Journal of Orthodontics最新文献

Objective: To evaluate the effectiveness of bone anchored maxillary protraction (BAMP) in the management of class III skeletal malocclusion in children aged 11-14 years compared with an untreated control group in terms of perceived need for orthognathic surgery, skeletal and dental change, and psychological impact.

Design: A multicentre two-armed parallel randomised controlled trial.

Setting: Six UK hospital orthodontic units.

Methods: A total of 57 patients were randomly allocated into either the BAMP group (BAMPG) (n = 28) or a no treatment control group (CG) (n = 29).

Outcomes: Data collection occurred at registration (DC1),18 months (DC2) and 3 years (DC3), where skeletal and dental changes were measured from lateral cephalograms and study models. Oral Aesthetic Subjective Impact Score (OASIS) and Oral Quality of Life (OHQOL) questionnaires were used to assess the psychological impact of treatment.

Results: The mean age was 12.9 ± 0.7 years and 12.6 ± 0.9 years in the BAMPG and CG, respectively. At DC2, the BAMPG achieved a class III ANB improvement of +0.6° compared with -0.7° in the CG (P = 0.004). The overjet improvement was +1.4 mm for the BAMPG and -0.2 mm for the CG (P = 0.002). There was no evidence of any other group differences for the other skeletal or dental cephalometric outcomes (P > 0.05) or the questionnaire data (OASIS P = 0.10, OHQOL P = 0.75). At DC2, the 18-month follow-up, 22% of the BAMPG achieved a positive overjet. At the 3-year follow-up (DC3), fewer participants in the BAMPG were perceived to need orthognathic surgery (48%) compared with 75% of participants in the CG (P = 0.04), with an odds ratio of 0.31 (95% confidence interval = 0.10-0.95).

Conclusion: The BAMP technique did not show any social or psychological benefits; however, the skeletal class III improvement in ANB and the overjet change were sufficient to reduce the perceived need for orthognathic surgery by 27% compared with the CG.

Introduction: The management of eruption disturbances in orthodontics may be challenging and requires a careful diagnosis and treatment planning. This case report discusses the challenges of a two-phase orthodontic treatment of a patient presenting with a dental eruption pattern anomaly.

Patient concerns: A 10-year-old boy presented with no complaints for a routine orthodontic evaluation during the mixed dentition.

Primary diagnoses: The patient was diagnosed with a skeletal Class I malocclusion with unilateral posterior crossbite, incomplete mandibular lateral incisor-canine transposition and a unilateral maxillary ectopic canine.

Interventions: Phase 1 started with rapid maxillary expansion to correct the maxillary constriction and the ectopic eruption of the right maxillary canine. In the mandibular arch, phase 1 included the extraction of the left primary lateral incisor and canine, alignment of the left permanent lateral incisor and orthodontic traction of the left permanent canine. The duration of phase 1 was 14 months. Phase 2 involved a comprehensive course of orthodontic treatment and started when the patient was aged 13 years. This phase lasted 18 months.

Results: An adequate dental occlusion was obtained, and the treatment results were stable after an 18-month follow-up.

Conclusion: In this case, the early diagnosis of the dental anomalies was valuable as it allowed an early intervention to be undertaken, which resulted in overall treatment simplification and potentially minimised the adverse effects. This case report reinforces the importance of a careful follow-up during mixed dentition.

Objective: To evaluate the prevalence of bullying among schoolchildren and to study the correlation between bullying and a specific type of malocclusion, self-esteem, oral health-related quality of life (OHRQoL), the need for orthodontic treatment and socioeconomic status.

Design: A cross-sectional study.

Setting: Low, middle and high socioeconomic group schools in the same educational district in Cairo, Egypt.

Participants: A total of 324 Egyptian schoolchildren aged 11-14 years.

Methods: Validated questionnaires were used to assess self-reported bullying frequency and intensity, self-esteem and OHRQoL. The Index of Orthodontic Treatment Need (IOTN) was used to assess the orthodontic treatment need and the participants' occlusion was classified according to the British Standard Incisors (BSI) classification.

Results: Bullying was found to be prevalent in 61.7% of the sample. Regression analysis revealed that participants with a Class II division 1 incisor relationship had the highest odds ratio (OR) for predicting bullying (OR = 1.86, 95% confidence interval [CI] = 1.38-2.15). Being bullied was significantly associated with lower self-esteem (OR = 0.47, 95% CI = 0.13-0.78), worse OHRQoL (OR = 2.73, 95% CI = 1.95-3.15) and a high need for orthodontic treatment, as determined by the IOTN Dental Health Component score (OR = 1.33, 95% CI = 1.05-1.95) and IOTN Aesthetic Component score (OR = 1.52, 95% CI = 1.12-1.88). Moreover, participants in high and middle socioeconomic groups had a lower OR for predicting bullying than those in the low socioeconomic group (OR = 0.27, 95% CI = 0.13-0.54).

Conclusion: The bullying prevalence among Egyptian schoolchildren aged 11-14 years was very high. The prevalence of bullying was higher in schoolchildren with higher orthodontic treatment need and Class II division 1 incisor relationship. Bullying was correlated to poor self-esteem as well as poor OHRQoL. In addition, low socioeconomic status was found to be a potential predictor for bullying.

Background: Identification of tooth ankylosis before comprehensive orthodontic treatment can be challenging. This case series illustrates different presentations of tooth ankylosis, the importance of early diagnosis, the use of surgical luxation to aid orthodontic alignment of ankylosed teeth and its sequelae.

Case presentation: All three cases were adolescents: a 14-year-old girl with a highly placed upper left lateral incisor and history of general anaesthesia; a 14-year-old boy with an impacted upper right first premolar and history of dental trauma; and a 13-year-old girl with an infraoccluded upper left central incisor with history of replantation due to avulsion. Iatrogenic malocclusion developed from attempts to align these ankylosed teeth. Subsequently, surgical luxation was performed, and the ankylosed teeth were successfully aligned. However, it was associated with pulp calcification, root resorption and recurrence of ankylosis.

Conclusion: Surgical luxation and orthodontic alignment of ankylosed teeth can be considered a useful short-term solution to delay the need of surgical removal and teeth replacement.

Tooth transposition is the positional interchange of two adjacent teeth, which may be incomplete or complete. The root apex may remain in a normal position despite a severely displaced crown. The aim of this paper is to provide a literature review on the incidence, aetiology and treatment options for pseudo-transposed mandibular incisors. A case series is also presented highlighting the various management techniques that have been utilised in treating five cases of pseudo-transposed mandibular lateral incisors.