differences in transverse arch dimensions and torque values. RESULTS: An incremental increase of arch widths was recorded, especially regarding maxillary and mandibular premolars. The increase in the transverse diameters was associated with a significant positive torque gain. No significant changes in arch perimeter and depth were recorded. In the retention period, slight significant changes in transverse diameters were recorded, and a transverse diameter constriction detected. Torque values remained almost unchanged in the follow-up period. CONCLUSIONS: Transverse arch dimensions, along with torque values, increased significantly after treatment with the use of a passive self-ligating appliance. In the 2 years following treatment, a tendency to transverse diameter restriction, especially for the maxillary and mandibular premolars, was observed.


Assuntos
Arco Dental/anatomia & histologia , Má Oclusão/terapia , Aparelhos Ortodônticos , Técnica de Expansão Palatina , Técnicas de Movimentação Dentária/métodos , Torque , Adolescente , Adulto , Análise de Variância , Dente Pré-Molar , Projeto Auxiliado por Computador , Técnica de Fundição Odontológica , Modelos Dentários , Feminino , Seguimentos , Humanos , Imagem Tridimensional/métodos , Masculino , Má Oclusão/patologia , Mandíbula , Maxila , Níquel , Desenho de Aparelho Ortodôntico , Técnica de Expansão Palatina/instrumentação , Software , Titânio , Coroa do Dente/anatomia & histologia , Técnicas de Movimentação Dentária/instrumentação , Resultado do Tratamento , Adulto Jovem
20.
Am J Orthod Dentofacial Orthop ; 155(6): 871-880, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31153508

RESUMO

This case report describes the orthodontic treatment of a patient with severe crowding; the maxillary right canines were ectopic, positioned far to the buccal side, and superimposed on the lateral incisors in near-transposition. Treatment included extraction of the 4 first premolars. A transpalatal bar was used as an anchorage device, and beta-titanium T-loop springs (0.019 × 0.025″) were used to better control the ideal force applied to retract the maxillary canines. A segmental T-loop spring was used as if it were a modified system of the segmental archwire technique. After the canines were retracted and space created for the anterior teeth, the latter were included in the treatment and the treatment was finished in the usual manner. Excellent results were achieved, both esthetic and functional. The treatment choices and their straightforward approach were appropriate, yielding predictable and stable results in the long term.


Assuntos
Dente Canino , Erupção Ectópica de Dente/terapia , Técnicas de Movimentação Dentária/métodos , Adolescente , Cefalometria , Estética Dentária , Feminino , Humanos , Radiografia Panorâmica , Erupção Ectópica de Dente/diagnóstico por imagem
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