Pub Date : 2024-10-29DOI: 10.1016/j.ortho.2024.100937
Enrico Albertini , Paolo Albertini , Anna Colonna , Federico Rivara , Luca Lombardo
This case report describes the treatment of a Class II malocclusion with upper lateral incisors agenesis in an adult patient, performed by an invisible preadjusted lingual appliance, monolateral space opening and dental Class II correction. The patient had previously been treated by clear aligners with the insertion of an implant in upper right canine position in order to close the remaining space. With the twofold aim of obtaining ideal occlusal relationship and smile aesthetic improvement, it highlights how a fixed orthodontic technique is needed to achieve the planned results, when anterior torque, bodily translations and deep-bite correction are necessary. On the other hand, it underlines how the treatment plan should not be adapted to the limits of the employed appliance, but should aim for the best clinical result for the patient. A prosthetic finalisation was in the end performed in order to obtain the best aesthetic result.
{"title":"Invisible treatment with preadjusted lingual appliance and monolateral space opening for an adult Class II malocclusion with upper lateral incisors agenesis: An ortho-prosthetic case report","authors":"Enrico Albertini , Paolo Albertini , Anna Colonna , Federico Rivara , Luca Lombardo","doi":"10.1016/j.ortho.2024.100937","DOIUrl":"10.1016/j.ortho.2024.100937","url":null,"abstract":"<div><div>This case report describes the treatment of a Class II malocclusion with upper lateral incisors agenesis in an adult patient, performed by an invisible preadjusted lingual appliance, monolateral space opening and dental Class II correction. The patient had previously been treated by clear aligners with the insertion of an implant in upper right canine position in order to close the remaining space. With the twofold aim of obtaining ideal occlusal relationship and smile aesthetic improvement, it highlights how a fixed orthodontic technique is needed to achieve the planned results, when anterior torque, bodily translations and deep-bite correction are necessary. On the other hand, it underlines how the treatment plan should not be adapted to the limits of the employed appliance, but should aim for the best clinical result for the patient. A prosthetic finalisation was in the end performed in order to obtain the best aesthetic result.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 1","pages":"Article 100937"},"PeriodicalIF":1.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539903","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}
Pub Date : 2024-10-29DOI: 10.1016/j.ortho.2024.100933
Yangyang Yang , Shengxuan Pan , Jie Zhao , Xiaogang Pan , Tsung-Yuan Tsai
Objectives
The distribution and size of the zone of the centres of resistance (ZCR) are critical for accurate orthodontic treatments and minimizing unexpected tooth movements. However, this information remains unclear for mandibular incisors and canines. This study aims to address these gaps in knowledge.
Methods
Finite element models of four incisors and canines from four individuals were created. Four centres of resistance (CRs) under four orthodontic directions (0° ∼ 45° ∼ 90° ∼ 135° to the sagittal plane in the horizontal plane) were assessed by a novel method. The height of the CRs was normalized to a percentage of the long axis, and the offsets were expressed as a distance value after normalization. The ZCR was obtained by fitting a 90% confidence sphere of the CR distribution. Validation was conducted to find the perturbations when the positions out of the zone were applied.
Results
The maximum variation of CR in the heights under four directions was 5.17% and 3.70% for the incisors and canines, respectively. The maximum offset between the CR and long axis was 0.14 mm in incisors and 0.99 mm in canines. The height of the zone in the incisor and canine was 57.75% and 59.72%, and the radius of the zone was 0.60 mm and 0.65 mm, respectively. The force-acting point outside the zone produced a large rotation, which was unexpected.
Conclusions
The ZCR of mandibular incisors located slightly lower than that of canines, but they were almost the same size. The ZCR was recommended as the “gold reference” for orthodontics to reduce unexpected movement.
{"title":"Three-dimensional zone of the centers of resistance of the mandibular incisors and canines: A novel approach by finite element analysis","authors":"Yangyang Yang , Shengxuan Pan , Jie Zhao , Xiaogang Pan , Tsung-Yuan Tsai","doi":"10.1016/j.ortho.2024.100933","DOIUrl":"10.1016/j.ortho.2024.100933","url":null,"abstract":"<div><h3>Objectives</h3><div>The distribution and size of the zone of the centres of resistance (ZCR) are critical for accurate orthodontic treatments and minimizing unexpected tooth movements. However, this information remains unclear for mandibular incisors and canines. This study aims to address these gaps in knowledge.</div></div><div><h3>Methods</h3><div>Finite element models of four incisors and canines from four individuals were created. Four centres of resistance (CRs) under four orthodontic directions (0° ∼ 45° ∼ 90° ∼ 135° to the sagittal plane in the horizontal plane) were assessed by a novel method. The height of the CRs was normalized to a percentage of the long axis, and the offsets were expressed as a distance value after normalization. The ZCR was obtained by fitting a 90% confidence sphere of the CR distribution. Validation was conducted to find the perturbations when the positions out of the zone were applied.</div></div><div><h3>Results</h3><div>The maximum variation of CR in the heights under four directions was 5.17% and 3.70% for the incisors and canines, respectively. The maximum offset between the CR and long axis was 0.14<!--> <!-->mm in incisors and 0.99<!--> <!-->mm in canines. The height of the zone in the incisor and canine was 57.75% and 59.72%, and the radius of the zone was 0.60<!--> <!-->mm and 0.65<!--> <!-->mm, respectively. The force-acting point outside the zone produced a large rotation, which was unexpected.</div></div><div><h3>Conclusions</h3><div>The ZCR of mandibular incisors located slightly lower than that of canines, but they were almost the same size. The ZCR was recommended as the “gold reference” for orthodontics to reduce unexpected movement.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 1","pages":"Article 100933"},"PeriodicalIF":1.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539900","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}
Pub Date : 2024-10-29DOI: 10.1016/j.ortho.2024.100936
Rehab A. Khalil , Walid S. Salem
Objective
This study aimed to assess the changes in the pharyngeal airway morphology after premolar extraction and maximum anchorage retraction of the anterior segments in adult bimaxillary protrusion patients by using CBCT.
