Angle Orthodontist最新文献

Objectives: To evaluate the outcome of treating deep overbite (OB) using anterior bite elevators concurrently with a pre-adjusted edgewise appliance.

Materials and methods: The Case Western Reserve University (CWRU) cephalometric analysis was used to isolate tipping movement of upper (TUI) and lower incisors (TLI), bodily tooth movement of upper (BUI), and lower incisors (BLI), as well as vertical skeletal changes in the anterior region of the maxilla (MXSK) and mandible (MNSK). Thirty treated subjects were examined at pretreatment (T1) and posttreatment (T2) and compared to an untreated control group matched on age, sex, and Angle malocclusion from the Bolton Brush Growth Study Collection (CWRU, Cleveland, Ohio).

Results: Overbite (OB) in the treated group was decreased significantly (P < .001) (-5.6 mm) compared to controls. Statistically significant (P < .001) changes were found for BUI (-0.7 mm), TUI (0.9 mm), TLI (-1.4 mm), BLI (-1.1 mm), and MNSK (-1.6 mm). Most of the overbite correction was in the lower arch and included tipping and intrusion of the lower incisors along with an increase in lower vertical facial height.

Conclusions: Deep OB correction was achieved efficiently using anterior bite elevators with pre-adjusted edgewise appliance. Correction using bite turbos would be a treatment option for individuals presenting with decreased lower facial height and deep bite.

Objectives: To investigate the association between the width of keratinized gingiva (WKG), gingival phenotype (GP), and gingival thickness (GT) with craniofacial morphology in sagittal and vertical dimensions.

Materials and methods: WKG, GP, and GT of mandibular anterior teeth in 177 preorthodontic patients (mean age 18.38 ± 5.16 years) were assessed clinically using a periodontal probe, a Colorvue Biotype Probe, and ultrasound by a single examiner. Patients were grouped into skeletal Class I, II, and III and hyperdivergent, normodivergent, and hypodivergent based on ANB and SN-MP angles. Mandibular incisor inclination (L1-NB) was also measured. Clinical and cephalometric measurements were repeated to assess inter- and intraexaminer reproducibility.

Results: A significant association was found between thin GP and skeletal Classes I and III for the left mandibular central incisor (MCI; P = .0183). In skeletal Class III patients, L1-NB angle demonstrated a decreasing trend as phenotype thickness decreased. A significant association was found between thin phenotype and normodivergent and hypodivergent groups for MCIs (left: P = .0009, right: P = .00253). No significant association between WKG or GT and craniofacial morphology was found.

Conclusions: Thin GP is associated with skeletal Class I and III for the left MCI. Thin GP is associated with hypodivergent and normodivergent skeletal patterns for the MCIs. There was no association between WKG and GT and craniofacial morphology in both skeletal and vertical dimensions. Dental compensations that exist due to different craniofacial morphology may influence the GP.

Objectives: To quantify the amount of residual monomer released from orthodontic adhesives used in the indirect bonding technique and compare it to a direct bonding composite resin.

Materials and methods: Five hundred stainless steel orthodontic brackets were bonded on bovine incisors using five groups of bonding resins: Transbond XT (TXT), Transbond Supreme LV (SLV), Sondhi Rapid-Set (SRS), Transbond IDB (IDB), and Custom I.Q. (CIQ). Liquid samples were gathered on the first, seventh, 21st, and 35th days. Residual monomer release was measured from the liquid samples with a liquid chromatography device. In addition, the amount and shape of the adhesive between the tooth surface and the bracket base was evaluated using obtained electron microscopy images. The data were analyzed using analysis of variance, and a Tukey post-hoc test was applied.

Results: Hydroxyethylmethacrylate and bisphenol A-glycidyl methacrylate monomers were released by all study groups. Urethane-dimethacrylate was released from the TXT, SLV, IDB, and CIQ groups. Triethylene glycol dimethacrylate was released from TXT, SLV, IDB, and SRS groups. The amount of total monomer release was higher in chemically cured adhesives than in light-cured adhesives. Among the chemically cured adhesives, premix adhesives had the highest amount of total monomer release. The light-cured adhesives had less thickness.

Conclusions: Light-curing adhesives have significantly less monomer release than chemically polymerized adhesives.

Objectives: To evaluate the efficacy of chewing gum on the intensity of pain in patients undergoing orthodontic treatment.

