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Critical issues concerning miniscrew-assisted rapid palatal expanders: A narrative review 有关微型螺钉辅助快速腭部扩张器的关键问题:叙述性综述
IF 4.2 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-04-10 DOI: 10.1053/j.sodo.2024.04.003
Jung Jin Park, Ki-Ho Park, Seong-Hun Kim, Hyo-Won Ahn
Maxillary transverse deficiency presents challenges in orthodontic treatment, affecting approximately 4–17 % of the population and leading to various malocclusions and facial imbalances. Traditional treatments like Rapid Palatal Expander (RPE) have been effective, particularly in younger patients, but are associated with drawbacks and limitations, especially in non-growing individuals. Miniscrew-assisted rapid palatal expansion (MARPE) has emerged as a viable, safe, and cost-effective alternative for late adolescents and adults. Over the past decade, the MARPE has been widely used, leading to substantial clinical data. This narrative review aimed to revisit the crucial aspects related to treatment success, contributing factors, and various designs and protocols for MARPE. The MARPE designs, categorized as pure bone-borne, tissue bone-borne, and tooth bone-borne types, were compared along with their expansion patterns and the clinical implications were discussed. This review also focused on the long-term stability of MARPE and its potential complications.
上颌横向缺损给正畸治疗带来了挑战,约有 4-17% 的人受到影响,并导致各种畸形和面部失衡。快速腭扩展器(RPE)等传统治疗方法效果显著,尤其是对年轻患者,但也存在缺点和局限性,尤其是对非生长期患者。微型螺钉辅助快速腭扩弓术(MARPE)已成为一种可行、安全且经济有效的替代方法,适用于晚期青少年和成年人。在过去的十年中,MARPE 得到了广泛的应用,产生了大量的临床数据。这篇叙述性综述旨在重新审视与治疗成功率、诱因以及 MARPE 的各种设计和方案相关的重要方面。对 MARPE 的设计(分为纯骨性、组织骨性和牙骨性类型)及其扩张模式进行了比较,并讨论了其临床意义。本综述还重点讨论了 MARPE 的长期稳定性及其潜在并发症。
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引用次数: 0
Biomechanical considerations for tooth movement and strategies to avoid undesirable side effects 牙齿移动的生物力学考虑因素和避免不良副作用的策略
IF 4.2 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-03-23 DOI: 10.1053/j.sodo.2024.02.006
Helder Baldi Jacob, Rafael Gonçalves Azeredo, Carolina Servidoni Spreafico
Orthodontists prescribe forces to provide tooth movement, and performing it without understanding the fundamentals can put the treatment at risk. To get out of trouble in managing complex cases, orthodontists should understand biomechanics concepts and solutions, as well tooth movement biology. The correct application of the force system impacts the biological tissue responses inducing different responses in a favorable or unfavorable manner. The biomechanical domain prevents round tripping, unnecessary increase in treatment time, and damage to the dentoalveolar tissues. Indubitably, minimizing or preventing unnecessary tooth movement helps to decrease treatment time, which has been associated with root resorption and surrounding tissue damage. In the absence of the correct force system application (forces and moments), orthodontic treatment outcomes become unpredictable. Therefore, the key to success is the correct application of the biomechanics, and clinicians must have biomechanical knowledge and skill in reserve, which will be required when unfortunate surprises strike. If the knowledge is not available, orthodontists limit their success. So, in this article we present some information about the biology of orthodontic tooth movement and rationale biomechanics to prevent orthodontic tooth movement side effects, as well few cases and their biomechanics associated with the treatment.
正畸医生需要施加一定的力量来实现牙齿移动,如果不了解基本原理,就会给治疗带来风险。为了在处理复杂病例时摆脱困境,正畸医生应了解生物力学概念和解决方案,以及牙齿移动生物学。力系统的正确应用会影响生物组织的反应,从而诱发有利或不利的不同反应。生物力学领域可以防止绕圈、不必要地增加治疗时间以及对牙槽组织造成损害。毫无疑问,尽量减少或防止不必要的牙齿移动有助于缩短治疗时间,而不必要的牙齿移动与牙根吸收和周围组织损伤有关。如果缺乏正确的力系统应用(力和力矩),正畸治疗的结果将变得不可预测。因此,成功的关键在于生物力学的正确应用,临床医生必须储备生物力学知识和技能,以便在不幸的意外发生时能够应对自如。如果不具备这些知识,正畸医生的成功就会受到限制。因此,在本文中,我们将介绍一些有关正畸牙齿移动的生物学知识,以及预防正畸牙齿移动副作用的合理生物力学,以及与治疗相关的一些病例及其生物力学。
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引用次数: 0
Temporomandibular disorders – Current concepts 颞下颌关节紊乱 - 当前概念
IF 4.2 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-03-07 DOI: 10.1053/j.sodo.2024.02.004
Rosaria Bucci, Roberto Rongo, Ambra Michelotti
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引用次数: 0
Treatment of temporomandibular disorders-Beyond splints! 除夹板外的颞下颌关节紊乱症治疗方法
IF 4.2 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-09 DOI: 10.1053/j.sodo.2024.01.001