Material and methods
Twenty-one subjects (mean age 23.8 ± 4.6 years) requiring extraction of four first premolars and en masse retraction of the anterior segments using maximum anchorage participated in the study from July 2022 to May 2024 with an average treatment duration of 19.9 months. CBCT scans were taken before treatment (pre) and after en masse retraction (post). Airway volume was measured by using Relu software. The pre- and post-CBCT scans were superimposed by using Romexis 1 software. The cross-sectional area (CSA) was measured at the level of the hard palate, soft palate, and epiglottis. The most constricted area (MCA) was recorded. The hyoid bone position was evaluated by using 5 linear measurements. The upper and lower incisor angulations to the Frankfort horizontal plane (FH) were measured before and after retraction. Paired t-test was used to analyse the measurements and correlation analyses were made using Spearman's rank-order correlation coefficient (rs). The significance level was set at P < 0.05 within all tests.
Results
Twenty-one participants (16 females, 5 males) followed the inclusion criteria and enrolled in the analysis. There were no significant differences in airway volume, cross-sectional areas, or hyoid bone position between before treatment and after en masse retraction (P > 0.05). There was a significant retraction of the incisors after treatment (P < 0.001). The change in the most constricted area had a large positive correlation with the change in the airway volume (rs = 0.509*) and the area of the soft palate (rs = 0.653*).
Conclusion
Maximum anchorage retraction had no significant effect on airway volume, cross-sectional area, or hyoid bone position.
{"title":"Three-dimensional evaluation of the airway morphology after miniscrew-supported en masse retraction in adult bimaxillary protrusion patients by using cone beam computed tomography: A single-arm clinical trial","authors":"Rehab A. Khalil , Walid S. Salem","doi":"10.1016/j.ortho.2024.100936","DOIUrl":"10.1016/j.ortho.2024.100936","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the changes in the pharyngeal airway morphology after premolar extraction and maximum anchorage retraction of the anterior segments in adult bimaxillary protrusion patients by using CBCT.</div></div><div><h3>Material and methods</h3><div>Twenty-one subjects (mean age 23.8<!--> <!-->±<!--> <!-->4.6 years) requiring extraction of four first premolars and en masse retraction of the anterior segments using maximum anchorage participated in the study from July 2022 to May 2024 with an average treatment duration of 19.9 months. CBCT scans were taken before treatment (pre) and after en masse retraction (post). Airway volume was measured by using Relu software. The pre- and post-CBCT scans were superimposed by using Romexis 1 software. The cross-sectional area (CSA) was measured at the level of the hard palate, soft palate, and epiglottis. The most constricted area (MCA) was recorded. The hyoid bone position was evaluated by using 5 linear measurements. The upper and lower incisor angulations to the Frankfort horizontal plane (FH) were measured before and after retraction. Paired <em>t</em>-test was used to analyse the measurements and correlation analyses were made using Spearman's rank-order correlation coefficient (rs). The significance level was set at <em>P</em> <!--><<!--> <!-->0.05 within all tests.</div></div><div><h3>Results</h3><div>Twenty-one participants (16 females, 5 males) followed the inclusion criteria and enrolled in the analysis. There were no significant differences in airway volume, cross-sectional areas, or hyoid bone position between before treatment and after en masse retraction (<em>P</em> <!-->><!--> <!-->0.05). There was a significant retraction of the incisors after treatment (<em>P</em> <!--><<!--> <!-->0.001). The change in the most constricted area had a large positive correlation with the change in the airway volume (rs<!--> <!-->=<!--> <!-->0.509*) and the area of the soft palate (rs<!--> <!-->=<!--> <!-->0.653*).</div></div><div><h3>Conclusion</h3><div>Maximum anchorage retraction had no significant effect on airway volume, cross-sectional area, or hyoid bone position.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 1","pages":"Article 100936"},"PeriodicalIF":1.8,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142539902","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}
Pub Date : 2024-10-28DOI: 10.1016/j.ortho.2024.100932
Beike Wang , Juan Qi
This case report describes the successful long-term management of a 19-year-old female patient presenting with a skeletal Class II pattern, mild anterior open bite, and mandibular retrognathia. The orthodontic treatment approach involved the distal movement of the maxillary and mandibular dentitions through the extraction of the maxillary second molars and mandibular third molars, combined with the use of extra-alveolar infrazygomatic crest (IZC) and buccal shelf (BS) miniscrews for anchorage. The treatment outcome achieved a stable, well-aligned dentition with ideal intercuspation and an improved facial profile. The 7-year post-treatment records demonstrated a stable occlusion and satisfactory facial aesthetics, confirming the long-term stability of this treatment approach. This case report supports that en-masse distalization of the entire dentition by extracting the upper second molars and lower third molars, coupled with bone miniscrew anchorages, can be a favourable alternative to the conventional premolar extraction approach for the correction of borderline Class II malocclusions.