Materials and methods: A search strategy that included both a manual search and a search of electronic databases was implemented; the electronic databases included PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), ScienceDirect, Scopus, and EBSCO. Only randomized controlled trials were included in this study. All of the studies were assessed independently and in duplicate in accordance with the exclusion and inclusion criteria. The Cochrane risk of bias tool was used to evaluate the risk of bias within the included studies, and the GRADE approach was used to evaluate the certainty of evidence.

Results: Sixteen RCTs were included in the final analysis. The meta-analysis revealed that chewing gum significantly reduced pain intensity in comparison to pharmacologic agents (mean difference [MD] -0.50 [95% confidence interval {CI} -0.90 to -0.10], P = .01). When compared with a placebo, chewing gum significantly reduced pain intensity (MD -0.60 [95% CI -1.06 to -0.13], P = .01), while bite wafer and chewing gum groups had the same levels of reduction in pain intensity (MD -0.15 [95% CI -0.56 to 0.26], P = .48).

Conclusions: In patients undergoing fixed orthodontic treatment, chewing gum was significantly more effective than both pharmacologic agents and placebo in reducing orthodontic pain 24 hours after the initial placement of the archwire.

The stomatognathic structures act as a complex and integrated system, thereby accomplishing several essential functions of the body. Aside from participating in food digestion, they are key for respiration and swallowing and play a central role in social interaction and stress management. The lifeworks of Robert M. Ricketts (1920-2003), an American orthodontist, and Rudolf Slavicek (1928-2022), an Austrian prosthodontist, were centered on this understanding. Both were educated in the time of gnathology, functional dentistry, and cephalometry and were ready to challenge conventional knowledge and traditions, leading toward innovation. As untiring clinicians, researchers, and mentors, they were fully invested in the study of the stomatognathic system, considering its morphology, dynamics, growth patterns, evolution, and interactions with the body and mind. Based on their extensive knowledge of the masticatory system, they advanced dentistry both with theoretical notions and by implementing new diagnostic and therapeutic concepts, thus reinforcing the idea of dentistry as a medical discipline requiring interdisciplinary effort. Their heritage is represented by numerous publications, discoveries, and inventions that inspire the dental community to follow their exemplary approach to the individualized care of patients. Their knowledge and passion are further passed on through their students. As part of their legacy, they prepared the ground for new research aimed at fostering advancements in occlusion medicine, hence supporting education in oral health.

Objectives: To investigate aligner treatment protocols among orthodontists in the United States and Canada and assess the factors influencing clinician choices in aligner systems, treatment protocols, and targeted malocclusions for aligners.

Materials and methods: A validated online questionnaire was developed specifically for this research and consisted of three sections. Section 1 evaluated demographics and experience with aligners. Section 2 assessed patient selection and demands and clinician confidence in treating various malocclusions with aligners. Section 3 evaluated treatment protocols used by clinicians. The American Association of Orthodontists Partners in Research Program distributed the survey via e-mail to active members in the United States and Canada.

Results: A total of 160 providers completed the survey. Aligners were used by 65.00% of respondents, with the Invisalign system the most popular (81.25%). Aligners were mostly used for adults (97.50%). Tipping was ranked as the easiest movement (1.79 ± 1.35). Extrusion (4.34 ± 1.53) and root movement (4.31 ± 1.27) were ranked as the most difficult. Most were confident treating mild (98.8%) and moderate (82.5%) crowded cases, spacing (96.9%), and anterior crossbite (85%). Of the providers, 58.12% recommended aligners to be changed weekly. Respondents who were confident addressing some of the severe malocclusions were more likely to use Invisalign.

Conclusions: Invisalign is the most popular aligner system, and clinicians seem to be confident using it. Providers are aware of the pitfalls of aligners; they find it challenging to perform root movement and extrusion, and they seem confident treating mild to moderate malocclusions. They avoid complex cases with impactions and severe skeletal problems.

Objectives: To compare skeletal and dentoalveolar changes of miniscrew-assisted rapid palatal expansion (MARPE) according to the length of the miniscrews.

Materials and methods: This two-arm parallel-randomized controlled trial included 32 adult patients aged 19-35 years who received orthodontic treatment with MARPE. Patients were allocated to two groups, group long (L) and short (S), through block randomization according to the length of the miniscrews installed in MARPE. Cone-beam computed tomography was performed before expansion and after removal of the MARPE; superimposition of the images was conducted. The primary outcome included the amount of bone expansion and the change in the inclination of the anchorage teeth. The secondary outcome included the success rate of midpalatal suture opening and stability of the miniscrews. Blinding was performed during outcome assessment.

