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1.
Angle Orthod ; 94(4): 414-420, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-39229946

RESUMO

OBJECTIVES: To compare the buccal and palatal bone changes of maxillary posterior teeth produced by hybrid hyrax (HH) and conventional hyrax (CH) expanders in growing patients. MATERIAL AND METHODS: A sample of 32 patients with posterior crossbites in the late mixed dentition was recruited and randomly allocated into two groups. Group HH was composed of 18 individuals with a mean age of 10.7 years (six female, 12 male) treated with a hybrid expander with two anterior parasagittal miniscrews. Group CH was composed of 14 individuals with a mean age of 11.4 years (six female, eight male) treated with a conventional Hyrax expander. Cone-beam computed tomography (CBCT) exams were obtained before expansion (T1) and after 11 months when the expander was removed (T2). Buccal and palatal bone plate thickness and height of maxillary posterior teeth were measured. Intergroup comparisons were performed using t or Mann-Whitney tests (P < .05). RESULTS: The CH group showed greater decreases of the buccal bone plate height (mean change: 1.27 mm) at the maxillary first premolars compared to the HH group (mean change: 0.11 mm, P = .001). No intergroup difference was found for changes in the buccal and palatal bone thickness. CONCLUSIONS: Hybrid expanders showed a tendency to cause less negative impact on the buccal bone plate height of first premolars compared to conventional Hyrax expanders. However, the difference was not clinically significant. Both hybrid and conventional Hyrax expanders are safe for the alveolar bone morphology in the late mixed dentition.


Assuntos
Processo Alveolar , Tomografia Computadorizada de Feixe Cônico , Técnica de Expansão Palatina , Humanos , Feminino , Masculino , Técnica de Expansão Palatina/instrumentação , Tomografia Computadorizada de Feixe Cônico/métodos , Criança , Processo Alveolar/diagnóstico por imagem , Maxila/diagnóstico por imagem , Desenho de Aparelho Ortodôntico , Má Oclusão/terapia , Má Oclusão/diagnóstico por imagem , Dentição Mista , Procedimentos de Ancoragem Ortodôntica/instrumentação , Procedimentos de Ancoragem Ortodôntica/métodos , Dente Pré-Molar/diagnóstico por imagem
2.
Angle Orthod ; 94(4): 392-399, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-39229950

RESUMO

OBJECTIVES: To compare changes in upper arch dimension and molar inclination between Invisalign First (IF) and removable acrylic expander (RE) treatments during the mixed dentition period. MATERIALS AND METHODS: Seventeen patients meeting inclusion criteria underwent IF treatment and were age matched with a group that received treatment with a removable acrylic expander (RE). Intercanine width (ICW), intermolar width, arch depth, buccolingual inclination of the first molars (MI), surface area (SA) and volume (VAP) of the anterior palate, and expansion were compared before and after treatment. The predictability of expansion was calculated for the IF group. Analysis of variance and Kruskal-Wallis tests were used to assess differences. RESULTS: The ICW increased significantly by 2.14 mm in the IF group and 3.49 mm in the RE group, with no significant intergroup difference. Both groups exhibited significant increases in intermolar width (P < .05), except for intermolar distopalatal width in the IF group (P = .246). Mesiobuccal rotation of the first molar was observed with IF treatment. Although SA and VAP increased in both groups, the changes were not significant for the IF group (P > .05). The RE group exhibited significantly higher increases (P < .05), with an SA increase of 34.32 mm2 and VAP increase of 119.15 mm3. MI changes were in the opposite directions. The prediction accuracy of expansion was 70.28% for canines and 34.12% for first molars. CONCLUSIONS: Both appliances effectively expanded the intercanine region in growing patients. Expansion predictability was lower in first molars than in canines for the IF group. Removable acrylic expanders could be a choice of preference for expansion targeted to the molar region.


Assuntos
Arco Dental , Dentição Mista , Maxila , Técnica de Expansão Palatina , Humanos , Feminino , Masculino , Criança , Técnica de Expansão Palatina/instrumentação , Aparelhos Ortodônticos Removíveis , Desenho de Aparelho Ortodôntico , Dente Molar , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos
3.
Angle Orthod ; 94(5): 496-503, 2024 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-39230021