本病例报告描述了对一名 19 岁女性患者的成功长期治疗，该患者的骨骼形态为 II 类、轻度前牙开合咬合和下颌后缩。正畸治疗方法包括通过拔除上颌第二磨牙和下颌第三磨牙来实现上颌和下颌牙体的远端移动，同时使用牙槽下颧嵴（IZC）和颊架（BS）微型螺钉进行固定。治疗结果显示，患者的牙列稳定、整齐，牙间隙理想，面部轮廓得到改善。治疗后 7 年的记录显示咬合稳定，面部美观令人满意，证实了这种治疗方法的长期稳定性。本病例报告证明，通过拔除上第二磨牙和下第三磨牙，对整个牙列进行整体远端化，再加上骨小螺钉固定，可以替代传统的前磨牙拔除法，用于矫正边缘性二类错合畸形。
{"title":"Successful management and stability of maxillary class II dentoalveolar protrusion with extractions of upper second and lower third molars, using en-masse distalization and vertical control with bone miniscrews: Adult case report with 7-year follow-up","authors":"Beike Wang , Juan Qi","doi":"10.1016/j.ortho.2024.100932","DOIUrl":"10.1016/j.ortho.2024.100932","url":null,"abstract":"<div><div>This case report describes the successful long-term management of a 19-year-old female patient presenting with a skeletal Class II pattern, mild anterior open bite, and mandibular retrognathia. The orthodontic treatment approach involved the distal movement of the maxillary and mandibular dentitions through the extraction of the maxillary second molars and mandibular third molars, combined with the use of extra-alveolar infrazygomatic crest (IZC) and buccal shelf (BS) miniscrews for anchorage. The treatment outcome achieved a stable, well-aligned dentition with ideal intercuspation and an improved facial profile. The 7-year post-treatment records demonstrated a stable occlusion and satisfactory facial aesthetics, confirming the long-term stability of this treatment approach. This case report supports that en-masse distalization of the entire dentition by extracting the upper second molars and lower third molars, coupled with bone miniscrew anchorages, can be a favourable alternative to the conventional premolar extraction approach for the correction of borderline Class II malocclusions.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 1","pages":"Article 100932"},"PeriodicalIF":1.8,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510125","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}
Pub Date : 2024-10-24DOI: 10.1016/j.ortho.2024.100935
Leda Kroselj Zevnik , Jasmina Primozic
<div><h3>Introduction</h3><div>Besides the mid-palatal suture maturation stage, the morphology of the palate might also play a role in the effectiveness of miniscrew insertion planning or effectiveness of palatal expansion.</div></div><div><h3>Objectives</h3><div>The aim was to assess the mid-palate length, height and surface area according to the mid-palatal suture maturation stage and its correlation to the maturity of the transverse palatine suture on cone-beam computed tomography (CBCT) maxillary images in a consequently selected group of subjects.</div></div><div><h3>Material and methods</h3><div>High-resolution CBCT images of 100 subjects (56 females, 44 males), aged 33.9<!--> <!-->±<!--> <!-->22.7 years, were selected. The images were clustered according to the mid-palatal suture maturation stage (stages B, C, D, and E) and 25 images per stage group were retrieved. The length, heights (at 2<!--> <!-->mm intervals) and surface area of the mid-palate were measured from the posterior border of the incisal foramen to the posterior nasal spine, and the maturity of the transverse palatine suture was recorded.</div></div><div><h3>Results</h3><div>No between-stage-group differences were seen for mid-palate length, while heights and surface areas were significantly different between maturational stages. The mid-palate height was significantly smaller in maturational stages D and E groups (5.65<!--> <!-->±<!--> <!-->1.55<!--> <!-->mm and 5.77<!--> <!-->±<!--> <!-->1.70<!--> <!-->mm, respectively) than in groups B and C (6.97<!--> <!-->±<!--> <!-->1.82<!--> <!-->mm and 7.00<!--> <!-->±<!--> <!-->1.53<!--> <!