Seminars in Orthodontics最新文献

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Insertion guide for palatal TADs: Advantages and disadvantages from the clinical point of view 腭部 TAD 插入指南：从临床角度看其优缺点

IF 2.2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-02-01 DOI: 10.1053/j.sodo.2024.06.001

G. Iodice , B. Ludwig

In recent years, there has been a growing trend in orthodontics to use the anterior palatal vault as an insertion site for temporary anchorage devices (TADs), to expand orthodontic possibilities and limit the collateral and unwanted dental effects. To improve accessibility and facilitate the procedure for clinicians, a guided approach for TAD insertion in the palatal vault, using insertion guides, has become increasingly prevalent. The manuscript primarily focuses on the real advantages and possible disadvantages that clinicians can expect when using insertion guides during TAD insertion into the palatal vault. Safety, precise evaluation of insertion depth, and the potential to execute a "one-visit protocol" are examined. Indeed, both direct and indirect palatal insertion protocols result to be efficient and safe in daily practice. The use of insertion guides result to be particularly beneficial for less experienced clinicians as well as for more complex patients and impacted teeth cases. Insertion guides can be created overlapping intraoral scanning to cbct or also to lateral teleradiograph, with sufficient accuracy and lower radiation exposure. However this method is limited in achieving bicortical evaluation, as well as relations to incisive canal and nasal floor. Finally a case report is presented, describing a full digital orthodontic treatment of a young adult patient presenting narrow maxilla. Slow maxillary expansion and fixed orthodontic treatment are described.

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引用次数: 0

Influence of guided insertion on the success of paramedian palatal miniscrews 引导插入对腭侧微型螺钉成功率的影响

IF 2.2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-02-01 DOI: 10.1053/j.sodo.2023.12.013

Manuel Nienkemper , Björn Ludwig

To evaluate the influence of guided insertion on the success of paramedian palatal miniscrews the treatment of 103 patients was evaluated. The patients were divided into two groups. The miniscrews of group A (65 patients, 130 miniscrews; conventional insertion) showed a success rate of 97.69 %, those of group B (38 patients, 76 miniscrews; guided insertion) a success rate of 97.37 %). The differences were not statistically significant. Guided insertion of miniscrews did not lead to a higher success rate compared to conventional freehand insertion when inserting in the paramedian part of the T-zone. Likewise, root damage could be avoided even without guide. Operator bias, in the sense of an experienced operator should be taken into account when interpreting the results. Nevertheless, the guided insertion offers advantages regarding the workflow and simplifies insertion.

为了评估引导性插入对腭侧微型螺钉成功率的影响，我们对 103 名患者的治疗情况进行了评估。患者被分为两组。A 组（65 名患者，130 个微型螺钉；传统插入）的微型螺钉成功率为 97.69%，B 组（38 名患者，76 个微型螺钉；引导插入）的成功率为 97.37%。）差异无统计学意义。与传统的徒手插入相比，在引导下插入微型螺钉时，T 区旁的成功率并不高。同样，即使没有引导，也可以避免牙根损伤。在解释结果时，应考虑到经验丰富的操作者的偏差。不过，引导插入在工作流程方面具有优势，并简化了插入过程。

引用次数: 0

Digital orthodontics: Hype, hope, or both?

IF 2.2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-02-01 DOI: 10.1053/j.sodo.2024.10.006

Bjorn Ludwig

This issue of seminars revolves around digital orthodontics and showcases cuttingedge technology. It's not just a trendy new concept; all authors strive to add a balanced opinion and clinical conclusions to evaluate if this present technology is merely a hype feeding our FOMO or if it indeed provides significant advantages to patients and doctors alike. The digital orthodontics wave has been rolling on for over a decade. The spread of scanners, printers, and connecting software is visible in every country. Reasons to push and justify this hype—beyond the financial interests of companies—often include a lack of skilled employees, more complex cases, economic pressures, and the hope that automation might solve many challenges

引用次数: 0

3D designed and manufactured retainers

IF 2.2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-02-01 DOI: 10.1053/j.sodo.2024.10.004

