Angle Orthodontist最新文献

Objectives: To investigate long-term stability 20 years after orthodontic treatment and the association with arch width changes during treatment.

Materials and methods: This retrospective study investigated 103 patients with Class I and II malocclusions treated with fixed appliances with and without extractions. The sample was treated by one experienced orthodontist and collected from a private orthodontic office. Dental casts were obtained pretreatment (T1), posttreatment (T2), and long-term postretention (T3); they were scanned and converted to STL files. Measurements were evaluated in for the upper and lower arch: intercanine width (IC), intermolar (IM) width, Little's irregularity index (LII).

Results: There were 73 female and 30 male patients. Class I was present in 74 patients and Class II in 29. Average postretention time was 17.2 (±6.5) years after an average active retention time of 3.4 (±1.17) years. Extraction was performed in 55 patients while 48 received nonextraction treatment. Bonferroni Post Hoc test showed that LII in the upper and lower arches at T1 was significantly higher in the extraction group (P < .001). Upper and lower arch LII at T3 was slightly higher in extraction cases but remained under 2.05 mm. LII at T3 in the upper and lower arches showed negative correlation with IM T3 in the upper arch (Pearson, N = 103, P = .047), while IC in the upper and lower arches at T3 correlated with IM T3 in the upper and lower (N = 103, P < .001).

Conclusions: Clinically relevant long-term stability in both arches was found in extraction and nonextraction cases. Intermolar width and its change during orthodontic treatment was an influential factor on long-term stability in extraction cases.

Objectives: To investigate skeletal and dentoskeletal changes 20 years after bionator treatment.

Materials and methods: Analog lateral cephalograms of 18 subjects treated with a bionator appliance during growth were digitized with a transmitted light scanner. Inclusion criteria were: increased overjet (≥4 mm), skeletal Class II, available lateral cephalograms before (T0), after (T1), and 20 years after (T2) treatment with only a Bionator. To assess standard cephalometric parameters, the software ivoris analyze was used. Data were analyzed using Friedman's two-way analysis of variance by ranks followed by Dunn's post hoc tests (P ≤ .05).

Results: During therapy (T0-T1), ANB decreased significantly by 1.9° and remained unchanged long term. SNA slightly decreased (-0.6°) during treatment, SNB and SNPg increased (+1.4°, +1.7°). All three parameters showed a significant increase at T2 (+1.2°, +1.6°, +1.6°). Vertical measurements (ML-NL, ML-NSL, NL-NSL) remained almost unchanged during therapy. NL-NSL also was unchanged during the long-term interval; ML-NSL and ML-NL decreased significantly (-3.4°, -4.9°). During treatment, the maxillary incisors retroclined (OK1-NL: -1.6°, OK1-NA: -0.6°), the mandibular incisors proclined (UK1-ML: +3.5°, UK1-NB: +4.9°), neither significantly. Long term, there was a nonsignificant tendency toward proclination of upper (OK1-NL: +0.1°, OK1-NA: +0.7°) and retroclination of lower incisors (UK1-ML: -1.5°, UK1-NB: -5°).

Conclusions: Changes of ANB after bionator treatment without additional fixed appliances remained stable after 20 years. The observed long-term changes are probably consequences of well-known physiological and age-related processes.

Objectives: To investigate the effectiveness of utility arch (UA) with inter-maxillary elastics compared with fixed anterior bite plane (FABP) for treating deep bite in brachy-facial children.

Materials and methods: This was a single-center, randomized controlled trial. Participants were children aged between 9 and 12 years with deep bite and a hypodivergent skeletal pattern. The sample was divided into the following two groups: (1) a UA group that was composed of patients with UAs with posterior inter-maxillary elastics and (2) an FABP group as a control. Outcomes were skeletal and dentoalveolar variables on cephalometric X-rays.

Results: A total of 28 patients (13 boys, 15 girls) with a mean age of 10.66 years were enrolled. The treatment duration was 8.16 months in the UA group and 7.22 months in the FABP group. After treatment, the angle between the anterior cranial base and the mandible in the vertical plane increased significantly (P = .000) in both groups (about 1.97 degrees in the UA group and 2.75 degrees in the FABP group). Overbite decreased significantly in both groups (-2.1 m in the UA group and -3.64 m in the FABP group), but it decreased less significantly in the UA group than in the FABP group. The upper incisors flared significantly after treatment with both appliances (6.6 degrees in the UA group and 5.9 degrees in the FABP group).

Conclusions: Treatment of deep bite in children with a horizontal growth pattern by each of the appliances used in this study is effective. The mandible showed minor, significant backward rotation after treatment. The overbite decreased less in the UA group than in the FABP group.