Prasanna Kumar Shivapuja , Rooban Thavarajah , Nathamuni Rengarajan Krishnaswamy
<div><h3>Introduction</h3><p>Temporomandibular disorders are a group of neuro-musculoskeletal disorders that have a multifaceted causation. The current study was a retrospective study undertaken to evaluate the outcome of different modalities of treatment provided in one office.</p></div><div><h3>Materials and methods</h3><p>Out of a cadre of 425 patients who had undergone TM joint treatment and had finished treatment at least 2 years before 2017, 171 patients were successfully recalled for the purpose of the study. The patients that were recalled were divided into groups based on the treatment they had received. The groups were 1. Splint only group. 2. Splint and Braces group. 3. Splint Braces and equilibration group, 4. Splint, Braces and Jaw surgery. 5. Splint braces Joint surgery and Jaw surgery. Pre-treatment Helkimo index scores of anamnestic score Ai, dysfunction scores Di were extracted from the medical records and compared to the Helkimo index scores at the time of recall appointments. Modification was made to the Helkimo index made to include the consistency of food the patient could eat without pain and was called the food index (Fi). This data was also extracted from the pre-treatment records and compared to the post treatment records. Data gathered was subjected to Pearson correlation and Kruskal Wallis analysis of variance. The test was considered significant at a p value of less than or equal to 0 .05. (95 percent confidence). Data was also gathered to evaluate the number of pain episodes post- treatment and compared to the per-treatment data from the chart.</p></div><div><h3>Results</h3><p>All patients treated in the group showed both clinical and statistical significance is all parameters of Ai. Di, and Fi scores. Acute exacerbation of pain was also reduced. Ai, Di, and Fi, scores showed most improvement in the groups that had Splint, braces and jaw surgery and the group Splint braces joint surgery and jaw surgery. Acute exacerbations of pain was also least in the aforementioned groups. Patients treated with splint only showed the most amount of acute exacerbation in pain. Another interesting observation in the study was that a linear relation was present between Ai and Fi with a nonlinear relation between Ai and Di, and Di and Fi, indicating that it is lack of pain and not the degree of mouth opening that is important that allows the patient to consume the hard and chewy foods.</p></div><div><h3>Conclusion</h3><p>1. In our study all modalities of treatment gave an improvement in patient status pretreatment to post treatment periods. 2. Most relief was attained in the groups of Splint braces and jaw surgery and splint braces joint surgery and jaw surgery. 3. Linearity in relation between Ai and Fi, indicated that it is lack of pain and not the degree of mouth opening that allows patients to consume diet of chewy and hard consistency. 4. Although our study indicates that the surgical options gave the best results, surgical options
导言颞下颌关节紊乱是一组神经-肌肉-骨骼疾病,其病因是多方面的。目前的研究是一项回顾性研究,旨在评估一个诊室提供的不同治疗方式的效果。材料和方法在425名接受过颞下颌关节治疗并在2017年之前至少2年完成治疗的患者中,有171名患者被成功召回进行研究。被召回的患者根据其接受治疗的情况分为几组。这些组别是:1.仅夹板组。2.夹板和支架组。3.夹板、支具和平衡组, 4. 夹板、支具和下颚手术组。5.夹板支具关节手术和下颌手术组。从病历中提取治疗前的 Helkimo 指数评分,包括异常评分 Ai 和功能障碍评分 Di,并与复诊时的 Helkimo 指数评分进行比较。对 Helkimo 指数进行了修改,加入了患者能吃而不会疼痛的食物的浓度,称为食物指数(Fi)。这些数据也从治疗前的记录中提取出来,并与治疗后的记录进行比较。对收集到的数据进行了皮尔逊相关分析和 Kruskal Wallis 方差分析。当 P 值小于或等于 0.05 时,检验结果为显著。(置信度为 95%)。此外,还收集了治疗后疼痛发作次数的评估数据,并与病历中的每次治疗数据进行了比较。Di 和 Fi 评分的所有参数均具有临床和统计学意义。急性疼痛加剧的情况也有所减少。Ai、Di 和 Fi 评分在夹板、支具和下颌手术组以及夹板支具联合手术和下颌手术组中改善最大。上述组别的急性疼痛加剧程度也最小。仅接受夹板治疗的患者的急性疼痛加剧程度最高。研究中另一个有趣的现象是,Ai 和 Fi 之间呈线性关系,而 Ai 和 Di、Di 和 Fi 之间则呈非线性关系,这表明患者能够进食坚硬和易咀嚼食物的重要原因是没有疼痛,而不是张口程度。在我们的研究中,所有的治疗方式都能改善患者从治疗前到治疗后的状态。2.2.夹板矫治器和颌骨手术组以及夹板矫治器联合手术和颌骨手术组的症状缓解程度最高。3.3. Ai 和 Fi 之间的线性关系表明,患者能够进食咀嚼性和硬质饮食的原因是没有疼痛,而不是张口程度。4.4. 虽然我们的研究表明手术方案的效果最好,但应在尝试了所有方案后再考虑手术方案。5.我们的研究表明,颞下颌关节问题无法根治,但通过控制诱发因素,可以非常有效地控制病情。
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引用次数: 0
Temporomandibular disk position after orthognathic surgery: A systematic review 正颌手术后的颞下颌椎间盘位置:系统性综述
IF 4.2 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-06 DOI: 10.1053/j.sodo.2024.02.001
Parisa Soltani , Amirhossein Moaddabi , Amirali Gilani , Niloufar Nafari , Farnaz Mirrashidi , Hugh Devlin , Gianrico Spagnuolo

