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1.
Niger J Clin Pract ; 23(11): 1624-1627, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33221792

RESUMO

This report describes the successful use of two multifunctional mini-implants that were inserted into the palate in the treatment of an 18-year-old woman in whom the maxilla was skeletally narrowed and the molars have migrated mesially on both sides. Three different appliances were used in sequence in the course of treatment: first, an appliance supported by bone and teeth (hybrid hyrax) for surgically-assisted rapid maxillary expansion (SARME); second, a distalization device supported by mini-implants to achieve molar distalization; and third, a transpalatal arch (TPA) stabilized by mini-implants to allow indirect anchorage during retraction of the incisors. The mini-implants in the palate led to a reduction in the adverse effects of the SARME procedure and made treatment with cervical headgear unnecessary. TPA stabilized by the mini-implant was also used to retract the anterior teeth en masse, with no need for alterations in the treatment mechanism and using routine orthodontic methods.


Assuntos
Má Oclusão de Angle Classe II/terapia , Maxila/cirurgia , Procedimentos de Ancoragem Ortodôntica/instrumentação , Técnicas de Movimentação Dentária/métodos , Adolescente , Cefalometria/métodos , Constrição , Feminino , Humanos , Incisivo , Dente Molar/patologia , Técnica de Expansão Palatina , Palato , Radiografia Dentária , Técnicas de Movimentação Dentária/instrumentação , Resultado do Tratamento
2.
PLoS One ; 15(9): e0239759, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32970759

RESUMO

OBJECTIVE: The purpose of this study was to evaluate the effects of miniscrew insertion angle and vertical facial type on the interradicular miniscrew-root distance available for molar distalization. MATERIALS AND METHODS: Cone-beam computed tomography images of 60 adults with skeletal Class I occlusion exhibiting hyperdivergent (n = 20), normodivergent (n = 20), and hypodivergent (n = 20) facial types were used. Placement of a 6-mm long, 1.5-mm diameter, tapered miniscrew was simulated at a site 4 mm apical to the cementoenamel junction, with insertion angles of 0°, 30°, 45°, and 60° relative to the transverse occlusal plane. The shortest linear distance between the miniscrew and anterior root at four interradicular sites was measured: maxillary second premolar and first molar (Mx 5-6), maxillary first and second molars (Mx 6-7), mandibular second premolar and first molar (Mn 5-6), and mandibular first and second molars (Mn 6-7). RESULTS: Miniscrew-root distance significantly increased as the insertion angle increased from 0° to 60°. In the mandible, the distances significantly differed among vertical facial types, increasing in the following order: hyperdivergent, normodivergent, and hypodivergent. The minimum mean distance was found in the Mx 6-7 (30°; 0.86±0.35 mm), and the maximum mean distance was found in the Mn 5-6 (60°; 2.64±0.56 mm). The rates of miniscrews located buccally outside the root distalization path were up to 70% and 55% when the miniscrews were placed at 60° insertion angles in the Mx 5-6 and Mn 5-6 regions, respectively. CONCLUSIONS: Miniscrew-root distance increased significantly with the increased insertion angle, and the amount of increase was affected by the miniscrew placement site and vertical facial type. To ensure adequate distalization of the posterior segment, the miniscrew should be inserted at an angle in the interradicular area between the second premolar and first molar.


Assuntos
Parafusos Ósseos , Simulação por Computador , Tomografia Computadorizada de Feixe Cônico/métodos , Dente Molar/diagnóstico por imagem , Procedimentos de Ancoragem Ortodôntica/métodos , Técnicas de Movimentação Dentária/métodos , Raiz Dentária/diagnóstico por imagem , Adulto , Feminino , Humanos , Masculino , Procedimentos de Ancoragem Ortodôntica/instrumentação , Técnicas de Movimentação Dentária/instrumentação
3.
Sci Rep ; 10(1): 12154, 2020 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-32699355