RESUMO

OBJECTIVES: To compare vertical and transverse changes in mixed dentition patients treated with the Invisalign First System (IFS) to those treated with a banded hyrax expander with fixed appliances (Hyrax) and control groups, and to assess the efficiency rate of dental arch expansion with IFS. MATERIALS AND METHODS: The study included 80 mixed dentition patients, with 40 in each group (IFS and Hyrax) and 40 controls from the American Association of Orthodontists Foundation Craniofacial Growth Legacy Collection. Skeletal and dental vertical dimension changes and arch width changes between pretreatment (T1) and posttreatment (T2) were evaluated. RESULTS: Age at T1, time interval (T1-T2), sex, and Angle class did not significantly differ among the groups. Mandibular plane angle changes showed a similar reduction for the control and IFS groups, with no changes in the Hyrax group. However, the differences among the three groups did not reach statistical significance (P = .06). The Hyrax group showed significantly greater expansion in maxillary intermolar width compared to the IFS group, 4.4 vs 2.5 mm, respectively. The efficiency of maxillary expansion using IFS ranged from 52.3% to 76.87%. CONCLUSIONS: During the mixed dentition stage, no significant changes occurred in vertical dimensions among the control, Hyrax, and IFS groups. Although there was a trend suggesting a greater reduction in mandibular plane angle in the IFS group compared to the Hyrax group, this may not be clinically significant given the less than 1° difference. IFS can be a viable option for addressing mild arch width deficiencies, with a predictable increase in intermolar width of approximately 2.5 mm.


Assuntos
Dentição Mista , Aparelhos Ortodônticos Fixos , Técnica de Expansão Palatina , Humanos , Masculino , Feminino , Técnica de Expansão Palatina/instrumentação , Criança , Arco Dental , Desenho de Aparelho Ortodôntico , Maxila , Dimensão Vertical , Cefalometria , Resultado do Tratamento , Mandíbula/crescimento & desenvolvimento
4.
J Indian Soc Pedod Prev Dent ; 42(3): 226-234, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-39250207

RESUMO

BACKGROUND: Contemporary imaging methods and quickly advancing technologies have increased the number of diagnostic tools available in medicine and orthodontics. The current study aimed to determine three-dimensional (3D) space changes that occurred after the extraction of either the maxillary or mandibular primary molars during the mixed dentition period. MATERIALS AND METHODS: The present study was a longitudinal split-mouth study with a study group and a control group. The sample consisted of 20 children aged between 6 and 9 years. Clinical examination, radiological analysis, and 3D digital images of the plaster casts were used sequentially to gather all the data. The dental cast measurements recorded were arch width, arch length, hemi-perimeter, dental space at the extraction site, and angulation of the first permanent molar. The children were recalled for follow-up after 9 months, and all dental cast measurements were repeated using nondestructive 3D computed tomography software. For repeated measurements, the test applied was a paired t-test, and for independent samples, the test was a Student's t-test. RESULTS: A significant decrease in arch width (P = 0.001), arch length (P < 0.001), hemi-perimeter (P < 0.001), D-space (P < 0.001), and E-space (P = 0.001) was observed following extraction. A significant increase in angulation measurements was observed (P = 0.001). CONCLUSION: The study revealed a comparative reduction in mandibular arch width, a reduction in arch length in both the maxilla and the mandible, a reduced hemi-perimeter of dental arches, loss of dental extraction space, and a change in angulation of the erupted first permanent molars following premature loss of the primary molar.


Assuntos
Arco Dental , Dente Molar , Dente Decíduo , Humanos , Arco Dental/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Criança , Dente Decíduo/diagnóstico por imagem , Feminino , Masculino , Estudos Longitudinais , Tomografia Computadorizada por Raios X/métodos , Imageamento Tridimensional/métodos , Extração Dentária , Mandíbula/diagnóstico por imagem , Dentição Mista , Maxila/diagnóstico por imagem
5.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 59(9): 886-891, 2024 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-39289975

RESUMO

Early orthodontic treatment is an important means of preventing and treating dentofacial deformities during the period of growth and development. In this stage, children have great potential in growth and development, high adaptability of muscles and temporomandibular joint, and good responsiveness to orthodontic force. Therefore, orthodontic intervention and treatment in this stage can prevent and guide the normal growth and development of dentition, occlusion and maxillofacial complex. This article summarizes the commonly used orthodontic techniques and appliances in the mixed dentition, including interceptive treatment of oral habits, application of functional appliances, fixed appliances, clear aligners, as well as management of severe crowding and space maintenance. This article comprehensively explains the application and indications of different orthodontic techniques in design and appliance selection in the treatment of malocclusions in the mixed dentition.


Assuntos
Dentição Mista , Má Oclusão , Humanos , Má Oclusão/terapia , Criança , Aparelhos Ortodônticos Fixos , Aparelhos Ortodônticos Funcionais , Ortodontia Corretiva/métodos , Ortodontia Interceptora , Desenho de Aparelho Ortodôntico
6.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 59(9): 919-926, 2024 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-39289980