Orthognathic surgery corrects dentofacial deformities by repositioning maxillary and mandibular bones. This review examined whether orthognathic surgery changes temporomandibular (TM) disk position. Databases searched on November 30, 2023 included Web of Science, PubMed, Scopus, Embase, Cochrane, and Google Scholar. Inclusion criteria were studies of orthognathic surgery in individuals with maxillomandibular deformities reporting on TM disk position. Risk of bias was assessed using Cochrane Risk of Bias 2 and Newcastle-Ottawa scales. From 948 retrieved articles, 31 were included. Bilateral sagittal split osteotomy (BSSO) was the most common mandibular osteotomy technique and largely maintained disk position post-operatively. Intraoral vertical ramus osteotomy (IVRO) appeared to improve disk position, though studied less extensively. Overall, surgery had conflicting effects on disk position; quantitative methods showed little change. Limitations were small sample sizes and lack of standardization in assessing disk position. In conclusion, orthognathic surgery does not consistently alter TM disk position, though IVRO may confer some benefit. Larger, standardized studies are needed to better understand effects on TM joint status.

正颌手术通过调整上颌骨和下颌骨的位置来矫正颌面部畸形。本综述研究了正颌手术是否会改变颞下颌(TM)盘的位置。2023 年 11 月 30 日检索的数据库包括 Web of Science、PubMed、Scopus、Embase、Cochrane 和 Google Scholar。纳入标准为针对上下颌畸形患者的正颌外科手术研究,并对颞下颌关节盘位置进行了报告。偏倚风险采用 Cochrane Risk of Bias 2 和纽卡斯尔-渥太华量表进行评估。在检索到的 948 篇文章中,31 篇被纳入。双侧矢状劈开截骨术(BSSO)是最常见的下颌骨截骨技术,术后基本能保持椎间盘位置。口内垂直颌骨截骨术(IVRO)似乎能改善牙盘位置,但研究较少。总体而言,手术对牙盘位置的影响相互矛盾;定量方法显示变化不大。局限性在于样本量较小,而且在评估牙盘位置时缺乏标准化。总之,正颌手术并不能持续改变颞下颌关节盘的位置,尽管 IVRO 可能会带来一些益处。为了更好地了解对颞下颌关节状态的影响,需要进行更大规模的标准化研究。
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引用次数: 0
Is malocclusion associated with jaw dysfunction? 错颌畸形是否与颌骨功能障碍有关?
IF 4.2 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-06 DOI: 10.1053/j.sodo.2024.02.002
Takashi Ono , Ikuo Yonemitsu

The maxillofacial region is an extremely important region of the body from birth, which is responsible for various functions such as sucking, swallowing, chewing, breathing and pronunciation. It has a complex structure and involves a variety of biological substances from the organ level to the molecular level. Since olden times, clinicians and basic researchers have been interested in the structural changes that occur when function is impaired, and numerous studies have been conducted. Nonetheless, the opposite direction, i.e., how structural disturbances, or malocclusion in orthodontics, affect function, has been less well understood. This is probably because of the methodological difficulties involved. In this review, we will first summarize the old question of whether dysfunction affects occlusion, focusing on masticatory function, especially jaw function, and then, based on this, we will outline a new concept, the proposition of whether malocclusion affects function, focusing on the "substances" that serve as the interface between structure and function.