Results: The final sample comprised 31 patients. There was no significant difference in patient characteristics between group L (n = 16) and group S (n = 15). The change in the width of the processus zygomaticus (P = .010) and ectocanine (P = .001) was significantly higher in group L. A significantly higher success rate of the posterior miniscrews was seen in group L (P = .024). There was no statistically significant difference in the success rate of suture separation or change in tooth inclination. Notable complications were not reported.

Conclusions: MARPE with longer miniscrews can increase the amount of expansion of the maxillary basal bone and canine alveolar bone. Although it also aided in miniscrew stability, it did not guarantee successful midpalatal suture separation.

Objectives: To evaluate the utility and efficiency of four voice-activated, artificial intelligence-based virtual assistants (Alexa, Google Assistant, Siri, and Cortana) in addressing commonly asked patient questions in orthodontic offices.

Materials and methods: Two orthodontists, an orthodontic resident, an oral and maxillofacial radiologist, and a dental student used a standardized list of 12 questions to query and evaluate the four most common commercial virtual assistant devices. A modified Likert scale was used to evaluate their performance.

Results: Google Assistant had the lowest (best) mean score, followed by Siri, Alexa, and Cortana. The score of Google Assistant was significantly lower than Alexa and Cortana. There was significant variablity in virtual assistant response scores among the evaluators, with the exception of Amazon Alexa. Lower scores indicated superior efficiency and utility.

Conclusions: The common commercially available virtual assistants tested in this study showed significant differences in how they responded to users. There were also significant differences in their performance when responding to common orthodontic queries. An intelligent virtual assistant with evidence-based responses specifically curated for orthodontics may be a good solution to address this issue. The investigators in this study agreed that such a device would provide value to patients and clinicians.

Objectives: To evaluate the content and quality of information about orthodontic pain on YouTube.

Materials and methods: YouTube was searched using the keywords "orthodontic pain" and "brace pain." A total of 65 videos were chosen for the final analysis. Videos were classified into high- and low-content groups using an eight-point scoring system and reviewed according to selected orthodontic pain-related topics. Video quality was rated by the Video Information and Quality Index (VIQI) and Global Quality Scale (GQS). Statistical data analysis was performed using SPSS 28.0 software, Mann-Whitney U-tests, χ2 tests, and Spearman correlation coefficients.

Results: Most YouTube videos related to orthodontic pain were low content (86.2%), and a few were high content (13.8%). Pharmacological pain relief was the most prevalent topic (50.8%), followed by duration of pain (32.3%) and influence of pain on patient quality of life (29.2%). The least-mentioned topic was possible location of pain (7.7%). Most of the videos were uploaded by laypeople (64.6%). Videos uploaded by dental professionals had significantly higher means of GQS scores (P = .035), flow of information (P < .001), information quality (P = .008), and total VIQI (P < .001). Compared with low-content, high-content videos had a higher mean of flow of information (P = .037). There was a weak correlation between total content and GQS scores and a strong correlation between GQS and VIQI scores (r = 0.740; P < .01).

Conclusions: Overall, YouTube was found to be an inadequate source of information on orthodontic pain.

Objectives: To investigate hyoid bone position and airway volume in subjects with adenoid hypertrophy, tonsillar hypertrophy, and adenotonsillar hypertrophy compared to subjects with nonobstructive adenoids or tonsils and to assess the correlation between hyoid bone and airway parameters.

Materials and methods: A total of 121 subjects were grouped based on adenoid or tonsillar hypertrophy into four groups, as follows: (1) control group (C-group), (2) adenoid hypertrophy group (AH-group), (3) adenotonsillar hypertrophy group (ATH-group), and (4) tonsillar hypertrophy group (TH-group). Hyoid bone position and airway volumes were measured. The Kruskal-Wallis test was used for intergroup comparison, followed by pairwise comparison using the Mann-Whitney U-test. Bivariate correlation was conducted using Spearman correlation coefficients. Multiple linear regression was performed to create a model for airway volume based on hyoid bone predictive variables.

Results: No significant difference was found between subjects with isolated adenoid or tonsillar hypertrophy compared to the C-group. However, the ATH-group exhibited a significantly decreased hyoid bone vertical distance (HV), total airway volume (TA volume), and retroglossal airway volume (RG volume) compared to the C-group. HV and age had a high potential in terms of explaining the RG volume, whereas the TA volume and retropalatal airway volume (RP volume) models were not as successful as the RG volume counterpart.

Conclusions: Subjects in ATH-group were characterized by an elevated hyoid bone position and constricted TA volume and RG volume compared to those in the C-group. HV and age were predictor variables that best explained retroglossal airway volume.