Viet Hoang, Thao Thi Nhu Dang, My Khanh Nguyen, Phuoc Hong Tran
Anterior cross-bite and Class I malocclusion are common in orthodontics. There are various methods to treat this condition. In this case report, we will be discussing our approach to treating anterior cross-bite in an adult patient. We used hybrid treatment by 2D lingual-fixed appliance and in-house clear aligner to provide esthetic orthodontic treatment. In addition, we utilized 3D simulation to ensure the accuracy of our treatment plan and mechanics. In this article field, we present the case of a 23-year-old woman who came to us with complaints of anterior cross-bite, smile esthetics, and her profile. On examination, we found that she had a skeletal Class I malocclusion and anterior cross-bite on the left side with erosion in her upper left incisors. Although she had good occlusion, there was some minor crowding in her upper and lower teeth. After conducting a 3D simulation, we decided to use a 2D lingual-fixed appliance on her upper teeth and an in-house aligner on her lower teeth. We chose this treatment plan because it was suitable, efficient, and cost-effective. However, after 2 months of treatment, the patient developed TMD, and her mandible shifted to the left. As a result, she had an X-bite on the right side. To address this issue, we removed the 2D appliance and switched to an in-house aligner for both upper and lower teeth. After 2 more months with the aligner, we noticed that the patient had occlusal interference in her left lateral incisor and erosion on this tooth. To fix this problem, we filled the tooth (22) and maintained the position of the lower teeth. We continued the finishing stage with the in-house aligner on both the upper and lower teeth. After 8 months of treatment, the case was successfully completed, and the patient no longer had TMD. Using a 2D lingual appliance and in-house aligner is an effective method for treating anterior cross-bites. Careful TMD control is essential in orthodontic treatments.
前交叉咬合和 I 类错合畸形在正畸学中很常见。治疗这种情况的方法有很多种。在本病例报告中，我们将讨论治疗一名成年患者前交叉咬合的方法。我们采用了二维舌侧固定矫治器和内部透明矫治器的混合治疗方法，以提供美观的正畸治疗。此外，我们还利用三维模拟来确保治疗方案和力学的准确性。在这篇文章中，我们介绍了一位 23 岁女性的病例，她前来就诊时抱怨前牙交叉咬合、微笑美观以及她的轮廓。检查时，我们发现她的左侧有骨骼Ⅰ类错颌和前交叉咬合，左上切牙有侵蚀。虽然她的咬合情况良好，但上下牙齿有一些轻微的拥挤。在进行三维模拟后，我们决定在她的上排牙齿上使用二维舌侧固定矫治器，在下排牙齿上使用内部矫治器。我们之所以选择这种治疗方案，是因为它合适、高效且经济实惠。然而，治疗 2 个月后，患者出现了 TMD，下颌向左侧移位。因此，她的右侧出现了 X 形咬合。为了解决这个问题，我们拆除了二维矫治器，改用内部矫治器矫正上下牙齿。使用矫正器两个多月后，我们发现患者的左侧侧切牙出现了咬合干扰，这颗牙齿也出现了腐蚀。为了解决这个问题，我们补上了这颗牙齿（22），并保持了下牙的位置。我们继续使用内部矫治器对上下牙齿进行矫治。经过 8 个月的治疗，病例顺利完成，患者不再有 TMD。使用二维舌侧矫治器和内部矫治器是治疗前牙交叉咬合的有效方法。在正畸治疗中，谨慎控制 TMD 至关重要。
{"title":"Accelerated and hybrid orthodontic treatment using a combination of 2D lingual appliance and in-house aligner: An anterior cross-bite and TMD case report after 1-year follow-up","authors":"Viet Hoang, Thao Thi Nhu Dang, My Khanh Nguyen, Phuoc Hong Tran","doi":"10.25259/apos_22_2024","DOIUrl":"https://doi.org/10.25259/apos_22_2024","url":null,"abstract":"Anterior cross-bite and Class I malocclusion are common in orthodontics. There are various methods to treat this condition. In this case report, we will be discussing our approach to treating anterior cross-bite in an adult patient. We used hybrid treatment by 2D lingual-fixed appliance and in-house clear aligner to provide esthetic orthodontic treatment. In addition, we utilized 3D simulation to ensure the accuracy of our treatment plan and mechanics. In this article field, we present the case of a 23-year-old woman who came to us with complaints of anterior cross-bite, smile esthetics, and her profile. On examination, we found that she had a skeletal Class I malocclusion and anterior cross-bite on the left side with erosion in her upper left incisors. Although she had good occlusion, there was some minor crowding in her upper and lower teeth. After conducting a 3D simulation, we decided to use a 2D lingual-fixed appliance on her upper teeth and an in-house aligner on her lower teeth. We chose this treatment plan because it was suitable, efficient, and cost-effective. However, after 2 months of treatment, the patient developed TMD, and her mandible shifted to the left. As a result, she had an X-bite on the right side. To address this issue, we removed the 2D appliance and switched to an in-house aligner for both upper and lower teeth. After 2 more months with the aligner, we noticed that the patient had occlusal interference in her left lateral incisor and erosion on this tooth. To fix this problem, we filled the tooth (22) and maintained the position of the lower teeth. We continued the finishing stage with the in-house aligner on both the upper and lower teeth. After 8 months of treatment, the case was successfully completed, and the patient no longer had TMD. Using a 2D lingual appliance and in-house aligner is an effective method for treating anterior cross-bites. Careful TMD control is essential in orthodontic treatments.","PeriodicalId":42593,"journal":{"name":"APOS Trends in Orthodontics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Syed Shahid Hilal, P. Teja, S. Mittal, S. Teja, Stuti Gulati, Rohini Sharma