RESUMO

Objective: To compare the effects of expansion screw with maxillary protractor and clear aligners combined with maxillary protractor on the maxilla and maxillary dentition of mixed dentition patients with class Ⅲ skeletal malocclusion using finite element analysis, further providing clinical guidance for clear aligner treatment. Methods: A finite element model was established based on maxillofacial cone-beam CT data of a 10-year-old boy with mixed dentition, class Ⅲ skeletal malocclusion, who visited Department of Orthodontics, School of Stomatology, The Fourth Military Medical University in January, 2024. The expander with protractor group (group A) and the clear aligners with protractor group (group B) were divided. The arch was extended by 0.25 mm in both groups, and the forward pull force was 2.94 N (working condition 1) and 4.90 N (working condition 2), respectively. The initial displacement trend of maxilla and maxillary dentition in two groups under two working conditions were evaluated. Results: Under two working conditions, the maxilla of both groups showed clockwise rotation and labial inclination. The labial inclination of maxilla was more significant in clear aligners with protractor group, about 2.2-3.0 times that of expander with protractor group under the same working condition. Maxillary dentition showed mesial and buccal displacement, with anterior teeth extrusion and posterior teeth intrusion in two groups under two working conditions. Under the working condition 1 and 2, the labial displacement of central incisor of clear aligners with protractor group (-0.065, -0.089 mm) were greater than that in expander with protractor group (-0.024, -0.024 mm). Under two working conditions, the posterior teeth of expander with protractor group moved close to the buccal bodily direction, while those of clear aligners with protractor group moved tilted towards the buccal direction in the horizontal direction. The forward displacement trend of maxilla and maxillary dentition in clear aligners with protractor group was more obvious than expander with protractor group with the increase of the forward pull force. Under two working conditions, the anterior teeth' s hydrostatic stress of periodontal membrane and the equivalent stress of alveolar bone in clear aligners with protractor group were higher than those in expander with protractor group, mainly concentrated on the labial cervical region of the incisor. Conclusions: Clear aligners combined with maxillary protractor can produce forward force on the maxilla, but labial inclination occurs in the anterior teeth. It can be an effective orthopedic treatment strategy for mixed dentition patients with class Ⅲ skeletal malocclusion.


Assuntos
Dentição Mista , Análise de Elementos Finitos , Má Oclusão Classe III de Angle , Maxila , Humanos , Má Oclusão Classe III de Angle/terapia , Criança , Masculino , Técnica de Expansão Palatina/instrumentação , Braquetes Ortodônticos
7.
J Clin Pediatr Dent ; 48(5): 69-78, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39275822

RESUMO

This study evaluated the mandibular development induced by rapid maxillary expansion (RME) therapy in mixed dentition patients with different vertical growth patterns through long-term observation. The research utilized a retrospective design that included two cohorts: a control group consisting of pediatric subjects with individualized malocclusions, and an experimental group received RME therapy. A total of 60 subjects were included; 37 in the RME group (17 males and 20 females) and 23 in the control group (13 males and 10 females). Based on mandibular plane angles, 19 pertinent cephalometric variables were quantified with Dolphin Imaging software, and participants were subclassified into high-angle and normal-angle subgroups. Changes in the groups during the observation period were statistically analyzed with a t-test. Compared to the control group, both sagittal parameters tended to decrease after treatment in the RME group (p < 0.05), and none of the vertical correlations were statistically different (p > 0.05). Within the normal-angle experimental subgroup, sagittal parameters markedly decreased when contrasted with their normal-angle control group (p < 0.05). Notably, a substantive decrease in overjet was solely observable in the sagittal dimension among the high-angle expansion subgroup when compared to the high-angle control subgroup (p < 0.05). In the vertical dimension, neither the normal-angle nor high-angle subgroups exhibited any statistically significant differences from their respective control cohorts (p > 0.05). Based on long-term observation, RME therapy promotes mandible sagittal growth of the mandible in subjects with normal-angle vertical growth patterns. A similar tendency was not observed in subjects with high-angle vertical growth patterns. In addition, the mandibular plane angle did not increase after RME in children with high-angles.


Assuntos
Cefalometria , Dentição Mista , Mandíbula , Técnica de Expansão Palatina , Dimensão Vertical , Humanos , Estudos Retrospectivos , Masculino , Feminino , Criança , Mandíbula/crescimento & desenvolvimento , Má Oclusão/terapia
8.
Folia Med (Plovdiv) ; 66(4): 521-527, 2024 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-39257272

RESUMO

INTRODUCTION: Mixed dentition analyses are used to determine possible tooth-size and arch-length discrepancies during the transition from primary to permanent dentition. Prediction methods using a probability table or linear regression equation use the sum of the mesiodistal widths of mandibular permanent incisors to predict the mesiodistal width of unerupted permanent teeth. Racial and sexual variations and sexual dimorphism in tooth size have been reported. The objective of this study is to validate Moyer's and Tanaka Johnston's mixed dentition analyses in a contemporary South Indian population.