Objectives: To analyze the effects of maxillary tooth distalization by clear aligner (CA) treatment with variations in the angular direction of the distalization force, presence of attachments, and force-application method used.

Materials and methods: A finite element model containing alveolar bone, dentition, and periodontal ligament was constructed. Analytical model groups were as follows: (1) distalization with buttons (without attachments), (2) buttons on canines (with attachments), (3) precision cuts on the canines (without attachments), and (4) precision cuts on the canines (with attachments). A distalization force of 1.5 N was applied to the button or precision cut at -30°, -20°, -10°, 0°, 10°, 20°, and 30° to the occlusal plane.

Results: As the direction of force approached +30°, the dentition inclined posteriorly. The posterior movement pattern was significantly influenced by the presence of an attachment and the direction of force, rather than the area where the force was applied. Distal inclination was dramatically reduced with attachments. A disengagement or deformation of the CA may reduce the distalization efficiency of the dentition or move the dentition in an inappropriate direction.

Conclusions: Attachments for efficient distalization by the CA are necessary. The use of miniscrews in the direction of force parallel to the occlusal plane is more advantageous than the use of Class II elastics. Due to CA deformation, distalization with the button on the canines can be more effective for distal movement of the maxillary dentition.

Objectives: To evaluate the effects of treatment of posterior crossbite (PXB) in the mixed dentition with the Function Generating Bite (FGB) appliance on the transverse dimension of the dental arches.

Materials and methods: This study included 84 PXB patients (female = 46; male = 38; mean age, 8.2 ± 1.8 years) and 69 control (C) patients (female = 31; male = 38; mean age, 8.9 ± 1.4 years). Measurements were taken with digital calipers on maxillary and mandibular study casts before (T0) and after (T1) treatment for the following measures: intermolar (IMD), intermolar gingival (IMGD), intercanine (ICD), and intercanine gingival distances (ICGD).

Results: At T0, there was a significant difference in all maxillary measurements between the PXB and C groups (P < .001), reflecting maxillary hypoplasia in PXB patients. At T1, there was no difference between the groups. In PXB patients, the mean increase between T0 and T1 for IMD was 4.34 ± 2.42 mm; this difference measured 3.51 ± 2.19 mm for IMGD, 2.78 ± 2.37 mm for ICS, and 1.89 ± 1.7 mm for ICGD. There was no significant difference in mandibular measurements between groups at T0 and T1.

Conclusions: Functional therapy with FGB is effective in significantly increasing the transverse dimension of the maxillary dental arch in PXB patients. Considering its efficacy in treating masticatory dysfunction, FGB may be considered a good treatment option for the correction of PXB in growing children.

Objectives: To compare the changes of palatal volume and area in patients treated with tooth-tissue-borne palatal expanders (conventional Haas) and miniscrew-supported palatal expanders (modified Haas).

Materials and methods: The sample included casts of 22 patients treated as part of a clinical study at the Department of Orthodontics, Al-Azhar University, to correct their crossbite malocclusion. Patients were divided equally into two groups upon arrival. The first group, with a mean age of 12 years and 6 months, received the miniscrew-supported palatal expander. The second group, with a mean age of 12 years and 2 months, received the Haas design-palatal expansion appliance. Pre- and post-expansion dental casts were cone beam computed tomography scanned and the slices were constructed into 3D volumes. Fully automated superimposition was done for pre- and post-expansion 3D models. Palatal volume and area were determined, and all measurements were carried out blindly. Paired t-test was used to assess the mean differences within each group and Welch's t-test was applied to assess the mean changes between the two groups. Shapiro-Wilk test was used to test for the normality of the data.

Results: There were no statistical differences in volume changes either within each group or between the groups. Although area changes were statistically significant within each group, the difference between the groups was not significant.

Conclusions: Changes that result from the use of either method to expand the upper arch occur primarily in the shape of the palate, but not in its size.

Objectives: To compare a novel body mandibular horizontal plane (mental foramen-protuberance menti; Body-MHP) with the conventional border mandibular horizontal plane (gonion-menton [Me]; Border-MHP) to assess mandibular body inclination and dental compensation of skeletal Class III patients with and without facial asymmetry.

Materials and methods: Retrospective data obtained from diagnostic cone-beam computed tomography of 90 skeletal Class III patients (mean age, 21.67 ± 2.93 years; range, 15.0-30.6 years) were divided into symmetry (n = 30) and asymmetry groups (n = 60). The asymmetry group was subdivided into roll (n = 30) and non-roll types (n = 30). The differences in body inclination and dental measurements (distance and angle) according to two mandibular planes (Body-MHP and Border-MHP) were assessed in the groups and subgroups.