The article aimed to compare the coating stability and surface characterization of different esthetic nickel-titanium (NiTi) archwires. A total of 48 esthetic NiTi archwires were categorized into four groups based on the type of coating material that was selected and studied (Groups: I. Epoxy coated, II. Polymer coated, III. Teflon coated, and IV. Rhodium coated). These wires were ligated in patients undergoing fixed mechanotherapy in the department. The surface details and coating stability were studied in the wires removed from patient’s mouth after 21 days using 3D profilometer, scanning electron microscope (SEM), and stereomicroscope. A maximum percentage of coating loss was observed in Group II (epoxy coated) and the minimum in Group III (polymer coated). Maximum surface roughness was observed in Group II (epoxy coated) and minimum in Group III (polymer coated). The average coating thickness of as received wires was observed to be 0.002” in dimension. All the wires had low esthetic values, as they presented a non-durable coating after oral exposure. On visual examination of SEM image, all four group esthetic wires showed variations ranging from microcracks and large sized striations to overall destruction of coating regularity.
{"title":"Comparison of coating stability and surface characterization of different esthetic NiTi arch wires – An in vivo study","authors":"Syed Shahid Hilal, P. Teja, S. Mittal, S. Teja, Stuti Gulati, Rohini Sharma","doi":"10.25259/apos_75_2024","DOIUrl":"https://doi.org/10.25259/apos_75_2024","url":null,"abstract":"\u0000\u0000The article aimed to compare the coating stability and surface characterization of different esthetic nickel-titanium (NiTi) archwires.\u0000\u0000\u0000\u0000A total of 48 esthetic NiTi archwires were categorized into four groups based on the type of coating material that was selected and studied (Groups: I. Epoxy coated, II. Polymer coated, III. Teflon coated, and IV. Rhodium coated). These wires were ligated in patients undergoing fixed mechanotherapy in the department. The surface details and coating stability were studied in the wires removed from patient’s mouth after 21 days using 3D profilometer, scanning electron microscope (SEM), and stereomicroscope.\u0000\u0000\u0000\u0000A maximum percentage of coating loss was observed in Group II (epoxy coated) and the minimum in Group III (polymer coated). Maximum surface roughness was observed in Group II (epoxy coated) and minimum in Group III (polymer coated).\u0000\u0000\u0000\u0000The average coating thickness of as received wires was observed to be 0.002” in dimension. All the wires had low esthetic values, as they presented a non-durable coating after oral exposure. On visual examination of SEM image, all four group esthetic wires showed variations ranging from microcracks and large sized striations to overall destruction of coating regularity.\u0000","PeriodicalId":42593,"journal":{"name":"APOS Trends in Orthodontics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141928152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ramy El Shahawy, Hanady Mohamed Sameeh, Youssef Sedky, Waleed Refaat El Nagar
This study evaluated the clinical effect of low-level laser therapy (LLLT) on pain perception after placement of initial orthodontic archwires. Forty-eight orthodontic patients were selected and randomly divided according to exposure to LLLT into two equal groups: Group 1 (Control group) Included 24 patients who were not subjected to any laser therapy, and Group 2 (Laser group), Included 24 patients who were subjected to LLLT. Pain perception was investigated for all patients after 6 h, 2nd day, 3rd day, and 7th day through a visual analog scale (VAS) with 0 indicating no pain and 10 indicating intolerable pain. All data were collected, tabulated, and statistically analyzed. There was a statistically significant difference between the laser group and the control group. According to VAS readings, the laser group showed lower means of pain scores than the control group . From the present study, the following could be concluded: (1) Diode laser using 940 nm wavelength with the used parameters showed positive results in reducing pain severity in the early stages of orthodontic treatment. (2) LLLT can have better biomodulating outcomes in promoting long-lasting analgesic action during the period of greatest pain sensitivity.