-->mm, respectively). However, differences were significant only distally to the sixth mm measurement point. The surface area was significantly different among groups, denoting higher values for stage B and C (1.82<!--> <!-->±<!--> <!-->0.55<!--> <!-->cm<sup>2</sup> and 1.86<!--> <!-->±<!--> <!-->0.41<!--> <!-->cm<sup>2</sup>, respectively), compared to stage D and E groups (1.53<!--> <!-->±<!--> <!-->0.38<!--> <!-->cm<sup>2</sup> and 1.57<!--> <!-->±<!--> <!-->0.54<!--> <!-->cm<sup>2</sup>, respectively). A significant negative but poor correlation was seen between mid-palate total average height, surface area and mid-palatal suture stage (rho<!--> <!-->=<!--> <!-->–0.278, <em>P</em> <!-->=<!--> <!-->0.005 and rho<!--> <!-->=<!--> <!-->–0.222, <em>P</em> <!-->=<!--> <!-->0.027, respectively). Moreover, a very strong to moderate positive correlation (rho<!--> <!-->=<!--> <!-->0.847, <em>P</em> <!--><<!--> <!-->0.001, rho<!--> <!-->=<!--> <!-->0.739, <em>P</em> <!--><<!--> <!-->0.001) was seen between age and the maturational stage of the mid-palatal and transverse palatine sutures, respectively. Both the mid-palatal and transverse palatine sutures maturity stages were positively and very strongly correlated (rho<!--> <!-->=<!--> <!-->0.839, <em>P</em> <!--><<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>The height and surface
导言：除了腭中缝的成熟阶段外，腭的形态也可能对迷你螺钉插入规划的有效性或腭扩张的有效性起作用：材料与方法：选取年龄为 33.9±22.7 岁的 100 名受试者（56 名女性，44 名男性）的高分辨率 CBCT 图像。根据腭中缝成熟阶段（B、C、D 和 E 阶段）对图像进行分组，每个阶段组检索 25 幅图像。测量腭中缝的长度、高度（间隔 2 毫米）和表面积，测量范围从切牙孔后缘到鼻后脊，并记录腭横缝的成熟度：结果：腭中部长度在不同阶段之间无差异，而高度和表面积在不同成熟阶段之间有显著差异。D组和E组的腭中部高度（分别为5.65±1.55毫米和5.77±1.70毫米）明显小于B组和C组（分别为6.97±1.82毫米和7.00±1.53毫米）。不过，只有在第六毫米测量点的远端才存在显著差异。各组间的表面积有明显差异，与 D 和 E 组（分别为 1.53±0.38cm2 和 1.57±0.54cm2）相比，B 和 C 组的表面积较高（分别为 1.82±0.55cm2 和 1.86±0.41cm2）。腭中部总平均高度、表面积与腭中部缝合期之间存在明显的负相关，但相关性较差（分别为 rho=-0.278, P=0.005 和 rho=-0.222, P=0.027）。此外，腭中缝的高度和表面积与腭中缝阶段存在极强至中等程度的正相关（rho=0.847，PConclusions：腭中部的高度和表面积在各成熟阶段组之间存在显著差异，而在腭中部长度方面则未观察到差异。成熟度较低的缝合线比成熟度较高的缝合线显示出更大的高度和表面积值。尽管在这方面还需要进一步的研究，但从横向腭骨成熟阶段来看，腭中缝成熟阶段 C 显示出更大的分布变异性，这可能是区分骨骼腭骨扩张成功与失败的一个因素，即使使用骨骼固定装置也是如此。
{"title":"Morphological characteristics of the palate according to mid-palatal suture maturational stage on cone-beam computed tomography images: A cross-sectional study","authors":"Leda Kroselj Zevnik , Jasmina Primozic","doi":"10.1016/j.ortho.2024.100935","DOIUrl":"10.1016/j.ortho.2024.100935","url":null,"abstract":"<div><h3>Introduction</h3><div>Besides the mid-palatal suture maturation stage, the morphology of the palate might also play a role in the effectiveness of miniscrew insertion planning or effectiveness of palatal expansion.</div></div><div><h3>Objectives</h3><div>The aim was to assess the mid-palate length, height and surface area according to the mid-palatal suture maturation stage and its correlation to the maturity of the transverse palatine suture on cone-beam computed tomography (CBCT) maxillary images in a consequently selected group of subjects.</div></div><div><h3>Material and methods</h3><div>High-resolution CBCT images of 100 subjects (56 females, 44 males), aged 33.9<!--> <!-->±<!--> <!-->22.7 years, were selected. The images were clustered according to the mid-palatal suture maturation stage (stages B, C, D, and E) and 25 images per stage group were retrieved. The length, heights (at 2<!--> <!-->mm intervals) and surface area of the mid-palate were measured from the posterior border of the incisal foramen to the posterior nasal spine, and the maturity of the transverse palatine suture was recorded.</div></div><div><h3>Results</h3><div>No between-stage-group differences were seen for mid-palate length, while heights and surface areas were significantly different between maturational stages. The mid-palate height was significantly smaller in maturational stages D and E groups (5.65<!--> <!-->±<!