Selena H.M. Tee , Jörg Glockengießer , Vanessa Knode , Padhraig S. Fleming

The increased adoption of CAD-CAM technology parallels the expansion of digital dentistry internationally with orthodontics forecast to experience the highest level of associated growth. We aim to provide an overview of CAD-CAM workflows including different methods and materials for retainer manufacturing underpinned by best-available contemporary evidence. CAD-CAM approaches to fixed retention have led to streamlined workflows potentially reducing manpower issues while broadening both the material and design options. The ability to customize retainers also promotes improved anatomical adaptation. These advantages may translate into improved longevity and effectiveness of CAD-CAM retainers. Further studies are however required to evaluate the relative merits of CAD-CAM retainers on a long-term basis.

引用次数: 0

Occlusal adjustment in the digital era – A working protocol

IF 2.2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-02-01 DOI: 10.1053/j.sodo.2024.11.003

Carol Weinstein , Miguel Hirschhaut , Carlos Flores-Mir

The closest possible coincidence between centric occlusion (CO) and centric relation (CR) is a meaningful goal of orthodontic treatment. Teeth should be related in a cusp-fossa interaction, with bilateral and symmetrical occlusal contacts and mandibular excursions without interferences. At a joint level, condyles should be well-seated in the glenoid fossae, without mandibular functional accommodations and muscular balance. To provide long-term stability of treatment results. Occlusal adjustment is one of the clinical procedures that help fine-tune this resulting occlusal relationship.

Traditional analog diagnostic methods can be upgraded to digital static and dynamic current technologies. Occlusal adjustment today can be integrated with digital flow and mounting by analyzing premature contacts after scanning the patient. The clinical procedure of selective grinding may be simple and reproducible by acquiring adequate knowledge, following the ten guidelines presented in this paper, and implementing judicious clinical skills. Since tooth structure preservation while achieving functional occlusal goals is of utmost importance.

Eight possible clinical scenarios where occlusal adjustment is indicated are presented. They can occur before, during, or after treatment, allowing for a better finish of the orthodontic case. The situations begin with diagnosis, followed by arch coordination, transverse, vertical, sagittal issues, rotations, upper and lower coupling, and relapse.

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引用次数: 0

Unlocking the biological insights of 3D printed aligners: A look at current findings

IF 2.2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-02-01 DOI: 10.1053/j.sodo.2024.10.001

Christina Erbe , Björn Ludwig , Maximilian Bleilöb

Direct Printing and Direct Printed Aligners (DPAs) are poised to revolutionize contemporary orthodontics and aligner therapy. DPAs made from Graphy's resin (Tera Harz TC-85, Graphy Inc, Seoul, Korea) are currently the only ones being CE and KFDA certified as well as FDA approved. The use of DPAs entails several advantages including increased efficiency of tooth movements due to customized pressure points or zones, a better fit and precision of the clear aligners as well as the ability to produce a wide range of different removable orthodontic appliances in-office. However, biocompatibility and thus safe use is dependent on strict adherence to the production guidelines given by the manufacturers. Alterations to the delicate manufacturing process, involving multiple production as well as post-curing steps, may lead to undesired side effects such as allergic reactions which can be as severe as an anaphylactic reaction. In particular, the vast variety of possible custom-design DPAs poses the risk of exposing patients to cytotoxic materials. Therefore, more research is needed to guarantee patients biological safe use. The latter must also be an orthodontist's major responsibility, particularly when treating children as well as adolescent patients who are still in their developmental stages.

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引用次数: 0

Digital models and 3D biomechanics analysis in orthodontics. Part 1: Vector calculations

IF 2.2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-02-01 DOI: 10.1053/j.sodo.2024.11.001