RESUMO

Animal experiments are essential for the elucidation of biological-cellular mechanisms in the context of orthodontic tooth movement (OTM). So far, however, no studies comparatively assess available mouse models regarding their suitability. OTM of first upper molars was induced in C57BL/6 mice either via an elastic band or a NiTi coil spring for three, seven or 12 days. We assessed appliance survival rate, OTM and periodontal bone loss (µCT), root resorptions, osteoclastogenesis (TRAP+ area) and local expression of OTM-related genes (RT-qPCR). Seven days after the elastic bands were inserted, 87% were still in situ, but only 27% after 12 days. Survival rate for the NiTi coil springs was 100% throughout, but 8.9% of the animals did not survive. Both methods induced significant OTM, which was highest after 12 (NiTi spring) and 7 days (band), with a corresponding increase in local gene expression of OTM-related genes and osteoclastogenesis. Periodontal bone loss and root resorptions were not induced at a relevant extent by neither of the two procedures within the experimental periods. To induce reliable OTM in mice beyond 7 days, a NiTi coil spring is the method of choice. The elastic band method is recommended only for short-term yes/no-questions regarding OTM.


Assuntos
Dente Molar/fisiologia , Técnicas de Movimentação Dentária/métodos , Perda do Osso Alveolar/diagnóstico , Perda do Osso Alveolar/diagnóstico por imagem , Animais , Remodelação Óssea , Catepsina K/genética , Catepsina K/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Modelos Animais , Braquetes Ortodônticos , Osteoclastos/citologia , Osteoclastos/metabolismo , Osteogênese , Reabsorção da Raiz/diagnóstico , Microtomografia por Raio-X
4.
Sci Rep ; 10(1): 10156, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-32576935

RESUMO

To evaluate tooth behaviours under various maxillary incisor retraction protocols for clear aligner therapy. A three-dimensional finite element model of maxillary dentition was constructed for first premolar extraction. A loading method was developed to mimic the mode of action of clear aligners for incisor en masse retraction. Three protocols with different amounts of retraction and intrusion on incisors were designed. Initial tooth displacements and stresses on periodontal ligaments were analysed with ANSYS software. The central (U1) and lateral (U2) incisors exhibited uncontrolled lingual tipping and extrusion upon 0.25 mm retraction. U1 exhibited translation movement, while U2 underwent less tipping during 0.2 mm retraction and 0.15 mm intrusion. Labial tipping and intrusion of U1 and bodily intrusion of U2 were observed during 0.1 mm of retraction and 0.23 mm of intrusion. With the additional intrusion on incisors, canine showed extrusion movement, and higher stresses on periodontal ligaments were shifted from U2 to canines. Incisors also exhibited different mesial-distal angulation in the three simulations, while posterior teeth all suffered mesial inclination. Incorporating intrusion displacement in clear aligners led to a tendency of lingual root movement during incisor retraction. The complexity of tooth movement should be recognized regarding clear aligner therapy.


Assuntos
Análise de Elementos Finitos , Maxila , Aparelhos Ortodônticos Removíveis , Impressão Tridimensional , Técnicas de Movimentação Dentária/métodos , Dente Pré-Molar , Fenômenos Biomecânicos , Dentição , Humanos , Incisivo , Ligamento Periodontal , Software , Estresse Mecânico , Mobilidade Dentária
5.
Cell Prolif ; 53(5): e12810, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32472648

RESUMO

OBJECTIVES: Gli1+ cells have received extensive attention in tissue homeostasis and injury mobilization. The aim of this study was to investigate whether Gli1+ cells respond to force and contribute to bone remodelling. MATERIALS AND METHODS: We established orthodontic tooth movement (OTM) model to assess the bone response for mechanical force. The transgenic mice were utilized to label and inhibit Gli1+ cells, respectively. Additionally, mice that conditional ablate Yes-associated protein (Yap) in Gli1+ cells were applied in the present study. The tooth movement and bone remodelling were analysed. RESULTS: We first found Gli1+ cells expressed in periodontal ligament (PDL). They were proliferated and differentiated into osteoblastic cells under tensile force. Next, both pharmacological and genetic Gli1 inhibition models were utilized to confirm that inhibition of Gli1+ cells led to arrest of bone remodelling. Furthermore, immunofluorescence staining identified classical mechanotransduction factor Yap expressed in Gli1+ cells and decreased after suppression of Gli1+ cells. Additionally, conditional ablation of Yap gene in Gli1+ cells inhibited the bone remodelling as well, suggesting Gli1+ cells are force-responsive cells. CONCLUSIONS: Our findings highlighted that Gli1+ cells in PDL directly respond to orthodontic force and further mediate bone remodelling, thus providing novel functional evidence in the mechanism of bone remodelling and first uncovering the mechanical responsive property of Gli1+ cells.


