International Orthodontics最新文献

Objective

The aim of the present study was to compare the changes in overjet and overbite measurements achieved in adolescent patients following an initial series of Invisalign® aligners (Align Technology, San Jose, California) with those planned by orthodontists via its ClinCheck® digital treatment planning facility.

Methods

Data provided by Align regarding patients who had completed an initial series of Invisalign® aligner treatment and were less than 18-years old were assessed in relation to pre-treatment, planned and achieved overjet and overbite measurements. Descriptive statistics, Wilcoxon rank-sum, Mann Whitney calculations were computed.

Results

A total of 290 patients satisfied inclusion criteria. The median (interquartile range (IQR)) age was 14.17 (13,15.42) years. The median achieved overjet and overbite changes were less than those planned (p < 0.01) with 53.33% of the planned median overjet increase achieved and 52.94% of planned median overjet reduction achieved. Additionally, 58.33% of the planned median overbite increase was achieved and 55.55% of the planned median overbite reduction was achieved. A total of 21.52% patients recorded no change or an increase from pre-treatment to the achieved overjet where reduction was planned, whereas 41.67% recorded no change or a reduction in overjet where increase was planned. A total of 18.72% recorded no change or an increase in overbite where reduction was planned, whereas 20.75% recorded no change or a reduction in overbite where increase was planned.

Conclusions

Less than 60% of the planned overjet and overbite changes per patient were achieved. Between 18.72 and 41.67% of patients experienced no change or changes in overjet and overbite in the opposite direction to that planned. This is likely to be clinically significant.

Objective

The aim of the present study was to evaluate the quality and readability of content contained within clear aligner therapy (CAT) informed consent forms.

Methods

CAT informed consent forms were identified via an online search. The presence of details related to CAT-related processes, risks, benefits and alternatives in each form was recorded. A 4-point Likert type scale was used to determine the quality of content (QOC). The readability of content was evaluated with the Simple Measure of Gobbledegook (SMOG) and Flesch Reading Ease Score (FRES).

Results

A total of 42 forms satisfied selection criteria. Nineteen (45.2%) were authored by companies who provided aligners to patients via clinicians. The QOC regarding CAT-related treatment processes [median 2.0; IQR 0, 2] and benefits [median 2.0; IQR 1, 2] was adequate. The QOC scores regarding treatment alternatives, consequences of no treatment and relapse were poor. There was no difference (P = 0.59) in the median (IQR) QOC of the informed consent forms provided by direct-to-consumer (DTC) aligner providers [10 (8.25, 16.25)] and non-DTC aligner providers [12 (10, 14)]. The median (IQR) SMOG score was 12.1 (10.9, 12.7) and FRES was 39.0 (36.0, 44.25).

Conclusions

The QOC of the evaluated forms was incomplete and poor. The content was difficult to read and failed to reach recommended readability standards. Consent is unlikely to be valid if it is based solely on the content of the forms. Clinicians need to be aware of the limitations of informed consent forms for CAT particularly in relation to alternatives, prognosis, risks, and the need for long-term maintenance of results.

Objective

The present study aimed to evaluate the mandibular bone structure of patients with different malocclusions by using fractal dimension (FD) analysis on dental panoramic radiographic images.

Material and methods

Pre-treatment panoramic radiographic images of 103 patients were included in the study and divided into 3 groups as Class I (group 1: 0 < ANB < 5), Class II (group 2: ANB ≥ 5), and Class III (group 3: ANB ≤ 0) malocclusion. Five bilateral regions of interests (ROI) were selected: anterior (near the mandibular midline), premolar (between the premolars and away from the mental foramen), molar (between the molars and away from the mandibular canal), angulus (geometric centre of mandibular angle), and condylar regions (geometric centre of mandibular condyle) of the mandibular bone and mean values were recorded as the FD value of each ROI. The mean value of the five ROIs was recorded as the FD value of the patient's mandibular bone. FD values of different malocclusion groups were compared and the relationships between the age and sex parameters and FD values were evaluated.

Results

FD values were lower in Class I sagittal skeletal pattern than Class II and III groups in anterior ROI FD, premolar ROI FD, angulus ROI FD, and mean FD values. There were differences between Class I and Class III skeletal patterns (P = 0.023 for anterior ROI FD, P = 0.016 for premolar ROI FD, P = 0.034 for angulus ROI FD, and P = 0.014 for mean FD). Class I and II malocclusions differed in anterior ROI FD (P = 0.029) and also Classes II and III showed differences in angulus ROI FD (P = 0.029).

Conclusion

Sagittal skeletal patterns may result in differences in the structure of the mandibular trabecular bone.

Introduction

The accurate assessment of active growth is pivotal for the correction of skeletal malocclusion in growing patients. Cervical vertebral maturation (CVM) staging is easy and devoid of unnecessary radiation, but its inter- and intra-observer agreement is still debatable.