{"title":"Clinical effect of low-level laser therapy on pain perception after placement of initial orthodontic archwires","authors":"Ramy El Shahawy, Hanady Mohamed Sameeh, Youssef Sedky, Waleed Refaat El Nagar","doi":"10.25259/apos_33_2024","DOIUrl":"https://doi.org/10.25259/apos_33_2024","url":null,"abstract":"\u0000\u0000This study evaluated the clinical effect of low-level laser therapy (LLLT) on pain perception after placement of initial orthodontic archwires.\u0000\u0000\u0000\u0000Forty-eight orthodontic patients were selected and randomly divided according to exposure to LLLT into two equal groups: Group 1 (Control group) Included 24 patients who were not subjected to any laser therapy, and Group 2 (Laser group), Included 24 patients who were subjected to LLLT. Pain perception was investigated for all patients after 6 h, 2nd day, 3rd day, and 7th day through a visual analog scale (VAS) with 0 indicating no pain and 10 indicating intolerable pain. All data were collected, tabulated, and statistically analyzed.\u0000\u0000\u0000\u0000There was a statistically significant difference between the laser group and the control group. According to VAS readings, the laser group showed lower means of pain scores than the control group .\u0000\u0000\u0000\u0000From the present study, the following could be concluded: (1) Diode laser using 940 nm wavelength with the used parameters showed positive results in reducing pain severity in the early stages of orthodontic treatment. (2) LLLT can have better biomodulating outcomes in promoting long-lasting analgesic action during the period of greatest pain sensitivity.\u0000","PeriodicalId":42593,"journal":{"name":"APOS Trends in Orthodontics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Babak Sayahpour, Sara Eslami, Brenda Schulz, Mauricio Gonzalez Balut, Nicolas Plein, V. Grassia, L. Nucci
The aim of the study was to examine the effects of buccal corridor width on the perception of facial esthetics and to determine the ideal buccal corridor size. It also aimed to determine the influence of facial shape or gender on the ideal size of buccal corridors and whether there are differences in perception between laypeople and dental professionals (LPs and DP). One female and one male study model were selected and photographed in portrait format. Using Photoshop, a total of 30 digitally manipulated images were generated from the original photographs, representing five different buccal corridor sizes (2%, 10%, 15%, 22%, and 28%) and three different facial shapes (dolichol-, normo-, and brachyfacial). Two groups of LP and DP evaluated the images. Each group consisted of 20 male and 20 female participants with a mean age of 30.33 ± 5.19 (LP) and 32.03 ± 4.43 (DP). Descriptive statistics, Wilcoxon sign-rank test, Mann–Whitney U-test, and Bonferroni correction were then used to assess the significance of the data, which identify differences between genders and the impact of facial form. The buccal corridor width was found to influence the facial and smile esthetics. The 2% buccal corridor proved to be the best-rated size and stood out from the other sizes in most face shapes with a significance of P < 0.004. A difference in the evaluation between the DP and LP could not be found. Large buccal corridors seem to affect facial esthetics negatively. The results of the present study suggest an ideal value of the buccal corridor at 2%.
{"title":"The perception of facial esthetics with regard to different buccal corridors and facial proportions","authors":"Babak Sayahpour, Sara Eslami, Brenda Schulz, Mauricio Gonzalez Balut, Nicolas Plein, V. Grassia, L. Nucci","doi":"10.25259/apos_105_2024","DOIUrl":"https://doi.org/10.25259/apos_105_2024","url":null,"abstract":"\u0000\u0000The aim of the study was to examine the effects of buccal corridor width on the perception of facial esthetics and to determine the ideal buccal corridor size. It also aimed to determine the influence of facial shape or gender on the ideal size of buccal corridors and whether there are differences in perception between laypeople and dental professionals (LPs and DP).\u0000\u0000\u0000\u0000One female and one male study model were selected and photographed in portrait format. Using Photoshop, a total of 30 digitally manipulated images were generated from the original photographs, representing five different buccal corridor sizes (2%, 10%, 15%, 22%, and 28%) and three different facial shapes (dolichol-, normo-, and brachyfacial). Two groups of LP and DP evaluated the images. Each group consisted of 20 male and 20 female participants with a mean age of 30.33 ± 5.19 (LP) and 32.03 ± 4.43 (DP). Descriptive statistics, Wilcoxon sign-rank test, Mann–Whitney U-test, and Bonferroni correction were then used to assess the significance of the data, which identify differences between genders and the impact of facial form.\u0000\u0000\u0000\u0000The buccal corridor width was found to influence the facial and smile esthetics. The 2% buccal corridor proved to be the best-rated size and stood out from the other sizes in most face shapes with a significance of P < 0.004. A difference in the evaluation between the DP and LP could not be found.\u0000\u0000\u0000\u0000Large buccal corridors seem to affect facial esthetics negatively. The results of the present study suggest an ideal value of the buccal corridor at 2%.\u0000","PeriodicalId":42593,"journal":{"name":"APOS Trends in Orthodontics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141798416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Krisnawati E Tarman, F. Jazaldi, Andina Alia Latief, B. Soegiharto
