Journal of Orthodontics最新文献

Objective: To compare the levels of interleukin (IL)-1 beta (IL-1β), alpha (IL-1α), receptor antagonist (IL-1Ra), IL-10 and IL-13 in peri-mini-screw crevicular fluid (PMCF) between unloaded and immediately loaded mini-screws during orthodontic treatment.

Design: Single-centre paired split-mouth controlled trial.

Participants: Patients who required at least two mini-screws as a part of their orthodontic treatment at orthodontic clinic of School of Dentistry of Ribeirão Preto, University of São Paulo (USP) were recruited.

Methods: A total of 40 mini-screws were inserted into the interradicular alveolar bone in 16 patients. Using the coin toss method, each mini-screw was randomly allocated into one of two groups: a control group of unloaded (n = 20) and a group of immediately loaded mini-screws (n = 20). Immediately postoperatively, a continuous load in the range of 150-200 cN was applied to the mini-screws allocated to the loaded group. The PMCF was collected in four experimental times: immediately postoperatively (and on load time, to mini-screws allocated into the loaded group) and 7, 14 and 21 days postoperatively. Biomarker levels were measured using Multiplex Microsphere Immunoassays and compared between groups and covariates using statistical tests that accounted for multiple observations per participant (alpha =5%).

Results: No mini-screws were lost. There was a progressive and statistically significant increase of the biomarker's levels in the two groups during the experimental times (P <0.001). The biomarker levels were significantly higher in the immediately loaded group compared to the unloaded group at all time points (P <0.05), except for IL-10 after 7 days postoperatively.

Conclusion: Although all biomarker levels were statistically higher in the immediately loaded group at all experimental time points in comparison with the unloaded group, no mini-screws were lost. This suggests a balanced and normal adaptive bone response to the mechanical stress of immediate loading, with no negative impact on clinical outcomes.

Objective: To test the validity and reliability of The Spacing Index (TSI).

Design: A single-centre diagnostic study.

Setting: Orthodontic Department, Tameside and Glossop Integrated Care NHS Foundation Trust, Manchester, UKMethods:TSI was outlined based on the principle of mild spacing (0-4 mm), moderate spacing (5-8 mm) and severe spacing (>8 mm). A total of 53 anonymised study models were selected as a convenience sample of patients attending hypodontia multidisciplinary clinics. A range of cases with different amounts of spacing in each arch was chosen. Each model was measured by ML-C in millimetres using calibrated Vernier callipers and then subdivided to give the gold standard spacing TSI categorisation of mild, moderate or severe. Two test raters (CB and NM) then visually assessed the same study models and rated the spacing as mild, moderate or severe. Comparison of the gold standard rating and the test rating was made to assess the validity of TSI. The reliability of the index was assessed by both the gold standard and test raters 2 weeks later.

Results: The weighted kappa score was 0.79 (substantial agreement) between the gold standard rater and the test raters for the mild, moderate and severe TSI categories. The weighted kappa scores were greater than 0.80, demonstrating almost perfect intra-observer reliability over time.

Conclusion: The proposed TSI has been shown to be valid and reliable and could be used to categorise spacing during routine orthodontic assessment.

Background: Clear aligner therapy (CAT) has become a popular choice among patients seeking orthodontic treatment. However, CAT is not optimal for certain types of tooth movements. This case report illustrates a hybrid approach combining CAT with power arms to achieve controlled space closure after lower incisor extraction.

Case presentation: A fit and healthy man presented with a Class 1 malocclusion on a Class 1 skeletal base with bimaxillary protrusion, slightly increased vertical proportions, and mild crowding in the upper and lower arches. He was concerned about his 'irregular lower front teeth and inability to clean them'.

Intervention: Lower incisor extraction treated with clear aligner therapy (CAT).

Results: The patient's malocclusion was successfully treated with CAT and the extraction of a lower incisor, achieving satisfactory root parallelism for the teeth adjacent to the extraction space. The patient reported satisfaction with the treatment results.

Conclusion: Power arms can be considered a useful adjunct to CAT for minimising unwanted tipping in lower incisor extraction cases. Further research on more complex cases and a larger sample size is warranted to validate the findings of this case report and explore long-term stability.

Objectives: To assess clinician perceptions of and satisfaction with remote appointments in orthodontics and oral and maxillofacial surgery (OMFS).

Design: Cross-sectional questionnaire-based study.

Setting: Orthodontic and OMFS departments in six acute NHS hospital Trusts in the UK.

Participants: A total of 36 (a mixture of consultants, specialty doctors, registrars and therapists in both orthodontics and OMFS) completed responses were received.

Method: Once piloted, questionnaires were disseminated across six hospital Trusts to orthodontic and OMFS clinicians. A combination of face-to-face (F2F) and online dissemination was used.

Results: A total of 28 of 36 (77.8%) questionnaires were completed, 75% (n = 21) by orthodontic clinicians and 25% (n = 7) by OMFS clinicians. A 100% (n = 21) response rate was achieved for orthodontic clinicians, compared to a 47% (n = 7/15) response rate for OMFS clinicians. High levels of clinician satisfaction were found for clinician confidentiality; however, concerns remained around patient confidentiality and the inability to conduct a clinical examination. The majority (n = 21, 75%) of clinicians felt that remote appointments had their place in the post-pandemic era, particularly for retainer reviews in orthodontics and biopsy results in OMFS.

Conclusion: When appropriately triaged, the majority of remote appointments do save a face-to-face visit, and there is a place for remote platforms in both specialties going forward. However further research is required in the post-pandemic era to ascertain the full long-term applicability of remote orthodontic and OMFS consultations.

In recent years, a segmental approach to Class II correction has gained popularity among orthodontists. This concept is best represented by the Carrière Motion 3D™ Class II Appliance (CMA), which is an efficient and effective appliance for the treatment of Class II malocclusions. Although it is original and innovative, it also has some inherent flaws that can potentially interfere with its daily use. A segmental approach is described, based on a section of 0.016 × 0.022-inch stainless steel archwire connected to a molar band distally and to a bracket on the mesial side. This simple alternative presents a 'do-it-yourself' and an easy-to-construct mechanism that employs the same principles and identical mechanics to achieve Class II correction yet overcomes most of the disadvantages of other modalities. In our clinic, we found that this optional, useful sectional appliance can correct Class II malocclusion effectively, predictively and on a regular basis.