Objective

This study aims to assess inter-observer (reliability) and intra-observer agreement (reproducibility) for CVM staging.

Methods

A comprehensive literature search across five databases up to October 2023 was conducted. Inclusion criteria comprised observational studies that specifically reported intra-rater, inter-rater, or both agreements as their primary objectives for cervical vertebral maturation (CVM) staging. Studies with a sample size exceeding 15 participants were considered for inclusion. After duplicate study selection, data extraction, and risk-of-bias assessment, random-effects meta-analyses of kappa (k)/correlation coefficient (r) and their 95% confidence intervals (CIs) were performed, followed by meta-regressions, sensitivity analyses, and subgroup analyses.

Results

Seventeen observational studies (comprising 1437 lateral cephalograms and 110 assessors) were included. The reliability (8 studies; k = 0.62 [95% CI: 0.44, 0.78]) and reproducibility (9 studies; k = 0.708 [95% CI: 0.59, 0.82]) were substantial. The inter-observer correlation was almost perfect (in 9 studies; r = 0.86 [95% CI: 0.82, 0.89]) while intra-observer correlation was substantial (in 2 studies; r = 0.75 [95% CI: 0.62, 0.84]). Tracing of lateral cephalograms significantly increased inter-observer reliability (β = 0.29 [0.57, 0.0031]) but cropping and time of assessment (initial vs. follow-up) had no significant impact. The reliability (P < 0.001) and reproducibility (P = 0.049) of high-quality studies were superior to those observed in low-quality studies.

Conclusion

Assessment of the CVM staging is accurate and reproducible to a satisfactory level. The accuracy and reproducibility of CVM are higher in studies utilizing traced cephalograms and those with a low-risk of bias.

Registration

PROSPERO registration (CRD42023468521).

Data is openly available at https://doi.org/10.5281/zenodo.10599129.

The patient presented in this case report is a 10-year-old boy with hyperdivergent skeletal Class II associated with familial genetic agenesis of the second premolars. The treatment plan chosen was to close the spaces of agenesis using a bimaxillary appliance fixed buccally. The advantages and disadvantages of this treatment option were discussed. The result was stable and made it possible to avoid an implant-prosthetic solution, which would undoubtedly have been more restrictive over time.

Objectives

This study aimed to prepare a glass ionomer (GI) cement reinforced with silver-hydroxyapatite-silica (Ag/HA/Si) hybrid nanoparticles and assess its compressive strength and fluoride release profile.

Material and methods

In this in vitro, experimental study, 60 cylindrical specimens were fabricated with 4 mm diameter and 6 mm height in 6 groups (n = 10) using BracePaste composite, GC Fuji II LC pure RMGI, and RMGI reinforced with 0.1wt%, 0.5wt%, 1wt%, and 2wt% Ag/HA/Si hybrid nanoparticles. The specimens were subjected to compressive force in a universal testing machine to measure their compressive strength (MPa). To assess their fluoride release profile, discs with 3 mm diameter and 2 mm thickness were fabricated from Fuji II LC pure resin-modified glass ionomer (RMGI), and RMGI with 0.1wt%, 0.5wt%, 1wt%, and 2wt% hybrid nanoparticles, and the concentration of released fluoride was measured by a digital ion-selective electrode. Data were analysed by ANOVA and Scheffe test (alpha = 0.05).

Results

The compressive strength was 114.14 MPa for BracePaste composite, and 97.14, 97.84, 100.65, 109.5, and 89.33 MPa for GI groups with 0%, 0.1%, 0.5%, 1% and 2% hybrid nanoparticles, respectively, with no significant difference among them (P = 0.665). Addition of 1% (0.21 ± 0.07 μg/mL, P = 0.029) and 2% (0.45 ± 0.22 μg/mL, P = 0.000) hybrid nanoparticles to RMGI significantly increased the amount of released fluoride, compared with the control group (0.09 ± 0.03 μg/mL).

Conclusions

Addition of Ag/HA/Si hybrid nanoparticles to RMGI in the tested concentrations had no significant effect on its compressive strength but addition of 1wt% and 2wt% concentrations of Ag/HA/Si hybrid nanoparticles increased its fluoride release potential.

Objectives

This systematic review aimed to assess the biological response at tissue, cellular, and molecular levels following Piezocision™ surgery, and its efficacy in accelerating orthodontic tooth movement.

Material and methods

A systematic review of the literature was conducted across 4 databases following the PRISMA guidelines up to May 2022. Prospective controlled animal studies involving healthy animals under active orthodontic treatment assisted by corticotomy performed with a piezotome (Piezocision™) published in the English language without time restrictions were included. The article selection, data extraction and risk of bias assessment (SYRCLE tool) were performed by two independent blinded review authors.