It has been observed that using a retainer during the retention phase of orthodontic treatment can result in various patient perceptions; however, only limited research exists concerning it. Therefore, the present research studies and analyzes the differences in acceptance and satisfaction perception between patients who use two types of removable retainers: Hawley retainers (HRs) and vacuum-formed retainers (VFRs). This research comprised 80 participants (n per group = 40). Eligible individuals who had finished treatment between 6 months and 5-years-prior and met the inclusion criteria were contacted to partake in this study. The participants were asked to complete a digital-based questionnaire consisting of seven questions. Each patient was asked the questions twice, once for maxillary and once for mandibular retainers. The visual analog scale was used to measure their responses. Blinding was implemented to minimize potential bias during data analysis. Statistically significant differences were found in the speaking ability and positive comments received with maxillary retainer in place. Statistically significant differences were not found in the perception of adaptation, cleaning ability, negative comments received, and overall retainers’ acceptance and patients’ satisfaction with both retainers in place, as well as the speaking ability and positive comments received with the mandibular retainer. During the study, no harm was observed in any of the patients. VFRs cause less speech difficulty and elicit more positive comments on the maxilla than HRs. No significant differences were found between HRs and VFRs concerning the perception of adaptation, cleaning ability, negative comments received, and overall retainers’ acceptance and patients’ satisfaction with both retainers in place. Moreover, no differences were found between patients’ speaking ability and positive comments received with the mandibular retainer.
{"title":"Difference in acceptance and satisfaction perception on the use of Hawley and vacuum-formed retainers among post-orthodontic patients","authors":"Krisnawati E Tarman, F. Jazaldi, Andina Alia Latief, B. Soegiharto","doi":"10.25259/apos_60_2024","DOIUrl":"https://doi.org/10.25259/apos_60_2024","url":null,"abstract":"\u0000\u0000It has been observed that using a retainer during the retention phase of orthodontic treatment can result in various patient perceptions; however, only limited research exists concerning it. Therefore, the present research studies and analyzes the differences in acceptance and satisfaction perception between patients who use two types of removable retainers: Hawley retainers (HRs) and vacuum-formed retainers (VFRs).\u0000\u0000\u0000\u0000This research comprised 80 participants (n per group = 40). Eligible individuals who had finished treatment between 6 months and 5-years-prior and met the inclusion criteria were contacted to partake in this study. The participants were asked to complete a digital-based questionnaire consisting of seven questions. Each patient was asked the questions twice, once for maxillary and once for mandibular retainers. The visual analog scale was used to measure their responses. Blinding was implemented to minimize potential bias during data analysis.\u0000\u0000\u0000\u0000Statistically significant differences were found in the speaking ability and positive comments received with maxillary retainer in place. Statistically significant differences were not found in the perception of adaptation, cleaning ability, negative comments received, and overall retainers’ acceptance and patients’ satisfaction with both retainers in place, as well as the speaking ability and positive comments received with the mandibular retainer. During the study, no harm was observed in any of the patients.\u0000\u0000\u0000\u0000VFRs cause less speech difficulty and elicit more positive comments on the maxilla than HRs. No significant differences were found between HRs and VFRs concerning the perception of adaptation, cleaning ability, negative comments received, and overall retainers’ acceptance and patients’ satisfaction with both retainers in place. Moreover, no differences were found between patients’ speaking ability and positive comments received with the mandibular retainer.\u0000","PeriodicalId":42593,"journal":{"name":"APOS Trends in Orthodontics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141675572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Autism Spectrum Disorder (ASD) is a multifaceted developmental disability that originates from a neurological disorder, leading to difficulties in the development of social interaction and communication skills. Consequently, this poses a challenge in the provision of oral health care. We report a case of a 13-year-old male with ASD who was concerned about “sticking out upper front teeth.” The patient presented with a Class II Division 1 incisor relationship on a Class 2 skeletal base with retrognathic mandible. The malocclusion was complicated by spacing in the upper and lower arches, proclined upper labial segment, increased overjet 12mm, overbite 90% complete to teeth, and incompetent lip with lower lip trap. The canine relationship was Class II ½ unit bilaterally, and the molar relationship was Class II ½ unit on the right and Class II ¾ unit on the left. The IOTN score was 5a for dental health and 9 for aesthetics. Growth modification to encourage mandibular growth, using a removable Twin Block appliance. The patient displayed excellent compliance with the appliance and effectively addressed his concerns while boosting his self-esteem. By understanding and addressing the unique needs of patients with ASD in orthodontic treatment, patient’s comfort and overall experience can be enhanced along with the likelihood of a successful treatment outcome. Customized treatment plans that respect sensory sensitivities and communication preferences pave the way for a more positive orthodontic journey for individuals with ASD, ultimately leading to enhanced dental well-being and bolstered self-assurance in one’s smile.