Assuntos
Dentição Mista , Humanos , Estudos Transversais , Feminino , Masculino , Índia , Reprodutibilidade dos Testes , Criança , Odontometria/métodos , Incisivo/anatomia & histologia , Adolescente
9.
Eur J Orthod ; 46(5)2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39271130

RESUMO

OBJECTIVES: This study aimed to determine the relative contribution of genetic and environmental factors in the phenotypic variation of the soft tissue facial profile during the mixed dentition and the permanent dentition stages. METHODS: In this retrospective cohort study, standardized facial profile photographs of 139 twin pairs (55 monozygotic and 84 dizygotic) were obtained from archival records at the Adelaide Dental School. Photographic analysis used 12 angular and 14 linear facial profile measurements from the mixed dentition (7-11 years) to the permanent dentition (12-17 years) stages. A genetic analysis was performed using a univariate structural equation model adhering to the normal assumptions of a twin model. RESULTS: In the mixed dentition stage, the additive genetic (A) and unique environment (E) model, AE model, was the most parsimonious in explaining the observed phenotypic variance for all 26 facial traits with the narrow-sense heritability estimates ranging between 0.38 and 0.79. In the permanent dentition, the AE model was the most parsimonious for 20 out of 26 traits, however, the variance of six traits, particularly those in the lower third of the face, was best explained by the shared environmental and unique environmental factors. LIMITATIONS: This study exclusively included twins of European ancestry. CONCLUSIONS: The soft tissue facial profile demonstrated dynamic genetic and environmental influences with a greater additive genetic influence during the mixed dentition and the early stages of the permanent dentition. However, there was evidence of increasing environmental influence in the lower third of the face during the early stages of the permanent dentition.


Assuntos
Dentição Mista , Face , Humanos , Face/anatomia & histologia , Masculino , Criança , Feminino , Adolescente , Estudos Retrospectivos , Gêmeos Monozigóticos/genética , Fenótipo , Interação Gene-Ambiente , Gêmeos Dizigóticos/genética , Dentição Permanente , Cefalometria , Desenvolvimento Maxilofacial/genética , Meio Ambiente
10.
Rev. Flum. Odontol. (Online) ; 3(65): 19-30, set-dez.2024. tab
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1567818

RESUMO

O objetivo desta revisão integrativa foi elaborar uma avaliação qualitativa da literatura existente sobre as modalidades de tratamento utilizadas para cistos dentígeros em pacientes pediátricos. O presente estudo trata-se de uma revisão integrativa da literatura na qual utilizou-se as bases de dados PubMed, BVS (Biblioteca Virtual em Saúde), LILACS, e SciELO. Como critérios de inclusão estavam os artigos publicados na íntegra, relatos de caso clínico, revisões sistemáticas e de meta-análise publicados nos últimos 10 anos, disponível nos idiomas português ou inglês, que abordassem a temática. Os critérios de exclusão foram: resumos, anais, editoriais, cartas ao editor, reflexão, duplicidade, artigos com detalhamento incompleto. O cisto dentígero é o tipo mais comum dos cistos odontogênicos de desenvolvimento e o segundo mais frequente entre todos que ocorrem nos maxilares, representando cerca de 20% de todos os cistos revestidos por epitélio nos ossos gnáticos. Clinicamente pode estar associado a qualquer dente impactado, porém ele envolve com mais frequência os terceiros molares inferiores. Acomete pacientes entre 10 a 30 anos de idade, com predileção pelo sexo masculino, sendo na maioria dos casos detectados em exames radiográficos de rotina. O tratamento baseia-se nas técnicas de descompressão, marsupialização e enucleação. O prognóstico para os cistos dentígeros é altamente favorável e não há chance de recorrência após a remoção completa. Assim, a decisão terapêutica deve ser tomada de forma adequada para cada caso, levando em consideração a localização anatômica, extensão clínica, tamanho, idade, remoção do dente não irrompido e possibilidades de acompanhamento.


The aim of this integrative review was to carry out a qualitative assessment of the existing literature on the treatment modalities used for dentigerous cysts in pediatric patients. This study is an integrative literature review using the PubMed, VHL (Virtual Health Library), LILACS and SciELO databases. The inclusion criteria were articles published in full, clinical case reports, systematic reviews and meta-analysis published in the last 10 years, available in Portuguese or English, which addressed the subject. The exclusion criteria were: abstracts, annals, editorials, letters to the editor, reflection, duplication, articles with incomplete details. The dentigerous cyst is the most common type of developmental odontogenic cyst and the second most frequent of all those that occur in the jaws, accounting for around 20% of all epithelium-lined cysts in the gnathic bones. Clinically, it can be associated with any impacted tooth, but it most often involves the lower third molars. It affects patients between 10 and 30 years of age, with a predilection for males, and in most cases it is detected during routine radiographic examinations. Treatment is based on decompression, marsupialization and enucleation. The prognosis for dentigerous cysts is highly favorable and there is no chance of recurrence after complete removal. Therefore, the therapeutic decision must be made appropriately for each case, taking into account the anatomical location, clinical extension, size, age, removal of the unerupted tooth and follow-up possibilities.