Assuntos
Remodelação Óssea/fisiologia , Osso e Ossos/metabolismo , Osso e Ossos/fisiologia , Proteína GLI1 em Dedos de Zinco/metabolismo , Animais , Diferenciação Celular/fisiologia , Mecanotransdução Celular/fisiologia , Camundongos , Camundongos Transgênicos , Osteoclastos/metabolismo , Osteoclastos/fisiologia , Ligamento Periodontal/metabolismo , Ligamento Periodontal/fisiologia , Estresse Mecânico , Técnicas de Movimentação Dentária/métodos
6.
PLoS One ; 15(4): e0231492, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32320408

RESUMO

OBJECTIVE: This meta-analysis aimed at critically assessing currently available evidence regarding the overall effectiveness of Piezocision in accelerating orthodontic tooth movement, as well as the adverse effects of this intervention in orthodontic patients. SEARCH METHODS: Electronic search of 6 databases and additional manual searches up to April 2019 without restrictions, also update the search was done by 20th November. SELECTION CRITERIA: Randomized controlled trials (RCT) and controlled clinical trials (CCT) reporting piezocision-assisted orthodontics versus conventional orthodontics were included in the review. DATA COLLECTION AND ANALYSIS: The data are expressed by mean differences (MD), 95% confidence intervals, fixed-effect model or random-effect model in the meta-analysis in regard to statistical heterogeneity analyses (tau2, and I2). Included randomized studies were assessed for risk of bias using the new Cochrane Risk of Bias tool (ROB.2) and the non-randomized studies were assessed using (ROBINS I) tool. The studies were graded according to the GRADE approach. RESULTS: Fourteen papers for 13 unique trials were included in this systematic review and eight studies were included in the meta-analysis. The meta-analysis showed that the mean difference of the canine retraction rate in the first and second month after piezocision was 0.66 mm/month and 0.48mm/month, respectively. A total canine retraction rate in the first two months after piezocision was statistically significant (0.57 mm/month, p<0.00001), favoring the piezocision group with a high heterogeneity between studies I2 = 69%. For the total treatment time outcome measure, there was a statistically significant difference in the overall treatment time (MD 101.64 Days, 95% CI, 59.24-144.06) favoring the piezocision group. CONCLUSIONS: Low quality evidence suggests that piezocision is an effective surgical procedure in accelerating the rate of canine retraction in the first two months and reducing the treatment duration. However, this effect appears to be clinically insignificant. SYSTEMATIC REVIEW REGISTRATION: CRD42019136303.


Assuntos
Técnicas de Movimentação Dentária/métodos , Ensaios Clínicos como Assunto , Humanos , Ortodontia/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto
7.
Medicine (Baltimore) ; 99(13): e19430, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32221067