{"title":"Autism spectrum disorder and compliance with a removable orthodontic functional appliance: A case report","authors":"Juliza Md Lepi, Nik Mukhriz Nik Mustapha","doi":"10.25259/apos_12_2024","DOIUrl":"https://doi.org/10.25259/apos_12_2024","url":null,"abstract":"Autism Spectrum Disorder (ASD) is a multifaceted developmental disability that originates from a neurological disorder, leading to difficulties in the development of social interaction and communication skills. Consequently, this poses a challenge in the provision of oral health care. We report a case of a 13-year-old male with ASD who was concerned about “sticking out upper front teeth.” The patient presented with a Class II Division 1 incisor relationship on a Class 2 skeletal base with retrognathic mandible. The malocclusion was complicated by spacing in the upper and lower arches, proclined upper labial segment, increased overjet 12mm, overbite 90% complete to teeth, and incompetent lip with lower lip trap. The canine relationship was Class II ½ unit bilaterally, and the molar relationship was Class II ½ unit on the right and Class II ¾ unit on the left. The IOTN score was 5a for dental health and 9 for aesthetics. Growth modification to encourage mandibular growth, using a removable Twin Block appliance. The patient displayed excellent compliance with the appliance and effectively addressed his concerns while boosting his self-esteem. By understanding and addressing the unique needs of patients with ASD in orthodontic treatment, patient’s comfort and overall experience can be enhanced along with the likelihood of a successful treatment outcome. Customized treatment plans that respect sensory sensitivities and communication preferences pave the way for a more positive orthodontic journey for individuals with ASD, ultimately leading to enhanced dental well-being and bolstered self-assurance in one’s smile.","PeriodicalId":42593,"journal":{"name":"APOS Trends in Orthodontics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141676505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To systematically compare dentoalveolar and skeletal changes of RME and SME using same expanders with different activation protocols via 3D radiographs. Pubmed, Scopus, LILACS, Cochrane Library and Google Scholar were searched till April 2022. Randomized control trials (RCTs) were included. Statistical analysis performed with Tau2 test to evaluate heterogeneity in the included studies. Risk of bias (RoB) was evaluated using Cochrane RoB 2.0 tool. 5 RCTs were included. RoB revealed one study have low risk of bias and others have some concerns. Meta-analysis showed that both RME and SME displayed significant intermolar expansion (p>0.05) with RME showing significantly greater molar tipping. Random effects meta-analysis performed for maxillary intermolar distance at cuspal [SMD=0.23(95% CI=-0.50 to 0.95)] and alveolar level [SMD=0.76(95% CI=-0.57 to 2.09)] revealed no significant difference between groups with low reliability. RME showed significantly increased posterior skeletal nasal width [P value=0.007, SMD= 0.95(95% CI= 0.25 to 1.64)] with low heterogeneity (I2=24%) and good reliability. Greater molar tipping, determined using buccolingual inclination can be noted in RME. Increase in effective arch width and greater bodily translation was observed in SME. Utilizing the correct expansion protocol in the relevant clinical scenarios can prevent adverse periodontal complications during expansion and provide greater post-expansion stability.
通过三维X光片系统比较使用相同扩张器和不同激活方案的RME和SME的牙槽骨和骨骼变化。截至 2022 年 4 月，对 Pubmed、Scopus、LILACS、Cochrane Library 和 Google Scholar 进行了检索。其中包括随机对照试验（RCT）。使用 Tau2 检验进行统计分析，以评估纳入研究的异质性。使用 Cochrane RoB 2.0 工具评估偏倚风险（RoB）。共纳入 5 项研究。RoB显示，一项研究的偏倚风险较低，其他研究则存在一些问题。荟萃分析表明，RME和SME都显示出明显的臼齿间扩张（p>0.05），RME显示出明显更大的臼齿倾斜。随机效应荟萃分析表明，上颌尖牙处的磨间距离[SMD=0.23（95% CI=-0.50至0.95）]和牙槽水平[SMD=0.76（95% CI=-0.57至2.09）]在各组之间无明显差异，可靠性较低。RME显示鼻后骨骼宽度明显增加[P值=0.007，SMD=0.95（95% CI=0.25至1.64）]，异质性低（I2=24%），可靠性好。使用颊舌侧倾斜度确定的臼齿倾角在 RME 中更大。在 SME 中可以观察到有效牙弓宽度的增加和更大的身体平移。在相关临床情况下使用正确的扩弓方案可以防止扩弓过程中出现不良的牙周并发症，并提供更高的扩弓后稳定性。
{"title":"Three-dimensional evaluation of dentoalveolar and skeletal transverse changes between rapid maxillary expansion and slow maxillary expansion in growing subjects – A systematic review and meta-analysis","authors":"Abirami Selvaraj, A. George, Prasanna Arvind","doi":"10.25259/apos_180_2022","DOIUrl":"https://doi.org/10.25259/apos_180_2022","url":null,"abstract":"To systematically compare dentoalveolar and skeletal changes of RME and SME using same expanders with different activation protocols via 3D radiographs. Pubmed, Scopus, LILACS, Cochrane Library and Google Scholar were searched till April 2022. Randomized control trials (RCTs) were included. Statistical analysis performed with Tau2 test to evaluate heterogeneity in the included studies. Risk of bias (RoB) was evaluated using Cochrane RoB 2.0 tool. 5 RCTs were included. RoB revealed one study have low risk of bias and others have some concerns. Meta-analysis showed that both RME and SME displayed significant intermolar expansion (p>0.05) with RME showing significantly greater molar tipping. Random effects meta-analysis performed for maxillary intermolar distance at cuspal [SMD=0.23(95% CI=-0.50 to 0.95)] and alveolar level [SMD=0.76(95% CI=-0.57 to 2.09)] revealed no significant difference between groups with low reliability. RME showed significantly increased posterior skeletal nasal width [P value=0.007, SMD= 0.95(95% CI= 0.25 to 1.64)] with low heterogeneity (I2=24%) and good reliability. Greater molar tipping, determined using buccolingual