Assuntos
Cirurgia Bucal , Cisto Dentígero/terapia , Cistos Odontogênicos , Criança , Dentição Mista
11.
J Clin Pediatr Dent ; 48(4): 214-221, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-39087233

RESUMO

Mid-root fractures are rare injuries in young permanent teeth and tend to have poor prognoses. This study presents a case of oblique root fracture of both maxillary immature central incisors in the middle third accompanied by delayed dental visit and severe caries of all primary teeth. After restoring all the primary and permanent teeth that needed stabilization, the coronal fragments were repositioned and stabilized with a flexible splint consisting of orthodontic wire and composite resin. A comprehensive and sequential dental treatment for other oral diseases and oral hygiene instructions were provided. A 16-month follow-up revealed that the two injured young permanent incisors were healed, surrounded by hard tissues and continued to grow both in length of the root and thickness of the root canal wall, with significant improvement in oral hygiene. Based on the outcome of this case, initial stabilization without endodontic therapy could be considered a successful treatment modality for young permanent teeth with oblique root fracture due to the growth of fractured teeth with vital pulp and the maintenance of natural dentition.


Assuntos
Cárie Dentária , Dentição Mista , Incisivo , Maxila , Fraturas dos Dentes , Raiz Dentária , Humanos , Fraturas dos Dentes/terapia , Incisivo/lesões , Raiz Dentária/lesões , Cárie Dentária/terapia , Criança , Masculino , Resinas Compostas
12.
Sci Rep ; 14(1): 18890, 2024 08 14.
Artigo em Inglês | MEDLINE | ID: mdl-39143117

RESUMO

This study had two aims. First, we aimed to investigate the prevalence of ACB, PCB, and oral habits among a group of Albanian children with ASD compared with a group of children without ASD. Second, we aimed to identify the associations of ASD with ACB, PCB, and oral habits. The sample inlcuded 125 children with ASD (91 males, 34 females) from 2 special schools for children with disabilities and 2 daily residential centers in Tirana. The control group included 125 children without ASD. The relationships between categorical variables were evaluated via the chi-square test. To identify the potential risk factors for ASD, we performed binary logistic regression. No statistically significant differences were found for CB or oral habits between the primary and adolescent dentition stages. A comparison of children with ASD with CB and oral habits revealed a significant difference in the prevalence of PCB. Binary logistic regression revealed that ACB, PCB and oral habits were not associated with ASD. CB was more prevalent among children with ASD in the primary and mixed dentition stages. Oral habits were more prevalent in the mixed and adolescent dentition stages. However, ASD is not a risk factor for CB or other oral habits.


Assuntos
Transtorno Autístico , Humanos , Masculino , Feminino , Criança , Albânia/epidemiologia , Adolescente , Prevalência , Transtorno Autístico/epidemiologia , Fatores de Risco , Pré-Escolar , Má Oclusão/epidemiologia , Transtorno do Espectro Autista/epidemiologia , Dentição Mista , Hábitos
13.
BMC Med Imaging ; 24(1): 172, 2024 Jul 11.
Artigo em Inglês | MEDLINE | ID: mdl-38992601

RESUMO

OBJECTIVES: In the interpretation of panoramic radiographs (PRs), the identification and numbering of teeth is an important part of the correct diagnosis. This study evaluates the effectiveness of YOLO-v5 in the automatic detection, segmentation, and numbering of deciduous and permanent teeth in mixed dentition pediatric patients based on PRs. METHODS: A total of 3854 mixed pediatric patients PRs were labelled for deciduous and permanent teeth using the CranioCatch labeling program. The dataset was divided into three subsets: training (n = 3093, 80% of the total), validation (n = 387, 10% of the total) and test (n = 385, 10% of the total). An artificial intelligence (AI) algorithm using YOLO-v5 models were developed. RESULTS: The sensitivity, precision, F-1 score, and mean average precision-0.5 (mAP-0.5) values were 0.99, 0.99, 0.99, and 0.98 respectively, to teeth detection. The sensitivity, precision, F-1 score, and mAP-0.5 values were 0.98, 0.98, 0.98, and 0.98, respectively, to teeth segmentation. CONCLUSIONS: YOLO-v5 based models can have the potential to detect and enable the accurate segmentation of deciduous and permanent teeth using PRs of pediatric patients with mixed dentition.