Results

Out of 738 articles screened, 10 studies were included with various level of bias. Biological responses were categorized into tissue, cellular, and molecular levels. Tissue-level changes included a global decrease in bone mineral content post-Piezocision™. At the cellular level, increased bone turnover activity was noted. Molecularly, elevated RANKL and OPG expression, along with increased TRAP+ and cytokines, were observed after Piezocision™. Studies confirmed Piezocision's efficacy, reporting 1.35 to 3.26 times faster tooth movements, peaking between the 3rd and 50th day post-surgery. Biological responses were transient, reversible, and proportional to surgical insult, with reactivation possible through a second Piezocision™.

Conclusions

After Piezocision™ surgery, a transient and reversible biological response was described at the tissue, cellular and molecular levels, which induced faster orthodontic tooth movements. This biological response could be re-activated by an additional Piezocision™ and is proportional to the surgical injury.

Systematic review registration

Prospero CRD42022303237.

Objective

To assess the allele rs 1143634 in IL-1β and rs1800587 in IL-1α in patients for orthodontically induced external apical root resorption (EARR).

Material and methods

Intra-oral periapical radiograph (IOPA) of maxillary incisors of 142 Patients were evaluated for resorption at two time points; before the start of fixed mechanotherapy (T1) and after one year of treatment (T2). The individuals with root resorption < 2 mm were categorized as a control group (group 1; n = 90), and resorption > 2 mm were categorized as case group (group 2; n = 52). Buccal swabs of all patients were taken and DNA could be isolated in 95 out of 142 samples (group 1 {n = 58}, group 2 {n = 37}), which were then screened for the selected two polymorphic targets to determine the nucleotide status of these targets. Tetra-primer ARMS PCR reactions were carried out using all 4 primers for each polymorphism.

Results

rs11800587 was not associated with risk of EARR in any inheritance model. Chi-square test for association of alleles with EARR revealed that rs1143634 was associated with the risk of EARR in an allelic model in such a way that A allele of this SNP increased the risk of EARR 4 folds [OR = 4.375; P = 0.016]. However, the adjusted level of significance using the Holm-Bonferroni method for rs1143634 was P < 0.010 for A and G comparison rendering the results non-significant.

Conclusion

SNP rs1143634 and SNP rs11800587 were not associated with risk of EARR in any inheritance model.

Introduction

The aim of this study was to assess the interaction between a 0.019 × 0.025-inch (″) stainless steel archwire and two types of passive self-ligating brackets with the same slot height (0.022″) and different slot depths (0.028″ and 0.026″, and to measure the archwire/slot play as well as to compare the torque expression with archwire torsions of 12°, 24°, and 36°.

Material and methods

An experimental device was developed along with a universal testing machine to measure torque expression in two types of brackets with 0.028″ and 0.026″ slot depths. Analysis of variance (ANOVA) and Tukey's test were performed to identify the differences between groups.

Results

The 0.026″ slot bracket presented greater archwire/slot play when compared to the 0.028″ bracket. Torque expression with torsions of 24° and 36° were significantly higher in the 0.028″ depth brackets when compared to the 0.026″ depth brackets.

Conclusion

The 0.022″ × 0.026″ passive self-ligating brackets attached with a 0.019″ × 0.025″ stainless steel archwire provided no greater torque control when compared to 0.022″ × 0.028″ passive self-ligating brackets.

Introduction

Treatment of skeletal class II growing patients often requires the use of functional appliances, aimed at promoting mandibular advancement. Among these, Herbst appliance is recommended for its effectiveness, efficiency, and reduced need for compliance. Despite its skeletal favourable effects, well-known dental compensations can occur, especially when the appliance is not used close to the pubertal peak: upper incisors retroclination, lower incisors proclination, upper molars distalization and lower molars mesialization could reduce the overjet needed for a proper mandibular advancement. To counteract these unfavourable effects skeletal anchorage could be crucial.

Aim

The aim of this case report is to describe and evaluate the effects of using a skeletally anchored Herbst appliance in an 18-year-old (CVM5) male patient with skeletal Class II malocclusion and a convex profile.

Treatment protocol

The treatment started with a tooth-bone-borne palatal expansion, then the upper arch was bonded with pre-adjusted ceramic brackets. After 2 months, a Manni Telescopic Herbst (MTH) supported by 4 miniscrews (two in the maxilla and two in the mandible) was applied. To avoid anchorage loss, TADs were connected with elastic chains to the arches. Nine months later, the Herbst was removed, the lower teeth were bonded and the patient wore class 2 elastics to stabilise the occlusion.

Results and conclusions

After 24 months the treatment goal was achieved with a considerable improvement of the profile and a clinically significant mandibular advancement (Pogonion moved forward 7 mm). A one-year follow-up lateral X-rays showed a good stability of the result.