--> <!-->1.55<!--> <!-->mm and 5.77<!--> <!-->±<!--> <!-->1.70<!--> <!-->mm, respectively) than in groups B and C (6.97<!--> <!-->±<!--> <!-->1.82<!--> <!-->mm and 7.00<!--> <!-->±<!--> <!-->1.53<!--> <!-->mm, respectively). However, differences were significant only distally to the sixth mm measurement point. The surface area was significantly different among groups, denoting higher values for stage B and C (1.82<!--> <!-->±<!--> <!-->0.55<!--> <!-->cm<sup>2</sup> and 1.86<!--> <!-->±<!--> <!-->0.41<!--> <!-->cm<sup>2</sup>, respectively), compared to stage D and E groups (1.53<!--> <!-->±<!--> <!-->0.38<!--> <!-->cm<sup>2</sup> and 1.57<!--> <!-->±<!--> <!-->0.54<!--> <!-->cm<sup>2</sup>, respectively). A significant negative but poor correlation was seen between mid-palate total average height, surface area and mid-palatal suture stage (rho<!--> <!-->=<!--> <!-->–0.278, <em>P</em> <!-->=<!--> <!-->0.005 and rho<!--> <!-->=<!--> <!-->–0.222, <em>P</em> <!-->=<!--> <!-->0.027, respectively). Moreover, a very strong to moderate positive correlation (rho<!--> <!-->=<!--> <!-->0.847, <em>P</em> <!--><<!--> <!-->0.001, rho<!--> <!-->=<!--> <!-->0.739, <em>P</em> <!--><<!--> <!-->0.001) was seen between age and the maturational stage of the mid-palatal and transverse palatine sutures, respectively. Both the mid-palatal and transverse palatine sutures maturity stages were positively and very strongly correlated (rho<!--> <!-->=<!--> <!-->0.839, <em>P</em> <!--><<!--> <!-->0.001).</div></div><div><h3>Conclusions</h3><div>The height and surface","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 1","pages":"Article 100935"},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510123","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}
Pub Date : 2024-10-24DOI: 10.1016/j.ortho.2024.100931
Bushra Sufyan Almaqrami , Majedh Abdo Ali Al-Somairi , Waseem Saleh Al-Gumaei , Barakat Al-Tayar , Ehab A. Abdulghani , Maged S. Alhammadi , Zhijian Liu , Hui Xiong , Hong He
Background
Miniscrew-assisted rapid palatal expansion (MARPE) has emerged as a noteworthy non-surgical method for treating maxillary transverse deficiency, especially in young adult patients. Studies have shown that MARPE can achieve significant dentoalveolar and skeletal expansion with long-term stability. The primary objective of this study was to assess the skeletal changes in the maxillary transverse dimension, and the secondary objective was to evaluate the dentoalveolar changes, following the use of a commercially available maxillary skeletal expander (MSE) in comparison to a custom-fabricated MARPE.
Methods
This retrospective study involved 50 young adult patients diagnosed with skeletal transverse maxillary deficiency, divided into two groups (MSE and custom MARPE), with 25 patients in each group. Pre- and post-expansion cone-beam computed tomography (CBCT) images were used to analyse skeletal, alveolar, and dental changes.
Results
Both MSE and custom MARPE groups achieved significant skeletal and dentoalveolar expansion. However, the custom MARPE group exhibited notably greater expansion in several metrics; in the axial plane, the average expansion was 4.68 ± 1.35 mm and 3.37 ± 1.53 mm at the anterolateral maxillary walls and 3.99 ± 1.35 mm and 3.28 ± 1.19 mm at the greater palatine foramen region for custom MARPE and MSE groups, respectively (P < 0.01). In coronal plane, the custom MARPE showed significantly greater transverse expansion at the mid-nasal, basal, alveolar, and dental levels.
Conclusion
Both MARPE systems are effective for maxillary expansion. However, the custom-fabricated MARPE may offer more favourable results, with broader and more uniform skeletal expansion. This can be especially beneficial for patients with specific anatomical requirements.