RESUMO

INTRODUCTION: Loss of a dental element can generate several repercussions in the stomatognathic system. According to the latest survey by the Ministry of Health, in 2010, Brazilian adults had, on average, 7 missing teeth. This loss may lead to movement of the adjacent teeth and the antagonist, which would make prosthetic rehabilitation harder to do. Anchoring systems, such as mini-implants, have been increasingly used as a treatment option because they act with heavy but controlled forces and without side effects. Recent studies have shown that photobiomodulation (PBM) can accelerate orthodontic movement in molar intrusion. The objective of this study will be to evaluate the effect of PBM on the acceleration of the orthodontic movement of molar verticalization and its effect on pain and inflammation of the periodontal tissues. PATIENT CONCERNS:: the concerns assessments will be done over the study using anamnesis interviews and specific questionnaire. DIAGNOSIS: verticalization will be evaluated by clinical and radiographic analysis. INTERVENTIONS: Thirty four healthy patients aged 30 to 60 years, who need to recover the prosthetic space for oral rehabilitation after loss of the posterior inferior dental elements and inclination of the adjacent element, will be randomly divided into 2 groups: G1 (control group) - verticalization by mini-implant + PBM simulation (placebo); G2 (experimental group) - verticalization by mini-implant + PBM. The movements will occur with the aid of mini-implants and elastomeric chains ligatures. The PBM will occur with diode laser application, 808 nm, 100 mW, receiving 1J per point, 10 seconds, 10 points (5 per buccal and 5 per lingual) and radiant exposure of 25 J/cm. The orthodontic forces of verticalization (corresponding to any exchange of elastomeric ligation) will be applied every 30 days and the PBM will be applied immediately, 3 and 7 days of each month, for a period of 3 months. The crevicular gingival fluid (CGF) will be collected on the 1st, 3rd, and 7th days after the first activation, and then on the 3rd day of the following 2 months. OUTCOMES: Interleukins IL1ß, IL-6, IL-8, IL-10, and TNF-α will be analyzed by ELISA. Panoramic radiography will be performed at baseline and 90 afterwards to ascertain the amount (in degrees) of verticalization. To evaluate the pain, the Visual Analog Scale (VAS) will be used in all the consultations, and to evaluate the quality of life, the Oral Health Impact Profile (OHIP-14) questionnaire will be applied. Analgesics will be given and the quantity of drugs will be counted. If the data are normal, they will be submitted to Student t test. The data will be presented as means ± SD and the value of p will be defined as <0.05. DISCUSSION: This protocol will determine the effectiveness of photobiomoduation regarding the orthodontic movement of molar verticalization. ETHICS AND DISSEMINATION: This protocol received approval from the Human Research Ethics Committee of Universidade Nove de Julho (certificate number: 3 533 219). The data will be published in a peer-reviewed periodical.


Assuntos
Interleucinas/biossíntese , Terapia com Luz de Baixa Intensidade/métodos , Dente Molar/efeitos da radiação , Técnicas de Movimentação Dentária/métodos , Adulto , Brasil , Método Duplo-Cego , Feminino , Líquido do Sulco Gengival , Humanos , Lasers Semicondutores , Masculino , Pessoa de Meia-Idade , Dor/etiologia , Medição da Dor , Qualidade de Vida , Técnicas de Movimentação Dentária/efeitos adversos , Fator de Necrose Tumoral alfa/biossíntese
8.
Int J Mol Sci ; 21(4)2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32102282

RESUMO

Surgical methods for accelerating orthodontic tooth movement are limited by possible damage to the tooth root and patient discomfort. 4-Hexylresorcinol (4HR) has been shown to increase bone remodeling and may potentially facilitate tooth movement. This study investigated the (1) effect of 4HR administration on osteoblast-like cells and (2) effect of 4HR administration on tooth movement in ovariectomized rats. Saos-2 cells were treated with either 4HR or solvent (control). Protein expression levels were investigated 2, 8, and 24 h after treatment. Thirty ovariectomized Sprague-Dawley rats were divided into two experimental groups (A and B) and one control group. After installation of an orthodontic tooth movement device, groups A and B received subcutaneous weekly injections of 4HR (1.28 and 128 mg/kg). Micro-computerized tomography and histological analyses were performed after 2 weeks of tooth movement. The application of 4HR elevated expression of osteogenic markers in Saos-2 cells. Movement of the first molars was significantly greater in rats administered 4HR. Furthermore, the expression of bone morphogenic protein-2, receptor activator of nuclear factor kappa-B ligand, osteocalcin, and tartrate-resistant acid phosphatase were increased after 4HR administration. 4HR application demonstrated increased expression of osteogenic markers in Saos-2 cells and accelerated orthodontic tooth movement in rats.