颌面部是一个极其重要的区域,从出生起就负责吸吮、吞咽、咀嚼、呼吸和发音等各种功能。它结构复杂,从器官层面到分子层面涉及多种生物物质。自古以来,临床医生和基础研究人员一直对功能受损时发生的结构变化感兴趣,并进行了大量研究。然而,人们对结构性紊乱或正畸中的错颌畸形如何影响功能的反方向研究却了解甚少。这可能是由于研究方法上的困难。在这篇综述中,我们将首先总结 "功能障碍是否影响咬合 "这个老问题,重点关注咀嚼功能,尤其是颌骨功能,然后在此基础上概述一个新概念,即 "错合畸形是否影响功能 "这一命题,重点关注作为结构与功能之间界面的 "物质"。
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引用次数: 0
Applications and challenges of implementing artificial intelligence in orthodontics: A primer for orthodontists 人工智能在正畸学中的应用与挑战:正畸学家入门指南
IF 4.2 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-01 DOI: 10.1053/j.sodo.2024.01.005
Min Kyeong Lee , Veerasathpurush Allareddy , Sankeerth Rampa , Mohammed H. Elnagar , Maysaa Oubaidin , Sumit Yadav , Shankar Rengasamy Venugopalan

Artificial Intelligence based systems are exerting tremendous influence in the way we practice and render care to our patients. Improvements in computing capacities, decreasing costs of computing, availability of data from a wide range of sources, and societal push towards embracing innovations have changed the fundamental landscape of healthcare. Like in all specialties, Orthodontics has witnessed a burgeoning interest in research in the artificial intelligence realm. We undertook this narrative review to examine some of the contemporaneous issues that our specialty is facing with regards to implementing artificial intelligence based systems in our research and clinical practice. We present a high level overview of some common applications of artificial intelligence based systems in the field of Orthodontics and challenges in interpreting the models and implementing them in everyday clinical practice.

基于人工智能的系统正在对我们的实践和为病人提供护理的方式产生巨大影响。计算能力的提高、计算成本的降低、数据来源的广泛性以及社会对创新的推动改变了医疗保健的基本格局。与所有专科一样,口腔正畸科对人工智能领域的研究兴趣日渐浓厚。我们撰写了这篇叙述性综述,以探讨本专业在研究和临床实践中实施人工智能系统时所面临的一些问题。我们从高层次概述了人工智能系统在口腔正畸领域的一些常见应用,以及在解释模型和在日常临床实践中实施这些模型所面临的挑战。
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引用次数: 0
FMi --- Ed Board FMi --- 教育委员会
IF 4.2 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-01 DOI: 10.1053/S1073-8746(24)00021-5
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引用次数: 0
Statistics every orthodontist should know 每个正畸医生都应了解的统计数据
IF 4.2 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-01 DOI: 10.1053/j.sodo.2024.01.013
Nikolaos Pandis
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引用次数: 0
Pay attention to the analysis: Common statistical errors in orthodontic randomised clinical trials 注意分析:正畸随机临床试验中常见的统计错误。
IF 4.2 4区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2024-02-01 DOI: 10.1053/j.sodo.2024.01.006
Jadbinder Seehra , Nikolaos Pandis

The introduction of reporting checklists such as CONSORT aimed to enhance the clarity and transparency of the reporting of Randomised Clinical Trials (RCTs). A benefit of clear reporting is to allow healthcare clinicians to assess both the study quality and trial findings and determine its applicability in the treatment of their patients. Despite this global initiative, the reporting of Randomised Clinical Trials (RCTs) undertaken in both dentistry and orthodontics has been reported to sub-optimal in relation to several domains affecting the validity of the trial. Within the literature the adequacy of the statistical analysis undertaken in a trial has been questioned. The aim of this narrative review is to provide clinicians with an overview of the common statistical errors evident in published orthodontic Clinical Trials and to highlight the potential consequences on the interpretation of the trial findings.

引入 CONSORT 等报告核对表旨在提高随机临床试验 (RCT) 报告的清晰度和透明度。清晰报告的一个好处是可以让医疗临床医生评估研究质量和试验结果,并确定其是否适用于患者的治疗。尽管有这一全球倡议,但据报道,牙科和正畸学领域的随机临床试验(RCT)报告在影响试验有效性的几个方面都不尽如人意。在文献中,试验中进行的统计分析的充分性也受到了质疑。这篇叙述性综述的目的是向临床医生概述已发表的正畸临床试验中常见的统计错误,并强调对试验结果解释的潜在影响。
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引用次数: 0
期刊
Seminars in Orthodontics
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