Giorgio Fiorelli

Biomechanics is essential for optimizing orthodontic appliances and controlling dental movement. Charles J. Burstone pioneered a three-dimensional (3D) approach in orthodontics, advocating for a shift beyond appliance-focused methods. Initially, biomechanics studies were constrained to two-dimensional (2D) analysis due to the complexities of 3D evaluation. Despite progress in computational tools and digital modeling, orthodontic biomechanics has largely maintained a 2D orientation. This paper advances orthodontic biomechanics into 3D, re-evaluating concepts previously limited to 2D frameworks. A dedicated software, DDP-Ortho (Ortolab, Poland), is introduced to enable orthodontists to analyze and resolve biomechanical challenges in 3D, facilitating appliance designs with precise 3D force systems. The representation and calculation of force vectors and moments in 3D are detailed, emphasizing the inherent complexity absent computational support. Key processes such as vector subtraction and addition, fundamental for assessing and refining orthodontic force systems, are explained. Additionally, the vector split (couple replacement) method, previously described in 2D, is extended to 3D, addressing the unique constraints and challenges of this approach. These tools promise to refine the accuracy and effectiveness of orthodontic treatments, setting the stage to examine the interactions between 3D force systems and dental movement, which will be addressed in a subsequent paper, to broaden the potential of contemporary orthodontic therapy.

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引用次数: 0

Future Issues

IF 2.2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-02-01 DOI: 10.1053/S1073-8746(24)00148-8

引用次数: 0

The twin block appliance in the era of digital orthodontics 数字化正畸时代的双块矫治器

IF 2.2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-02-01 DOI: 10.1053/j.sodo.2024.06.003

Richard RJ Cousley

The traditional Twin Block appliance (TBA) has been an effective treatment for adolescent Class II patients since the 1980s, but with limitations related to its design, and combination of acrylic and metal components. This paper describes a paradigm shift following the recent introduction of the digital Twin Block appliance (DTB) with its virtual design, indirect and direct 3D printing options, in-house fabrication, potential advantages and difficulties.

引用次数: 0

Does 3D simulation impact clinical reasoning for orthodontic treatment planning of impacted maxillary canines? 三维模拟是否会影响上颌犬牙反颌正畸治疗计划的临床推理？

IF 2.2 4区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Seminars in Orthodontics

Pub Date : 2025-02-01 DOI: 10.1053/j.sodo.2024.06.011

Cheryl Su-Hsyen LAI , Mark Joo Seng GAN , Ching-Chiuan YEN , Kelvin Weng Chiong FOONG

Clinical reasoning is an essential competence to develop in the diagnosis and treatment planning of impacted maxillary canines to ensure good treatment outcomes. It involves skills of radiographic interpretation and mental visualization. To master these, postgraduate students learn to interpret 2D and 3D X-rays to locate these canines accurately. This process demands the creation of mental models of the impaction and resolving it either by envisioning the canine's movement to its correct position or considering its removal. To facilitate this cognitive exercise, a 3D-printed simulator, derived from Cone Beam Computed Tomography scans, serves as a tool to allow students to experiment with various movement simulations, helping them select the most viable treatment approach.

This project aimed to assess the differences in expert and novice orthodontists’ clinical reasoning for impacted maxillary canines, and whether the addition of a 3D simulator would affect their reasoning. Thirteen (13) novices randomly assigned to a control and intervention group and three (3) experts took part in a Think-Aloud exercise to diagnose and treatment plan a case of bilaterally impacted maxillary canines. Experts and intervention group novices had the 3D simulator in addition to standardized patient records. Their responses were recorded and analyzed according to a coding scheme reflecting the clinical reasoning process. While experts demonstrated quick clinical judgment and found the 3D simulator redundant, novices were more uncertain and required additional cues. Novices using the 3D simulator described more elaborate treatment plans and had increased awareness of potential complications as compared to the control group.

临床推理能力是上颌犬齿撞击的诊断和治疗计划中需要培养的一项基本能力，以确保良好的治疗效果。这涉及到X光片判读和心理可视化技能。为了掌握这些技能，研究生们要学习解读二维和三维 X 射线，以准确定位这些犬齿。这一过程要求建立阻生牙的心理模型，并通过设想将阻生牙移动到正确位置或考虑将其拔除来解决这一问题。为了促进这种认知练习，一个根据锥形束计算机断层扫描图像制作的 3D 打印模拟器可作为一种工具，让学生尝试各种运动模拟，帮助他们选择最可行的治疗方法。

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