Results: Mandibular body inclinations relative to the Body-MHP were not different in the roll-type asymmetric mandible between the sides, while those relative to the Border-MHP were different (P < .001). For the mandibular first molar positions relative to the Border-MHP, the differences in vertical distance between the sides were undermeasured and the inclination differences were overmeasured when compared relative to the Body-MHP.

Conclusions: The Body-MHP demonstrated better bilateral similarity in body inclination compared with the Border-MHP in patients with roll-type facial asymmetry. The novel body mandibular plane ensures an accurate diagnosis for tooth movement and jaw surgery, particularly in the roll-type asymmetric mandible.

Objectives: The objectives of this article were the following: (1) to analyze bone thickness and height (BTH) of the buccal shelf area (BS) quantitatively in four different potentially eligible sites for miniscrew insertion; (2) to compare and contrast BTH and the changes in spatial position of the inferior alveolar nerve canal (IANC); and (3) to assess differences with age among vertical facial patterns (hypodivergent, normodivergent, and hyperdivergent) and well as by sex.

Materials and methods: Cone-beam computed tomography scans of 205 individuals (110 women and 95 men) were divided into groups according to age, vertical facial pattern, and sex. The BTH of the BS and the BTH to the IANC were measured in the mesial and distal roots of the first and second molars.

Results: BTH progressively increased in a posterior direction (P < .001), while BTH to the IANC increased and decreased (P < .001) for thickness and height, respectively, in the same direction in all age groups, for the three different vertical facial patterns, and in both sexes. Women showed significantly less BTH to the IANC (P < .002). Hypodivergent patients had greater BTH (P < .024) and a smaller bone height to the IANC (P < .018) only in the first molar region. Patients over 40 years of age had lower bone height in the second molar area (P < .003).

Conclusions: The ideal place for BS miniscrew insertion is the region of the distal root of the second molars, regardless of facial pattern, sex, and age. The BS in women has less BTH and less BTH to the IANC.

Objectives: To evaluate the success rate, treatment duration, and pain perceived during forced eruption of maxillary palatally impacted canines using the K9 and Ballista springs.

Materials and methods: Thirty unilateral palatal canine impactions of moderate and difficult category as determined by KPG index (score between 10 and 19) were enrolled. Group 1 comprised canine impactions managed with K9 springs, and Group 2 comprised Ballista springs. Block randomization and opaque sealed envelopes were used for allocation. The success rate and treatment duration (application of force to ligation of the impacted canine into the initial alignment archwire) were recorded. Pain perception was evaluated on a 10-point visual analogue scale (VAS) and modified McGill Pain Questionnaire. Chi-square test and Mann-Whitney U-test were used to compare the groups.

Results: The success rate for eruption of palatally impacted canines was 100%. The average treatment duration was 296.13 ± 96.45 days and 311.93 ± 94.34 days, respectively for Group 1 and Group 2. VAS scale scores for pain were greater for Group 2 compared to Group1, and the differences were statistically significant at all time intervals except at T1. The frequency of none and mild pain was significantly greater at all time intervals in both groups.

Conclusions: The impacted canines of moderate and difficult category were erupted with a 100% success rate and similar treatment duration with both interventions. The pain scores of Ballista springs were greater after 24 hours of force application.

Objectives: To evaluate the integration accuracy of cone-beam computed tomography (CBCT) images with three-dimensional (3D) facial scans according to different registration areas.

Materials and methods: Twenty-five patients (14 males and 11 females), with a mean age of 19.0 ± 11.3 years, were included in this study. Each patient underwent CBCT and facial scans on the same day in an upright position. The facial scans were integrated with the corresponding soft-tissue images of CBCT scans. Three methods were used to integrate the two imaging modalities based on the facial regions scanned: R1, only the forehead and nasal bridge area were included; R2, the right and left malar area were included; and R3, the forehead, nasal bridge, and malar areas were included. The integration accuracy between the facial scans and CBCT images was evaluated by color-mapping methods and average surface distances, calculated by measuring the 3D distances between the surface points on the two superimposed images.

Results: The average surface differences between facial scans and CBCT images were less than 1.0 mm in all three methods. The R3 method showed fewer differences between the facial scans and CBCT images than the other methods did.

Conclusions: Facial scans obtained using a low-cost facial scanner showed clinically acceptable performance. The integration accuracy of facial and CBCT scans can be increased by including the forehead, nasal bridge, and malar areas as registration areas.