Assuntos
Aprendizado Profundo , Dentição Mista , Odontopediatria , Radiografia Panorâmica , Dente , Radiografia Panorâmica/métodos , Aprendizado Profundo/normas , Dente/diagnóstico por imagem , Humanos , Pré-Escolar , Criança , Adolescente , Masculino , Feminino , Odontopediatria/métodos
14.
Clin Oral Investig ; 28(7): 412, 2024 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-38963565

RESUMO

OBJECTIVE: To investigate the relationship between oral muscle pressure and malocclusion in the mixed dentition. MATERIALS AND METHODS: Maximum tongue, lip and cheek pressure was measured using the Iowa Oral Performance Instrument (IOPI) in 3 patient cohorts: patients with (1) posterior crossbite, (2) class II relationship and (3) a control group of patients without malocclusion. Linear models were used to compare the mean differences in muscle pressure between groups, with correction for age and gender. The imbalance between lips and tongue and between lips and cheeks was calculated by the Delta z-scores of each group. RESULTS: A total of 146 participants were included, 46 (mean age 8.71±0.85), 41 (mean age 11.74±1.17) and 35 (mean age 10.71±1.92) in groups 1, 2 and 3 respectively. Patients with malocclusion showed significantly higher lip and lower cheek pressure and imbalance favouring the lips over the tongue compared to controls. Class II,1 patients showed significantly higher tongue pressure than Class II,2. No differences were found in muscle pressure or imbalance between crossbite and Class II nor between crossbite types. CONCLUSION AND CLINICAL RELEVANCE: These findings suggest that oral muscle pressure may be associated with malocclusion. This highlights the importance of functional diagnosis and its implications on the prevention and treatment of malocclusion, as well as on orthodontic stability.


Assuntos
Dentição Mista , Lábio , Má Oclusão , Pressão , Humanos , Feminino , Masculino , Estudos Transversais , Má Oclusão/fisiopatologia , Criança , Lábio/fisiopatologia , Bochecha/fisiopatologia , Língua/fisiopatologia
15.
Medicine (Baltimore) ; 103(27): e38742, 2024 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-38968482

RESUMO

In orthodontic treatment of patients during the mixed dentition period, arch expansion and opening deep overbite are one of the objectives to achieve proper alignment of the teeth and correction of sagittal and vertical discrepancies. However, the expected outcomes of most therapeutic regimens are not clear, making it impossible to standardize early treatment effects. Therefore, this study was designed to evaluate the impact of the Invisalign® First System on the dental arch circumference and incisor inclination in patients during the mixed dentition period. A total of 21 children during the mixed dentition period (10 females and 11 males, with an average age of 8.76 years) were included in this study. The patients received non-extraction treatment through Invisalign® First System clear aligners, and no other auxiliary devices were used except Invisalign® accessories. Subsequently, the cooperation degree of patients during treatment and the oral measurement parameters at the beginning (T1) and the end (T2) of treatment were collected. All patients showed moderate/good cooperation degree during treatment. Besides, horizontal width of the maxillary first molar increased significantly; the designed arch expansion was 4.1 mm (±1.4 mm), while the actual arch expansion was 3.0 mm (±1.7 mm). Furthermore, the torque expression rate of upper anterior teeth reached 56.53%. Invisalign® First System clear aligners can effectively correct the teeth of patients during the mixed dentition period, widen the circumference of dental arch, and control the torque of incisors.


Assuntos
Dentição Mista , Incisivo , Má Oclusão , Dente Molar , Torque , Humanos , Masculino , Feminino , Criança , Má Oclusão/terapia , Aparelhos Ortodônticos Removíveis , Arco Dental , Desenho de Aparelho Ortodôntico , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos
16.
Am J Orthod Dentofacial Orthop ; 166(3): 203-214, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39066746

RESUMO

INTRODUCTION: This study aimed to evaluate the efficacy of Invisalign First Phase I treatment compared with tooth-borne rapid maxillary expansion (RME) in mixed dentition patients by examining changes in palatal volume, palatal surface area, and maxillary interdental transverse measurements. METHODS: In this open-label, 2-arm, parallel, randomized controlled trial, patients with a posterior transverse discrepancy ≤6 mm were allocated into the clear aligner therapy (CAT) group (Invisalign First Phase I treatment) and RME group (tooth-borne RME) according to a computer-generated randomization list immediately before the start of treatment. Digital models were obtained before the beginning of the treatment (T0) and at the end of the retention period/treatment (T1) using an intraoral scanner. Palatal volume was measured as the primary outcome, and palatal surface area and intermolar and intercanine transverse widths at the cusps and gingival level were measured as secondary outcomes. Patients and interventionists were not blinded because of the nature of the intervention. RESULTS: Out of 50 patients, 41 (19 males and 22 females; mean age, 8.12 ± 1.53 years) were enrolled and divided into 2 groups: 20 in the CAT group and 21 in the RME group. Two participants did not receive the allocated intervention for different reasons (1 patient discontinued the intervention in the CAT group, and another patient was lost to follow-up in the RME group). Thus, 19 patients (5 males and 14 females; mean age, 8.48 ± 1.42 years) were analyzed from the CAT group, and 20 patients (12 males and 8 females; mean age, 7.83 ± 1.19 years) from the RME group. Regarding intragroup comparisons, all outcome measures significantly increased from T0 to T1 in both groups. In terms of intergroup comparisons, there were no significant differences in the variation (Δ) of outcome measures between the 2 groups from T0 to T1, except for the intermolar width at the gingival level (P <0.005). The change in palatal volume was 532.01 ±540.52 mm³ for the RME group and 243.95 ± 473.24 mm³ for the CAT group (P = 0.084), with a moderate effect size (d = 0.57). CONCLUSIONS: RME showed trends favoring better outcomes compared with Invisalign First Phase I treatment across all assessed measures. The only parameter that showed statistically significant differences between the 2 groups was variation in intermolar width at the gingival level, suggesting the occurrence of buccal tipping in patients undergoing Invisalign First Phase I treatment. TRIAL REGISTRATION: The trial was registered at ClinicalTrial.gov (no. NCT04760535).