{"title":"Degree and pattern of expansion of commercially available and custom-fabricated miniscrew-assisted rapid palatal expansion systems in young adult patients: A retrospective comparative analysis","authors":"Bushra Sufyan Almaqrami , Majedh Abdo Ali Al-Somairi , Waseem Saleh Al-Gumaei , Barakat Al-Tayar , Ehab A. Abdulghani , Maged S. Alhammadi , Zhijian Liu , Hui Xiong , Hong He","doi":"10.1016/j.ortho.2024.100931","DOIUrl":"10.1016/j.ortho.2024.100931","url":null,"abstract":"<div><h3>Background</h3><div>Miniscrew-assisted rapid palatal expansion (MARPE) has emerged as a noteworthy non-surgical method for treating maxillary transverse deficiency, especially in young adult patients. Studies have shown that MARPE can achieve significant dentoalveolar and skeletal expansion with long-term stability. The primary objective of this study was to assess the skeletal changes in the maxillary transverse dimension, and the secondary objective was to evaluate the dentoalveolar changes, following the use of a commercially available maxillary skeletal expander (MSE) in comparison to a custom-fabricated MARPE.</div></div><div><h3>Methods</h3><div>This retrospective study involved 50 young adult patients diagnosed with skeletal transverse maxillary deficiency, divided into two groups (MSE and custom MARPE), with 25 patients in each group. Pre- and post-expansion cone-beam computed tomography (CBCT) images were used to analyse skeletal, alveolar, and dental changes.</div></div><div><h3>Results</h3><div>Both MSE and custom MARPE groups achieved significant skeletal and dentoalveolar expansion. However, the custom MARPE group exhibited notably greater expansion in several metrics; in the axial plane, the average expansion was 4.68<!--> <!-->±<!--> <!-->1.35<!--> <!-->mm and 3.37<!--> <!-->±<!--> <!-->1.53<!--> <!-->mm at the anterolateral maxillary walls and 3.99<!--> <!-->±<!--> <!-->1.35<!--> <!-->mm and 3.28<!--> <!-->±<!--> <!-->1.19<!--> <!-->mm at the greater palatine foramen region for custom MARPE and MSE groups, respectively (<em>P</em> <!--><<!--> <!-->0.01). In coronal plane, the custom MARPE showed significantly greater transverse expansion at the mid-nasal, basal, alveolar, and dental levels.</div></div><div><h3>Conclusion</h3><div>Both MARPE systems are effective for maxillary expansion. However, the custom-fabricated MARPE may offer more favourable results, with broader and more uniform skeletal expansion. This can be especially beneficial for patients with specific anatomical requirements.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 1","pages":"Article 100931"},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510122","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 compare the difference in failure rates between orthodontic brackets bonded with light-cured primer and those bonded without primer.
Material and methods
An electronic search of five databases and additional manual searches were performed until January 2024. Randomized and prospective non-randomized controlled trials directly comparing the bracket failure rate with and without primer. Two authors independently collected study characteristics by extracting outcome data from pre-defined sheets. After evaluating the risk of bias, the odds ratio and 95% confidence intervals (CIs) were calculated with random-effects models.
Results
Four studies were evaluated using qualitative and quantitative analysis. The analysis included data from 199 patients (1691 brackets with primer and 1646 brackets without primer). Random effects of pooled meta-analysis demonstrated statistically significant differences in the bracket failure rates (odds ratio = 1.50, p = 0.010, [95% CI 1.10 to 2.05]). The risk of failure was 1.5 times greater when brackets were bonded without primer.
Conclusion
The results should be interpreted in the context of the limited sample size, even though there was a substantial difference in the failure rates of brackets with and without a primer, favouring the use of a primer. Furthermore, the validity of the finding may be limited by potential variables such as patient factors, clinician expertise, and isolation. More extensive research is required to validate these findings (PROSPERO CRD42024593134).
{"title":"Orthodontic bracket failure rate after bonding with and without primer – A systematic review and meta-analysis","authors":"Thangabalu Rajamuthu , Anjana Rajagopalan , Anusuya Venkatachalapathy , Prabhakar Krishnan , Naveen Munusamy , Udhayan Asokan","doi":"10.1016/j.ortho.2024.100934","DOIUrl":"10.1016/j.ortho.2024.100934","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the difference in failure rates between orthodontic brackets bonded with light-cured primer and those bonded without primer.</div></div><div><h3>Material and methods</h3><div>An electronic search of five databases and additional manual searches were performed until January 2024. Randomized and prospective non-randomized controlled trials directly comparing the bracket failure rate with and without primer. Two authors independently collected study characteristics by extracting outcome data from pre-defined sheets. After evaluating the risk of bias, the odds ratio and 95% confidence intervals (CIs) were calculated with random-effects models.</div></div><div><h3>Results</h3><div>Four studies were evaluated using qualitative and quantitative analysis. The analysis included data from 199 patients (1691 brackets with primer and 1646 brackets without primer). Random effects of pooled meta-analysis demonstrated statistically significant differences in the bracket failure rates (odds ratio<!--> <!-->=<!--> <!-->1.50, <em>p</em> <!-->=<!--> <!-->0.010, [95% CI 1.10 to 2.05]). The risk of failure was 1.5 times greater when brackets were bonded without primer.</div></div><div><h3>Conclusion</h3><div>The results should be interpreted in the context of the limited sample size, even though there was a substantial difference in the failure rates of brackets with and without a primer, favouring the use of a primer. Furthermore, the validity of the finding may be limited by potential variables such as patient factors, clinician expertise, and isolation. More extensive research is required to validate these findings (PROSPERO CRD42024593134).</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 1","pages":"Article 100934"},"PeriodicalIF":1.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510124","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}
This report chronicles the case of an adolescent female with cleft palate associated severe hypoplastic maxillary Class III deformity. Treatment involved anterior maxillary segmental distraction osteogenesis (AMSDO) in conjunction with pre-distraction and post-distraction orthodontics. Following pre-distraction orthodontics, AMSDO was performed using a customized Hyrax distractor assembly. Post-distraction orthodontics helped stabilize distraction outcomes and finalize occlusion. Post-treatment, midface deficiency and prognathic profile improved dramatically with establishment of acceptable interincisal relationship and well-balanced functionally interdigitated occlusion. Three-year follow-up showed excellent morphologic and functional stability. AMSDO is a viable modality that contributes to effective stomatological rehabilitation of patients with cleft maxillary hypoplasia.
