Journal of Orthodontics最新文献

This paper describes the orthodontic treatment of two cases that were successful in winning the William Houston Gold Medal at the Membership in Orthodontics Examinations of the Royal College of Surgeons of Edinburgh in 2022. Both cases discuss the management of palatally impacted maxillary canines and treatment was initiated during the emerging COVID-19 crisis and completed over a 27-month period. The first case describes the management of a 15-year-old female with a Class II division 1 incisor relationship complicated by a palatally impacted upper left canine, moderate upper and lower arch crowding, and a lower centreline discrepancy with an associated right lateral displacement on closure. Treatment involved open surgical exposure of the impacted canine, a quad helix appliance, premolar extractions, and upper and lower fixed appliances. The second case describes the management of a 14-year-old female with a Class III incisor relationship complicated by bilaterally impacted maxillary canines, impeded eruption of the lower right second molar, moderate lower and severe upper arch crowding, and an upper centreline discrepancy. These case reports aim to demonstrate the high standards of care achieved by Orthodontic Specialty Trainee Registrars in the UK and provide aspirational standards for future trainees.

Objective: To evaluate the knowledge and preference of patients treated at a Dental School in Jaraguá do Sul, Brazil, about using aligners and the reasons for choosing this device as a treatment option.

Design: A cross-sectional study.

Participants: A total of 82 participants aged 18-45 years recruited at a screening clinic.

Methods: A questionnaire was completed in person using a tablet with digital forms.

Results: Almost half of the participants (49%) knew about aligners; 40% were aged 18-24 years, and 77% were female. When observing the images of the types of orthodontic appliances, the aligners had an acceptance rate of 80%. Among the reasons that led to the preference for choosing aligners, 68% cited aesthetics and 42% comfort.

Conclusion: Recently, clear aligners have become a popular choice for orthodontic treatment, particularly among adults. Despite their popularity and effectiveness, many patients still need more information about aligner treatment. Over half of the respondents did not know what orthodontic aligners were. Younger participants had more knowledge about aligners than older participants. Patients still need more knowledge about the types of appliances available for orthodontic treatment. When presented with images of the kinds of devices available, almost 80% of participants showed greater satisfaction with aligners.

Objective: To compare the periodontal outcomes of surgically exposed and orthodontically aligned buccally impacted maxillary canines to spontaneously erupted maxillary canines.

Data sources: An unrestricted search was carried out of indexed databases (Medline, EMBASE, Web of Science and Scopus), reference lists of included studies, and grey literature published until December 2023.

Data selection: Observational and experimental studies that addressed the focused question 'Do periodontal outcomes of buccally impacted maxillary canines that were surgically exposed and subsequently extruded and aligned using orthodontic alignment, differ from those of spontaneously erupted maxillary canines?' were included.

Data extraction: Study screening, selection and data extraction were performed independently by two authors, with disagreement resolved by a third reviewer. The risk of bias was assessed using the JBI Critical Appraisal Checklist and GRADE approach.

Results: A total of 857 citations were found and five studies were eligible for inclusion. Supragingival plaque accumulation and gingival inflammation were similar between impacted canines and their contralaterals in most studies. Meta-analyses revealed no significant differences in keratinised tissue width (prospective studies: MD = -0.28, 95% confidence interval [CI] = -1.13-0.56, I² = 78%; retrospective studies: MD = 0.61, 95% CI = -1.51-2.72, I² = 94%). However, a meta-analysis of prospective studies showed slightly greater mean probing depth for impacted canines compared to their contralateral canines (prospective studies: MD = 0.16, 95% CI = 0.04-0.28, I² = 0%). The evidence certainty for keratinised tissue width and probing depth outcomes was low.

Conclusion: Surgically exposed and orthodontically aligned buccally impacted canines have slightly greater probing depths, potential bone loss and increased clinical crown length, compared to their counterparts. However, these small differences (<1 mm) are unlikely to be clinically significant.

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.