Journal of Orthodontics最新文献

Objective: To assess changes in clinical crown height (CCH) in adult orthodontic patients treated by fixed appliances to distalise the molars.

Design: Retrospective case series study.

Setting and patients: A total of 30 adults with healthy periodontal tissues who received orthodontic treatment at the Department of Orthodontics, Yokohama, Japan and its related orthodontic clinic were assessed.

Methods: CCH was measured as the distance from the gingival margin to the crown plane perpendicular to the tooth axis. Treatment changes of CCH of each tooth were examined on the labial/buccal and lingual/palatal side.

Results: In the upper dentition, on the labial/buccal side, the CCH of the lateral incisors, canines, first premolars, first molars and second molars were increased significantly (P < 0.01), with a median value of 0.41 mm, 0.43 mm, 0.28 mm, 0.43 mm and 0.55 mm, respectively. In contrast on the palatal side, the CCH of the central incisors, first molars, and second molars decreased significantly (P < 0.01), with a median value of -0.41 mm, -0.30 mm and -0.20 mm, respectively. In the lower dentition on the labial/buccal side, the CCH of the first premolars, second premolars and first molars were increased significantly, with a median value of 0.39 mm (P < 0.01), 0.43 mm (P < 0.01) and 0.19 mm (P < 0.05), respectively. The second molars exhibited a significant decrease in CCH with a median value of -0.26 mm (P < 0.05). On the lingual side, the CCH of the central incisors, lateral incisors, canines, first premolars, second premolars and first molars were increased significantly (P < 0.01), with a median value of 0.28 mm, 0.22 mm, 0.31 mm, 0.37 mm, 0.26 mm and 0.28 mm, respectively.

Conclusion: Significant differences were observed in CCH before and after treatment for many teeth, the average change was less than 0.5 mm. The impact on the long-term health of the periodontal tissue is unknown.

Objective: To evaluate the difference in the oral hygiene status of participants with fixed appliances between a 'weekly WhatsApp application oral hygiene message reminders' trial group and a 'verbal instructions' control group over a follow-up duration of 12 weeks.

Design: Prospective, single-blind, randomised controlled trial with an allocation ratio of 1:1 over a 12-week follow-up.

Setting: Government Orthodontic Unit, Raub Dental Clinic, Raub, Pahang, Ministry of Health, Malaysia.

Participants: A total of 40 patients aged 13-25 years undergoing orthodontic treatment with fixed appliances.

Methods: The 40 patients were recruited and randomly allocated to a control (n = 20) or trial group (n = 20). Participants in the trial group received weekly oral hygiene reminders via the WhatsApp application for 12 weeks, while the control group did not receive any reminders. The primary outcome was oral hygiene, which was measured by the single-blinded examiner using the Orthodontic Plaque Index (OPI) at three orthodontic check-ups: baseline (T0); 6-week follow-up (T1); and 12-week follow-up (T2).

Results: The mean age of participants was 17 years, and 80% were female. At the end of the 12-week follow-up, improvements in OPI scores were observed, regardless of the intervention. At T2, the median OPI score for the trial group (n = 20) was 0 (interquartile range [IQR = 0) while that for the control group (n = 20) was 2 (IQR = 0). A Mann-Whitney U test revealed a statistically significant difference (P <0.05), with effect size r = 0.87 between the control and trial groups, whereby the latter witnessed marked improvement in OPI throughout the visits. No harms or adverse effects occurred in this trial.

Conclusion: The short-term findings demonstrated that participants receiving regular reminders of oral hygiene via WhatsApp messaging had a significant improvement in oral hygiene compared to the control group.

Objective: To correlate the clinical perception of maxillary incisor inclination from photographs of the smiling face with cephalometric measurements, using conventional incisor axis reference points and crown reference points.

Design: Cross-sectional study.

Setting: Department of Orthodontics, School of Dentistry, University of Lisbon (Portugal).

Participants: Eight orthodontists.

Methods: The perception of maxillary incisor inclination of 47 female patients (mean age 23.4 ± 1.5 years) was evaluated by eight orthodontists. The participants' photographs (smiling frontal, smiling three-quarter and smiling profile) were shown to each assessor and a continuous visual analogue rating scale was used to assess the perception of maxillary incisor inclination. Pearson's correlation and linear regression were calculated between each cephalometric measurement and the perception of incisor inclination.

Results: Anatomical crown inclination measurements U1ac-FH (r = 0.854; P < 0.01) and U1ac-SN (r = 0.845; P < 0.01) had the highest correlation values with the assessors' perception of maxillary incisor inclination. Conventional incisor axis measurements showed the lowest correlation values (r = 0.668-0.756).

Conclusion: Cephalometric measurements of the labial surface of the anatomical crown of the maxillary incisors showed the strongest correlations with the clinical perception of maxillary incisor inclination from photographs. For optimal aesthetics, the inclination of the labial surface of maxillary incisor crown should be evaluated.