inclination can be noted in RME. Increase in effective arch width and greater bodily translation was observed in SME. Utilizing the correct expansion protocol in the relevant clinical scenarios can prevent adverse periodontal complications during expansion and provide greater post-expansion stability.","PeriodicalId":42593,"journal":{"name":"APOS Trends in Orthodontics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141674426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cervical vertebral maturation (CVM) is widely used to evaluate growth potential in orthodontics. This study aims to develop an artificial intelligence (AI) algorithm that automatically predicts the CVM stages in terms of growth phases using cone-beam computed tomography images. A total of 30,016 slices were obtained from 56 patients with an age range of 7–16 years. After cropping the region of interest, a convolutional neural network (CNN) was built to classify the slices based on the presence of a good vision of vertebrae. The output was used to train another model capable of categorizing the slices into phases of growth, which were defined as Phase I (prepubertal), Phase II (circumpubertal), and Phase III (postpubertal). After training the model, 88 new images were used to evaluate the performance of the model using multi-class classification metrics. The average classification accuracy of the first and second CNN-based deep learning models was 96.06% and 95.79%, respectively. The multi-class classification metrics also showed an overall accuracy of 84% for predicting the growth phase in unseen data. Moreover, Phase I ranked the highest accuracy in terms of F1-score (87%), followed by Phase II (83%) and Phase III (80%). Our proposed models could automatically detect the C2–C4 vertebrae and accurately classify slices into three growth phases without the need for annotating the shape and configuration of vertebrae. This will result in the development of a fully automatic and less complex system with reasonable performance.
{"title":"Deep learning models to classify skeletal growth phase on 3D radiographs","authors":"N. Ameli, M. Lagravère, Hollis Lai","doi":"10.25259/apos_73_2024","DOIUrl":"https://doi.org/10.25259/apos_73_2024","url":null,"abstract":"\u0000\u0000Cervical vertebral maturation (CVM) is widely used to evaluate growth potential in orthodontics. This study aims to develop an artificial intelligence (AI) algorithm that automatically predicts the CVM stages in terms of growth phases using cone-beam computed tomography images.\u0000\u0000\u0000\u0000A total of 30,016 slices were obtained from 56 patients with an age range of 7–16 years. After cropping the region of interest, a convolutional neural network (CNN) was built to classify the slices based on the presence of a good vision of vertebrae. The output was used to train another model capable of categorizing the slices into phases of growth, which were defined as Phase I (prepubertal), Phase II (circumpubertal), and Phase III (postpubertal). After training the model, 88 new images were used to evaluate the performance of the model using multi-class classification metrics.\u0000\u0000\u0000\u0000The average classification accuracy of the first and second CNN-based deep learning models was 96.06% and 95.79%, respectively. The multi-class classification metrics also showed an overall accuracy of 84% for predicting the growth phase in unseen data. Moreover, Phase I ranked the highest accuracy in terms of F1-score (87%), followed by Phase II (83%) and Phase III (80%).\u0000\u0000\u0000\u0000Our proposed models could automatically detect the C2–C4 vertebrae and accurately classify slices into three growth phases without the need for annotating the shape and configuration of vertebrae. This will result in the development of a fully automatic and less complex system with reasonable performance.\u0000","PeriodicalId":42593,"journal":{"name":"APOS Trends in Orthodontics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141677161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pycnodysostosis (PYCD) is a rare lysosomal storage disease of the bone caused by a mutation in the gene that codes the enzyme cathepsin K. Patients diagnosed with PYCD demonstrate certain physical characteristics, including deformity in craniofacial structure for which patients seek orthodontic treatments to improve occlusal functions and esthetics. In addition, growth hormone therapy is indicated for these patients due to their short stature. This article is the first to report on the successful completion of the non-surgical orthodontic treatments of a patient diagnosed with PYCD. The patient was treated in two phases due to a waiting period for growth hormone therapy. However, superimposition of pre-and post-treatment radiographs showed no evidence of accelerated skeletal growth at the conclusion of the hormonal therapy. The rate of orthodontic tooth movement for Phase I with conventional appliance and Phase II treatment with clear aligners was similar with healthy individuals treated with four premolars extraction. Surgical exposure of the impacted permanent molars was contraindicated as no posterior dentition was available as anchorage for molar uprighting. Extraction of impacted molars in the mandible was performed with care due to the high risk of fracture. Orthognathic surgery treatment carries an increased risk of osteomyelitis for these patients due to dense bone with poor vascularity. Therefore, non-surgical camouflage orthodontic treatment can be the best option to achieve functional occlusion for patients diagnosed with PYCD.