{"title":"Anterior maxillary distraction for cleft palate associated severe hypoplastic maxillary Class III deformity during adolescence – A case report","authors":"Harpreet Singh , Dhirendra Srivastava , Pranav Kapoor , Poonam Sharma , Sonal Mishra , Lokesh Chandra , Raj Kumar Maurya","doi":"10.1016/j.ortho.2024.100927","DOIUrl":"10.1016/j.ortho.2024.100927","url":null,"abstract":"<div><div>This report chronicles the case of an adolescent female with cleft palate associated severe hypoplastic maxillary Class III deformity. Treatment involved anterior maxillary segmental distraction osteogenesis (AMSDO) in conjunction with pre-distraction and post-distraction orthodontics. Following pre-distraction orthodontics, AMSDO was performed using a customized Hyrax distractor assembly. Post-distraction orthodontics helped stabilize distraction outcomes and finalize occlusion. Post-treatment, midface deficiency and prognathic profile improved dramatically with establishment of acceptable interincisal relationship and well-balanced functionally interdigitated occlusion. Three-year follow-up showed excellent morphologic and functional stability. AMSDO is a viable modality that contributes to effective stomatological rehabilitation of patients with cleft maxillary hypoplasia.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"22 4","pages":"Article 100927"},"PeriodicalIF":1.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477251","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}
The prevention of white spot lesions (WSLs) during orthodontic treatment with fixed appliances is of paramount importance to orthodontists. Numerous non-invasive techniques have been extensively researched to effectively manage WSLs. The objective of this study was to investigate the efficacy of MI varnish application, diode laser irradiation and their combination on remineralization of WSLs.
Materials and methods
In this in vitro study, 40 enamel samples were divided randomly into 4 groups based on the applied treatment after demineralization. In Group I, MI varnish was applied to the enamel samples for a period of 7 days. In Group II, samples were irradiated with diode laser. In Group III, MI varnish was applied for 7 days, followed by diode laser irradiation. Whereas Group IV (control group) received no treatment and samples were stored in artificial saliva for 7 days. Microhardness assessments were performed at baseline, after demineralization and following the different treatment protocols. A representative sample from each group was randomly selected for scanning electron microscopy (SEM) analysis. One-way ANOVA, repeated measures ANOVA, and Tukey's Post Hoc tests were used for statistical analysis, with significance set at P ≤ 0.05.
Results
All treatment groups demonstrated significantly higher mean microhardness values compared to the control group (P < 0.05). Group 1 (MI varnish) had a final microhardness mean value of 193.50 (P < 0.001), Group 2 (diode laser) recorded the highest final mean of 214.20 (P = 0.018), and Group 3 (MI varnish + diode laser) had a mean of 203.93 (P = 0.011). SEM observations supported these findings by showing enhanced surface morphology in the treatment groups.
Conclusions
MI varnish application, laser irradiation, and their combination demonstrated enhanced microhardness of artificially demineralized enamel, highlighting their effectiveness in remineralization of WSLs.