Assuntos
Hexilresorcinol/farmacologia , Osteogênese/efeitos dos fármacos , Ovariectomia , Técnicas de Movimentação Dentária/métodos , Animais , Biomarcadores/sangue , Linhagem Celular Tumoral , Ensaio de Imunoadsorção Enzimática , Hexilresorcinol/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Osteocalcina/sangue , Osteocalcina/metabolismo , Osteopontina/sangue , Osteopontina/metabolismo , Ratos Sprague-Dawley , Fator de Crescimento Transformador beta1/sangue , Fator de Crescimento Transformador beta1/metabolismo
9.
Comput Methods Biomech Biomed Engin ; 23(7): 295-302, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31985276

RESUMO

The objective of this study was to assess the biomechanical effects of different corticotomy designs used for orthodontic anterior retraction through finite element analysis. MATERIALS AND METHODS: A basic finite element model simulating retraction of anterior teeth was built reversely from CBCT films of an adult patient with protruded maxillary anterior teeth. Another thirteen FE models were created according to different corticotomy designs varied with site width and the extent of incision. The initial displacement, Von Mises stress and pressure stress of dento-alveolar structures was computerized and analyzed. RESULTS: Corticotomy can increase the initial displacement of anterior segment including teeth and surrounding alveolar bone, change the distribution of Von Mises stress in cancellous bone and the pressure stress in periodontal ligament of anterior teeth. When the incision was near the periphery of apical, the anterior segment showed the greatest displacement, the cancellous bone at either sockets or incision region showed the maximum stress. Bilateral incision combined with palatal incision showed approximate initial displacement and stress distribution with circumscribing incision. While the incision width increased, the biomechanical effects of corticotomy amplified. CONCLUSIONS: Varied corticotomy designs can change the biomechanical effects on dento-alveolar structures. The incision near the periphery of apical and bilateral incision combined with palatal incision may be the optimized design used for retraction of anterior teeth.


Assuntos
Análise de Elementos Finitos , Técnicas de Movimentação Dentária/métodos , Adulto , Fenômenos Biomecânicos , Humanos , Maxila/cirurgia , Ligamento Periodontal/cirurgia , Estresse Mecânico , Dente/cirurgia
10.
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
11.
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
12.
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
13.
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
14.
J Craniofac Surg ; 31(1): 172-177, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31842074

RESUMO

This retrospective research aimed to highlight the changes of occlusal plane in Class II hyperdivergent subjects that received cervical headgear treatment and compared them to untreated controls in order to evaluate the occlusal changes that might be connected to a potential mandibular rotation.The sample of this investigation was represented by 20 hyperdivergent Class II subjects (10 males, 10 females; mean age 8.54) corrected by using cervical headgear (treated group) and 21 Class II patients (11 males, 10 females; mean age 8.41) hyperdivergent who had no therapy (control group). Lateral head films were studied for all the patients before treatment (T1) and after therapy (T2) for both groups; cephalometric analysis was used in order to seek the modifications between time points and between groups.Means and standard deviation have been computed for both groups. In order to confront the modification between the time points within the same group the Wilcoxon test was applied. The Mann-Whitney U test was applied to confront the dissimilarities between groups at T2.As a result of the Class II correction by using the cervical headgear treatment the occlusal plane was lowered and flattened compared to T1 and to the control group; the upper molars showed extrusion to the palatal plane, there was a significant forward rotation of mandible and the vertical dimension was not significantly modified. Downward and backward displacement of the upper jaw occurred.


Assuntos
Dimensão Vertical , Cefalometria , Criança , Feminino , Cabeça , Humanos , Masculino , Má Oclusão de Angle Classe II/terapia , Pescoço , Estudos Retrospectivos , Rotação , Estatísticas não Paramétricas , Técnicas de Movimentação Dentária/métodos
15.
Pain Res Manag ; 2019: 6271835, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31772695