侏儒症（Pycnodysostosis，PYCD）是一种罕见的溶酶体贮积性骨病，由编码 cathepsin K 酶的基因突变引起。确诊为PYCD 的患者会表现出某些身体特征，包括颅面部结构畸形，患者会寻求正畸治疗以改善咬合功能和美观。此外，由于患者身材矮小，生长激素治疗也适用于这些患者。本文首次报道了一名被诊断为PYCD的患者成功完成非手术正畸治疗的案例。由于生长激素治疗需要等待一段时间，该患者的治疗分两个阶段进行。然而，治疗前后的 X 光片叠加显示，在激素治疗结束时，并没有骨骼加速生长的迹象。使用传统矫治器进行第一阶段治疗和使用透明矫治器进行第二阶段治疗的牙齿移动率与拔除四颗前臼齿的健康人相似。由于没有后牙作为臼齿直立的锚，因此禁忌手术暴露受影响的恒磨牙。由于下颌阻生臼齿骨折的风险很高，因此拔除时要小心谨慎。由于骨质致密且血管不畅，正颌手术治疗会增加这些患者患骨髓炎的风险。因此，对于被诊断为PYCD的患者来说，非手术伪装正畸治疗是实现功能性咬合的最佳选择。
{"title":"Orthodontic treatment of a patient with pycnodysostosis","authors":"Peter Ngan, Dami Kim, Guoqiang Guan","doi":"10.25259/apos_56_2024","DOIUrl":"https://doi.org/10.25259/apos_56_2024","url":null,"abstract":"Pycnodysostosis (PYCD) is a rare lysosomal storage disease of the bone caused by a mutation in the gene that codes the enzyme cathepsin K. Patients diagnosed with PYCD demonstrate certain physical characteristics, including deformity in craniofacial structure for which patients seek orthodontic treatments to improve occlusal functions and esthetics. In addition, growth hormone therapy is indicated for these patients due to their short stature. This article is the first to report on the successful completion of the non-surgical orthodontic treatments of a patient diagnosed with PYCD. The patient was treated in two phases due to a waiting period for growth hormone therapy. However, superimposition of pre-and post-treatment radiographs showed no evidence of accelerated skeletal growth at the conclusion of the hormonal therapy. The rate of orthodontic tooth movement for Phase I with conventional appliance and Phase II treatment with clear aligners was similar with healthy individuals treated with four premolars extraction. Surgical exposure of the impacted permanent molars was contraindicated as no posterior dentition was available as anchorage for molar uprighting. Extraction of impacted molars in the mandible was performed with care due to the high risk of fracture. Orthognathic surgery treatment carries an increased risk of osteomyelitis for these patients due to dense bone with poor vascularity. Therefore, non-surgical camouflage orthodontic treatment can be the best option to achieve functional occlusion for patients diagnosed with PYCD.","PeriodicalId":42593,"journal":{"name":"APOS Trends in Orthodontics","volume":null,"pages":null},"PeriodicalIF":0.5,"publicationDate":"2024-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141673825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Dalaie, Katayoun Talebi Rafsanjan, Hanieh Nojehdehian, Zahra Namazi
This study assessed the physical and chemical changes of clear aligners after thermoforming and intraoral exposure. This ex vivo study evaluated raw sheets, thermoformed sheets, and aligners used for 2 weeks from two commercial brands of Erkodur and Shinseki (n = 8 in each group). The surface hardness (by the Vickers hardness test), thickness (by a digital caliper), and glass transition temperature (Tg) (by differential scanning calorimetry) of the specimens were measured, and they underwent X-ray diffraction (XRD) to assess their degree of crystallinity and attenuated total reflectance-Fourier-transform infrared spectroscopy (ATR-FTIR) for analysis of their molecular composition. Data were analyzed by one-sample, paired and independent t-tests, and Mann–Whitney U and Wilcoxon signed-rank tests (alpha = 0.05). The XRD and ATR-FTIR spectra of Erkodur and Shinseki aligners matched those of polyethylene terephthalate glycol polymer and did not change after thermoforming or intraoral exposure. Unlike intraoral exposure (P > 0.05), thermoforming significantly decreased the hardness of both brands of aligners (P < 0.05). Intraoral exposure significantly decreased the thickness of Erkodur aligners at some points and significantly increased the thickness of Shinseki aligners (P < 0.05). Thermoforming significantly decreased the Tg of both brands of aligners (P < 0.05). Intraoral exposure significantly decreased the Tg of Erkodur and increased the Tg of Shinseki aligners (P = 0.000). Erkodur and Shinseki aligners showed high chemical and structural stability after thermoforming and 2 weeks of intraoral exposure. However, thermoforming affected the thermal and physical properties of both brands of aligners. Erkodur aligners had higher dimensional stability than Shinseki aligners.