{"title":"Efficacy of fluoride varnish containing casein phosphopeptide-amorphous calcium phosphate application and diode laser irradiation on white spot lesions remineralization: An in vitro study","authors":"Mona El Sayed , Rahma ElNaghy , Toka Hesham Fathi , Reem Zeid","doi":"10.1016/j.ortho.2024.100929","DOIUrl":"10.1016/j.ortho.2024.100929","url":null,"abstract":"<div><h3>Background/Objectives</h3><div>The prevention of white spot lesions (WSLs) during orthodontic treatment with fixed appliances is of paramount importance to orthodontists. Numerous non-invasive techniques have been extensively researched to effectively manage WSLs. The objective of this study was to investigate the efficacy of MI varnish application, diode laser irradiation and their combination on remineralization of WSLs.</div></div><div><h3>Materials and methods</h3><div>In this in vitro study, 40 enamel samples were divided randomly into 4 groups based on the applied treatment after demineralization. In Group I, MI varnish was applied to the enamel samples for a period of 7 days. In Group II, samples were irradiated with diode laser. In Group III, MI varnish was applied for 7 days, followed by diode laser irradiation. Whereas Group IV (control group) received no treatment and samples were stored in artificial saliva for 7 days. Microhardness assessments were performed at baseline, after demineralization and following the different treatment protocols. A representative sample from each group was randomly selected for scanning electron microscopy (SEM) analysis. One-way ANOVA, repeated measures ANOVA, and Tukey's Post Hoc tests were used for statistical analysis, with significance set at <em>P</em> <!-->≤<!--> <!-->0.05.</div></div><div><h3>Results</h3><div>All treatment groups demonstrated significantly higher mean microhardness values compared to the control group (<em>P</em> <!--><<!--> <!-->0.05). Group 1 (MI varnish) had a final microhardness mean value of 193.50 (<em>P</em> <!--><<!--> <!-->0.001), Group 2 (diode laser) recorded the highest final mean of 214.20 (<em>P</em> <!-->=<!--> <!-->0.018), and Group 3 (MI varnish<!--> <!-->+<!--> <!-->diode laser) had a mean of 203.93 (<em>P</em> <!-->=<!--> <!-->0.011). SEM observations supported these findings by showing enhanced surface morphology in the treatment groups.</div></div><div><h3>Conclusions</h3><div>MI varnish application, laser irradiation, and their combination demonstrated enhanced microhardness of artificially demineralized enamel, highlighting their effectiveness in remineralization of WSLs.</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 1","pages":"Article 100929"},"PeriodicalIF":1.8,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142438028","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}
The primary objective of this study was to investigate the biomechanical effects and stresses on bone, periodontal ligament (PDL), cementum and displacement along X-, Y- and Z-axis during true intrusion of incisors using mini-implants with Finite Element Analysis; the secondary objective of the study was to find out the best method for anterior intrusion in clinical practice to treat anterior deep bite malocclusions.
Materials and methods
A 3D finite element method was used to simulate true anterior intrusion with sliding mechanics using mini-implants. Two groups were modelled with mini-implants placed distal to lateral incisors for Model 1, and below the anterior nasal spine (ANS) for Model 2, to achieve intrusion. von Mises stress, principal stress on PDL and alveolar bone, displacements in all 3 planes were determined.
Results
Amongst the modalities compared in the present study, the stresses on bone and PDL were showing best behavior for mini-implants placed distal to lateral incisors (Model 1). The teeth showed controlled tooth movement in Model 1.
Conclusion
Maximum stress was found in the cortical bone and in the PDL. Nature of the stress changed from compressive to tensile from cervical area to root apex, concentrating mainly at the apical area. Amongst the modalities compared, the best controlled tooth movements for anterior intrusion to treat anterior deep bite malocclusions, was for mini-implants placed distal to lateral incisors (Model 1).
{"title":"A 3D finite element analysis of biomechanical effects on teeth and bone during true intrusion of anteriors using miniscrews","authors":"Ankit Bharadwaj , Sachin Ahuja , Japjee Uppal , Eenal Bhambri , Renu Sewta , Seema Gupta","doi":"10.1016/j.ortho.2024.100925","DOIUrl":"10.1016/j.ortho.2024.100925","url":null,"abstract":"<div><h3>Purpose</h3><div>The primary objective of this study was to investigate the biomechanical effects and stresses on bone, periodontal ligament (PDL), cementum and displacement along X-, Y- and Z-axis during true intrusion of incisors using mini-implants with Finite Element Analysis; the secondary objective of the study was to find out the best method for anterior intrusion in clinical practice to treat anterior deep bite malocclusions.</div></div><div><h3>Materials and methods</h3><div>A 3D finite element method was used to simulate true anterior intrusion with sliding mechanics using mini-implants. Two groups were modelled with mini-implants placed distal to lateral incisors for Model 1, and below the anterior nasal spine (ANS) for Model 2, to achieve intrusion. von Mises stress, principal stress on PDL and alveolar bone, displacements in all 3 planes were determined.</div></div><div><h3>Results</h3><div>Amongst the modalities compared in the present study, the stresses on bone and PDL were showing best behavior for mini-implants placed distal to lateral incisors (Model 1). The teeth showed controlled tooth movement in Model 1.</div></div><div><h3>Conclusion</h3><div>Maximum stress was found in the cortical bone and in the PDL. Nature of the stress changed from compressive to tensile from cervical area to root apex, concentrating mainly at the apical area. Amongst the modalities compared, the best controlled tooth movements for anterior intrusion to treat anterior deep bite malocclusions, was for mini-implants placed distal to lateral incisors (Model 1).</div></div>","PeriodicalId":45449,"journal":{"name":"International Orthodontics","volume":"23 1","pages":"Article 100925"},"PeriodicalIF":1.8,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406929","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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