RESUMO

Background: This first-in-human study in Saudi orthodontic patients has evaluated the role of low-level laser therapy (LLLT) in pain perception (PP). The outcome of single application of LLLT with 4 different treatment modalities (TM) on PP are evaluated following orthodontic bracket bonding on maxilla. Materials and Methods: A prospective clinical intervention with implementation of parallel technique in each group, 32 orthodontic patients with ectopic canine requiring fixed orthodontic appliance were enrolled and randomly allocated to the 4 groups: LLLT + self-ligating (SL) bracket, LLLT + conventional (Conv.) bracket, non-LLLT + SL bracket, and non-LLLT + Conv. bracket. Orthodontic bracket bonding from 1st molar to 1st molar and superelastic 0.012 inch NiTi were applied for the maxilla. For each patient, maxillary 1st molar to molar received a single application of LLLT using a 940 nm Ga-Al-As laser device on 5 different points labially/buccally and palatally. Main outcome measure was the degree of PP score during the 1st week of orthodontic tooth movement (OTM) after 4 hours, 24 hours, 3 days, and 7 days of both LLLT and non-LLLT treatment applications. A questionnaire with an 11-point numeric rating scale (NRS) was used for PP. Results: Mean ± SD of PP in the LLLT + SL group was 3.33 ± 1.4, 3.58 ± 1.06, 2.31 ± 0.67, and 1.89 ± 0.54 in 4 hours, 24 hours, 3 days, and 7 days, respectively. Compared to all 4 TM groups, LLLT groups showed better PP. More statistically significant differences were found in LLLT groups. No harms were encountered. Limitations: The intervention provider and the patient were not blinded to the intervention. Conclusion: The LLLT + SL group revealed significantly promising benefits on PP during OTM.


Assuntos
Terapia com Luz de Baixa Intensidade/métodos , Braquetes Ortodônticos/efeitos adversos , Manejo da Dor/métodos , Dor/etiologia , Técnicas de Movimentação Dentária/métodos , Adolescente , Adulto , Feminino , Humanos , Masculino , Dor/prevenção & controle , Medição da Dor/métodos , Percepção da Dor/efeitos da radiação , Estudos Prospectivos , Arábia Saudita , Inquéritos e Questionários , Técnicas de Movimentação Dentária/efeitos adversos , Adulto Jovem
16.
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
17.
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
18.
Int Orthod ; 17(4): 817-825, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31481304

RESUMO

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


Assuntos
Dente Pré-Molar/cirurgia , Má Oclusão de Angle Classe II/terapia , Má Oclusão de Angle Classe I/terapia , Extração Dentária , Técnicas de Movimentação Dentária/métodos , Adolescente , Pontos de Referência Anatômicos , Cefalometria , Modelos Dentários , Mentoplastia , Humanos , Masculino , Má Oclusão de Angle Classe I/diagnóstico por imagem , Má Oclusão de Angle Classe II/diagnóstico por imagem , Aparelhos Ortodônticos Fixos , Fios Ortodônticos , Osteotomia , Técnicas de Movimentação Dentária/instrumentação , Resultado do Tratamento
19.
Int Orthod ; 17(4): 806-816, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31477527

RESUMO

The treatment of skeletal deep bite does not remain stable. The patient was a Japanese woman aged 16 years and 10 months. Her chief complaint was maxillary protrusion. The degree of overjet was + 10.5 mm and overbite was + 5.0 mm; the intermolar relationship was Angle Class II. An excessive curve of Spee was observed in the mandibular arch. A hypodivergent skeletal pattern was indicated by a small mandibular plane angle and gonial angle. The maxillary incisors were proclined and the mandibular incisors were retroclined. Based on the above findings, the patient was diagnosed with Angle Class II maxillary protrusion and deep bite with hypodivergency. Both maxillary first premolars were extracted and orthodontic treatment was performed using multi-bracket appliances. A proper overbite was achieved by 5.0 mm intrusion of the mandibular incisors. The maxillary incisors were retracted by 11.2 mm and a proper overjet was achieved. Good treatment results were obtained without apical root resorption. After 2 years of retention, the occlusion has been well maintained. This report may constitute a remarkable suggestion for treatment of an unstable deep bite.


Assuntos
Incisivo , Má Oclusão de Angle Classe II/terapia , Maxila , Procedimentos de Ancoragem Ortodôntica/métodos , Sobremordida/terapia , Técnicas de Movimentação Dentária/métodos , Adolescente , Dente Pré-Molar , Cefalometria , Modelos Dentários , Oclusão Dentária , Feminino , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Mandíbula , Procedimentos de Ancoragem Ortodôntica/instrumentação , Braquetes Ortodônticos , Fios Ortodônticos , Sobremordida/diagnóstico por imagem , Técnicas de Movimentação Dentária/instrumentação , Resultado do Tratamento
20.
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
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