Objective: To compare the sagittal and vertical cephalometric effects in participants treated with an expander with differential opening (EDO) versus the fan-type expander (FE).

Design: Two-arm parallel randomised clinical trial (RCT).

Methods: This study comprised cone-beam computed tomography-derived cephalometric images from 48 participants from a RCT. The sample was randomly allocated into two groups. The study was single-blinded. In total, 24 participants were treated with rapid maxillary expansion (RME) using EDO and 24 participants underwent RME using FE. The primary outcomes were the dentoskeletal vertical changes produced by RME. The secondary outcomes were the dentoskeletal sagittal changes. A cephalometric analysis was performed before treatment and 1 or 6 months after the active phase of RME using Dolphin Imaging Software. Intergroup comparisons of interphase changes were performed using the t-test and Mann-Whitney U test (P < 0.05).

Results: The final sample comprised 24 patients (11 men, 13 women; mean age = 7.6 ± 0.9 years) in the EDO group and 24 patients (10 boys, 14 girls; mean age = 7.8 ± 0.9 years) in the FE group. Both expanders produced a similar clockwise rotation of the mandible (FMA; mean difference [MD] = 0.09°, 95% confidence interval [CI] = -1.01 to 0.84). In the FE group, a greater increase of the SNA angle was observed after expansion compared to the EDO group (MD = 1.04°, 95% CI = -1.90 to -1.58). More palatal torque of maxillary incisors was observed in the FE group (MD = 1.32°, 95% CI = 0.05-2.56). Of the participants, 54% reported a little discomfort during the active phase of treatment and 46% of the participants did not report any discomfort.

Conclusion: Both expanders produced similar vertical cephalometric changes. FEs caused slightly more maxillary anterior displacement after expansion with a compensatory palatal torque of the maxillary incisors, compared to the EDOs. However, the amount of sagittal difference was not clinically relevant.

Trial registration: The trial was registered at ClinicalTrials.gov, under the identifier NCT03705871.

Objective: To assess and compare the validity of 2D modified Easy Box and measurement of the Beta angle on standard conventional orthopantomogram (OPG) versus 3D cone-beam computed tomography (CBCT) OPG-constructed view.

Design: A retrospective agreement study.

Methods: The aim of this study was to construct an Easy Box on a standard conventional OPG and to validate this novel method by comparing it with the Easy Box method on 3D CBCT. After approval from the Ethics Committee, OPG and CBCT radiographs were obtained for the study from departmental records and five private practices in the same location (Indore, India). The radiographs were selected based on record availability and with written consent from the participants before the commencement of the study. The records were analysed to enable a comparison and to assess the accuracy of Easy Box construction on both 3D CBCT and standard conventional OPG radiographs. The location of the impacted canine within the Easy Box boundaries and the measurement of the Beta angle were determined on both views.

Results: A perfect agreement was obtained for the comparison of 3D Easy Box CBCT analysis with 2D modified Easy Box on OPG for impacted maxillary canines (Kappa = 1.0). A Bland-Altman (LoA) analysis showed no proportional bias in the comparison of the Beta angle on 3D and 2D OPG radiographs.

Conclusion: Beta angle and 2D modified Easy Box on a conventional OPG yield similar results when compared to Easy Box on 3D CBCT OPG-constructed view. The standard OPG was valuable and cost-effective, particularly in the early stages of diagnosis and treatment planning, either as a substitute or when CBCT was unavailable.

Objective: To understand patients' motivations for pursuing treatment, to appreciate what information patients seek and to explore potential factors affecting decision making in adults considering, undergoing or who have had orthodontic treatment in the private sector.

Design: Cross-sectional questionnaire study.

Setting: Online questionnaire.

Participants: A total of 209 (83% women, 16% men, 1% preferred not to say) completed responses were received.

Methods: Once piloted, the final survey was made available online to adults in the United Kingdom (UK) and Republic of Ireland (RoI) who were either considering having orthodontic treatment, currently undergoing treatment or had recently completed treatment in the private sector.

Results: The most commonly selected motivating factor was to 'improve the appearance of my teeth' (82%). The information sought related predominantly to treatment duration (64%), potential end results (56%), types of appliances that were available (55%) and cost (52%). The two most commonly reported social factors that had influenced participants to consider treatment were 'seeing myself on social media' (31%) and 'it is more socially acceptable to have braces' (31%).

Conclusion: While this area remains relatively underexplored in the literature, it is crucial to develop a comprehensive understanding due to the increasing number of adults seeking orthodontic treatment. This study not only reinforces the existing knowledge regarding adults seeking orthodontic treatment, such as the predominant role of aesthetics as a motivating factor, but also introduces some novel insights. Specifically, we highlight the influence of social factors on decision-making processes and the importance of effectively communicating the duration of treatment to patients.