Seminars in Orthodontics最新文献

Purpose

To determine if there are differences in condylar volume, glenoid cavity and joint space between patients diagnosed with facial asymmetry (FA), between affected and contralateral sides and with respect to subjects without FA.

Methods

Cross-sectional, retrospective study comparing CT/CBCT images from patients with FA diagnosis referred to a private clinic, versus a control group, age and sex matched, of patients requiring orthodontic treatment without FA. The 3D Slicer software was used for the analysis. Bivariate analysis was performed to compare qualitative variables using Chi-square or Fisher tests, and for normal distribution quantitative variables, the t-student test was used. The level of significance was p < 0.05.

Results

The FA group (n = 138) included: Hemimandibular Elongation (HE) (n = 64), Hemimandibular Hyperplasia (HH) (n = 12), Hybrid Form (HF) (n = 20), Asymmetric Mandibular Prognathism (AMP) (n = 25), Glenoid Cavity Asymmetry (GCA) (n = 9) and Functional Laterognathism (FL) (n = 8). The control group (n = 20) had no FA and no signs or symptoms of temporomandibular dysfunction. The right condylar and glenoid cavity volumes were significantly larger in FA cases. The volumes of the right and left joint space had significant differences only in HE patients.

Conclusion

Condylar volumes are higher in almost all FA subgroups compared to matched controls. The glenoid cavity volume is larger in FA patients, except for the GCA right and FL left sides. Regarding articular spaces, HE was the only entity with less volume on the contralateral side. The evaluation of structural volume by 3D-CT images helps to diagnose and differentiate FA subgroups.

Gingival recession of lower incisors is a periodontal condition that mostly develops in young adults as a result of various etiological factors, such as mechanical trauma, bacterial associated gingival inflammation, viral infection or a mixture of the above. Several predisposing factors contribute to its occurrence, including thin gingival biotype, reduced alveolar bone thickness, the presence of dehiscence and fenestrations, frenum pull, root malposition due to crowding or previous orthodontic treatment, as well as distorted fixed orthodontic retainers. The treatment approaches vary from supportive periodontal therapy alone to different surgical root coverage procedures. In situations where the root is in close proximity to or beyond the cortical bone, orthodontic repositioning of the root within the bone prior to surgical root coverage has been shown to be beneficial. Historically, such orthodontic correction required insertion of fixed orthodontic devices over an extended period, which posed challenges to patients who may have already undergone orthodontic treatment in the past and are therefore reluctant to undergo retreatment. This case series illustrates that, in contrast to certain beliefs, clear aligners are an effective tool for repositioning the lower incisors’ roots before surgical root coverage procedures. The article provides guidelines for treatment planning and aligners’ design to achieve the best outcome in the shortest duration.

Patients affected by severe periodontitis can develop a secondary malocclusion due to pathologic tooth migration that, if untreated, can hinder the maintenance of the entire dentition. In these cases, the combination of the appropriate stepwise periodontal therapy together with orthodontic treatment may become essential to re-establish health, aesthetics and function, leading to patient satisfaction and long-term stability. However, to successfully perform orthodontic tooth movement in stage IV periodontitis patients is paramount to carefully plan the treatment with a interdisciplinary approach, respecting the correct timing of the different phases of treatment, adapting biomechanics and appliance design individually, considering loss of periodontal support suffered from each patient. At the end of orthodontic treatment, after eventual prosthetic procedures, life-long retention and supportive periodontal care are needed to ensure good long-term prognosis. The present review describes the diagnostic, prognostic and therapeutic challenges associated with the combined ortho-perio treatment of stage IV periodontitis patients, providing both a literature and expert-based support for a biologically-orientated approach.

Orthodontic societies play a significant role in raising public awareness of the profession, and supporting patient care by debunking misinformation and helping patients make informed and appropriate decisions. In this article we highlight four web-based and social media campaigns run or supported by the British Orthodontic Society, namely ‘Hold that Smile’, ‘#KeepStokeSmiling’, ‘Your Jaw Surgery’ and ‘SafeSmiles’. We describe the rationale, aim, target audience, format and content of these campaigns and evaluate how they were publicised. We also discuss the impact and level of engagement of the campaigns as well as lessons learned for future campaigns. Professionals are highly encouraged to contribute to the distribution of these campaigns by endorsing them on social media platforms, ensuring that this information reaches and benefits patients.

Social media is increasingly imbedded in our daily routines. Facebook groups can harness the benefits of connectivity and community as well as diverse knowledge, practices and opinions to powerful effect. A plethora of excellent groups now exist offering diverse information relating to practice management, daily troubleshooting, evidence-based practice, clinical tips and new technologies. The experiences of the authors in developing groups focusing on clinical orthodontic application of theoretical knowledge and the implementation of cutting-edge digital practice are discussed. Suggestions for shaping complementary resources are also outlined.

Podcasts are one of the most recent innovations in media to enter orthodontics. The sector is worth an estimate 18 billion dollars and has a compound annual growth of 27 %. The popularity of on-demand audio and video podcasts has been attributed to ease of production and publishing, free access, the ability to listen whilst engaged with other activities, industry investment, community engagement, mobile data availability, and smartphone popularity. Podcasts however have the limitation of no formal peer review process, potential poor-quality production, and have possibility to mislead the audience. This paper seeks to describe the podcast sector with a focus on healthcare, as well as describes the experiences of two orthodontic podcasts, the Orthodontics in Summary Podcast and the Illuminate Orthodontic Podcast.