Assuntos
Dentição Mista , Técnica de Expansão Palatina , Palato , Humanos , Técnica de Expansão Palatina/instrumentação , Feminino , Masculino , Criança , Palato/diagnóstico por imagem , Palato/anatomia & histologia , Resultado do Tratamento , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Desenho de Aparelho Ortodôntico , Aparelhos Ortodônticos Removíveis , Má Oclusão/terapia , Má Oclusão/diagnóstico por imagem
17.
Am J Orthod Dentofacial Orthop ; 166(3): 244-251, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-38935005

RESUMO

INTRODUCTION: This study evaluated the probability of developing malocclusions in mixed dentition. METHODS: A longitudinal study was conducted with 598 children (aged 5 years) in deciduous dentition. The children were followed for 3 years until mixed dentition (aged 8 years). Overjet, overbite, and transversal relations were evaluated. Bayesian models were used to analyze the data and estimate the parameters. RESULTS: The parameter θ was used for the distributions, indicating the probability of presenting a given condition with a credibility index (ICr) of 95%. After 3 years of follow-up, 121 children were reevaluated. The results showed that children have a high probability of malocclusion in mixed dentition. There was a higher probability of developing an increased overjet in the mixed dentition of 20.5% (ICr 95%, 13.6-28.4) to 48.3% (ICr 95%, 39.1-57.7) and a higher probability of having a normal overbite in the deciduous dentition and a lower probability in the mixed dentition (ICr 95%, 9.2-21.3). CONCLUSIONS: Considering the probabilistic model of Bayesian analysis, children with normal overjet in the deciduous dentition may show an increased overjet in the mixed dentition. Concerning overbite, children may present an anterior open bite during the transition between deciduous and mixed dentition, as well as self-correction of deep overbite in mixed dentition. Furthermore, they may present a posterior crossbite during the mixed dentition when there is a normal transverse relationship in the deciduous dentition.


Assuntos
Teorema de Bayes , Dentição Mista , Má Oclusão , Humanos , Estudos Longitudinais , Criança , Má Oclusão/etiologia , Feminino , Pré-Escolar , Masculino , Dente Decíduo , Probabilidade
18.
BMC Oral Health ; 24(1): 694, 2024 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-38879479

RESUMO

BACKGROUND: to evaluate the predictability of expansion achieved in patients in early mixed dentition treated with Clear Aligners (CA), analyzing the efficiency of the expansion at the end of the first set of aligners and at the end of the therapy in the upper and lower arch. METHODS: 36 patients (20 F, 16 M; mean age 8.3 ± 1.5 years) were selected retrospectively from the Department of Orthodontics of the Hospital of Rome "Tor Vergata". All subjects were treated with CA with no other auxiliaries than attachments. For each patient a standardized sequential expansion protocol was planned for both arches. Digital dental casts were created at three observation periods from an intraoral scanner: prior to treatment (T0), at the end of the first set of aligners (T1), at the end of treatment (T2). The 3D models in planned position determined by the first Clincheck (CC) were obtained for comparison with T1 and T2. Six linear transversal measurements were used to evaluate the dimensional changes and the predictability of expansion movements, comparing T1-CC and T2-CC. RESULTS: a statistically significant increase within the pre-treatment and the final outcomes for all the variables examined was found. In the upper arch, the greatest level of predictability was detected at the level of the first (46.44%) and second deciduous molar width (44.95%) at T1. The analysis of T2-CC changes showed a significant increase in the percentage of predictability of expansion at the level of the first permanent molars, at mesial (54.86%) and distal (58.92%) width. In the lower arch, a higher percentage of predictability than the upper arch was reported at T1-CC and T2-CC, with the greatest values at the level of second (T1-CC: 48.70%; T2-CC: 75.32%) and first deciduous molar width (T1-CC: 45.71%; T2-CC: 72.75%). CONCLUSIONS: CA can induce significant transversal increments. The predictability of expansion is variable, but it did not exceed the 50% during the first set of aligners. It was necessary to apply refinement set to achieve a good predictability for expansion of about 70%. The expansion in the lower arch was observed to be more predictable than in the upper arch.