本研究评估了透明矫治器在热成型和口内暴露后的物理和化学变化。这项体内外研究评估了原始板材、热成型板材以及使用两周的Erkodur和Shinseki两种商业品牌的矫治器（每组n=8）。研究人员测量了试样的表面硬度（通过维氏硬度测试）、厚度（通过数字卡尺）和玻璃化转变温度（Tg）（通过差示扫描量热法），并通过 X 射线衍射（XRD）评估了试样的结晶度，还通过衰减全反射-傅立叶变换红外光谱（ATR-FTIR）分析了试样的分子组成。数据分析采用单样本、配对和独立 t 检验，以及 Mann-Whitney U 和 Wilcoxon 符号秩检验（α = 0.05）。Erkodur 和 Shinseki 矫正器的 XRD 和 ATR-FTIR 光谱与聚对苯二甲酸乙二酯聚合物的光谱一致，在热成型或口内暴露后没有变化。与口内暴露不同（P > 0.05），热成型显著降低了两种品牌矫治器的硬度（P < 0.05）。口内暴露明显降低了Erkodur矫治器某些部位的厚度，而明显增加了Shinseki矫治器的厚度（P < 0.05）。热成型明显降低了两种品牌矫正器的Tg（P < 0.05）。经过热成型和2周的口内暴露后，Erkodur和Shinseki矫正器显示出较高的化学和结构稳定性。然而，热成型影响了两种品牌矫治器的热性能和物理性能。埃克多尔矫正器的尺寸稳定性高于新石矫正器。
{"title":"Physical and chemical changes of clear aligners after thermoforming and intraoral exposure","authors":"K. Dalaie, Katayoun Talebi Rafsanjan, Hanieh Nojehdehian, Zahra Namazi","doi":"10.25259/apos_169_2023","DOIUrl":"https://doi.org/10.25259/apos_169_2023","url":null,"abstract":"\u0000\u0000This study assessed the physical and chemical changes of clear aligners after thermoforming and intraoral exposure.\u0000\u0000\u0000\u0000This ex vivo study evaluated raw sheets, thermoformed sheets, and aligners used for 2 weeks from two commercial brands of Erkodur and Shinseki (n = 8 in each group). The surface hardness (by the Vickers hardness test), thickness (by a digital caliper), and glass transition temperature (Tg) (by differential scanning calorimetry) of the specimens were measured, and they underwent X-ray diffraction (XRD) to assess their degree of crystallinity and attenuated total reflectance-Fourier-transform infrared spectroscopy (ATR-FTIR) for analysis of their molecular composition. Data were analyzed by one-sample, paired and independent t-tests, and Mann–Whitney U and Wilcoxon signed-rank tests (alpha = 0.05).\u0000\u0000\u0000\u0000The XRD and ATR-FTIR spectra of Erkodur and Shinseki aligners matched those of polyethylene terephthalate glycol polymer and did not change after thermoforming or intraoral exposure. Unlike intraoral exposure (P > 0.05), thermoforming significantly decreased the hardness of both brands of aligners (P < 0.05). Intraoral exposure significantly decreased the thickness of Erkodur aligners at some points and significantly increased the thickness of Shinseki aligners (P < 0.05). Thermoforming significantly decreased the Tg of both brands of aligners (P < 0.05). Intraoral exposure significantly decreased the Tg of Erkodur and increased the Tg of Shinseki aligners (P = 0.000).\u0000\u0000\u0000\u0000Erkodur and Shinseki aligners showed high chemical and structural stability after thermoforming and 2 weeks of intraoral exposure. However, thermoforming affected the thermal and physical properties of both brands of aligners. Erkodur aligners had higher dimensional stability than Shinseki aligners.\u0000","PeriodicalId":42593,"journal":{"name":"APOS Trends in Orthodontics","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141338950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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