Assuntos
Arco Dental , Dentição Mista , Modelos Dentários , Técnica de Expansão Palatina , Humanos , Estudos Retrospectivos , Feminino , Criança , Masculino , Arco Dental/anatomia & histologia , Técnica de Expansão Palatina/instrumentação , Desenho de Aparelho Ortodôntico , Imageamento Tridimensional/métodos , Técnicas de Movimentação Dentária/instrumentação , Técnicas de Movimentação Dentária/métodos , Maxila/anatomia & histologia , Mandíbula/anatomia & histologia , Aparelhos Ortodônticos Removíveis , Previsões , Cefalometria/métodos , Má Oclusão/terapia , Resultado do Tratamento
19.
Braz Oral Res ; 38: e039, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38747826

RESUMO

The aim of this study was to evaluate the convergence between the domains of the Autoquestionnaire Qualité de Vie Enfant image (AUQUEI) and the Child Perceptions Questionnaire (CPQ8-10) in the mixed dentition. A sample of 676 children aged 8 to 10 years responded to the health-related quality of life (HRQoL) and oral health-related quality of life (OHRQoL) questionnaires using the AUQUEI and the CPQ8-10, respectively. Clinical (dental caries and malocclusion) and socioeconomic variables were assessed. The validity of convergence between scores (total and per domain) of the two instruments was assessed by Spearman correlation analysis, considering that non-zero coefficient values represented a correlation between scores. The median was calculated to compare the scores of each questionnaire relative to the variables, and the nonparametric Mann-Whitney test was applied to determine statistically significant differences between the categories. A weak significant correlation (between 0.30 and 0.50) was observed between the domains and the total scores of instruments (p < 0.05), except for the leisure domain (p > 0.05). Participants with a lower family income had worse HRQoL (p < 0.05), and those with caries and malocclusion experience had worse OHRQoL (p < 0.05). In conclusion, the AUQUEI and CPQ8-10 instruments showed a weak correlation. Income and clinical variables had a negative impact on the AUQUEI and CPQ8-10, respectively.


Assuntos
Cárie Dentária , Dentição Mista , Má Oclusão , Saúde Bucal , Qualidade de Vida , Fatores Socioeconômicos , Humanos , Criança , Saúde Bucal/estatística & dados numéricos , Feminino , Masculino , Inquéritos e Questionários , Má Oclusão/psicologia , Estatísticas não Paramétricas , Cárie Dentária/psicologia , Reprodutibilidade dos Testes , Estudos Transversais , Valores de Referência
20.
Eur J Orthod ; 46(3)2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38808562

RESUMO

BACKGROUND: Unilateral posterior crossbite is a common malocclusion, and early treatment is recommended to enable normal growth. There are several possibilities regarding choice of appliances used for correcting this malocclusion; however, when treatment is financed by public funds the decision needs to be based not only on the effects but also on the effect in relation to the costs. OBJECTIVES: The aim was to perform a cost-effectiveness analysis comparing quad helix (QH) and rapid maxillary expanders (RME; hyrax-type) in children in the early mixed dentition. MATERIAL AND METHODS: Seventy-two patients were randomized to treatment with either QH or RME, at two different centres. Data were collected from the patient's medical records regarding success rate, number of visits, total treatment time, emergency visits, and so forth, together with answers from patient questionnaires concerning absence from school and use of analgesics. A cost-effectiveness analysis with both an intention-to-treat (ITT) and a per-protocol approach was performed, as well as a deterministic sensitivity analysis. RESULTS: The success rate, one year after the completion of the expansion, was equal between groups according to the ITT approach. From a healthcare perspective, the mean cost difference between RME and QH was €32.05 in favour of QH (P = 0.583; NS). From a societal perspective, the mean cost difference was €32.61 in favour of QH (P = 0.742; NS). The total appliance cost alone was higher in the RME group €202.67 resp. €155.58 in the QH group (P = 0.001). The probability of RME having a higher cost was 71% from a healthcare perspective and 62.7% from a societal perspective. The total treatment time was 97 days longer in the QH group. In the deterministic sensitivity analysis, when using a higher valuation of the children's educational loss, the QH becomes €58 more costly than the RME. There was a statistically significant difference in chair time and visits between centres (P < 0.001). CONCLUSION: The difference in costs between RME and QH is not statistically significant, however, there is a slightly higher probability that RME is more expensive than QH with a mean cost of an additional €32 per patient from a healthcare perspective. Different work procedures at different centres indicate that logistics around the patient's treatment is a more important aspect than appliance used to decrease the number of visits and save chair time and thereby also costs.


Assuntos
Análise Custo-Benefício , Dentição Mista , Má Oclusão , Técnica de Expansão Palatina , Humanos , Técnica de Expansão Palatina/instrumentação , Técnica de Expansão Palatina/economia , Criança , Má Oclusão/terapia , Má Oclusão/economia , Feminino , Masculino , Desenho de Aparelho Ortodôntico/economia , Resultado do Tratamento , Análise de Custo-Efetividade
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