American Journal of Orthodontics and Dentofacial Orthopedics最新文献

英文中文

Treatment acceptance in adult patients with anterior open bite: A National Dental Practice-Based Research Network study 前牙开合咬合成年患者的治疗接受度：一项基于国家牙科实践研究网络的研究。

IF 2.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

American Journal of Orthodontics and Dentofacial Orthopedics

Pub Date : 2024-10-01 DOI: 10.1016/j.ajodo.2024.06.007

Introduction

Orthodontists have many techniques to treat anterior open bites and must involve patients in making treatment decisions. This study aimed to investigate orthodontic treatment plan acceptance by United States adults with anterior open bites and to identify associations between treatment acceptance and patient demographics and dentofacial characteristics.

Methods

A prospective, observational cohort study enrolled the patients of 91 orthodontic providers. A total of 345 adults were included in the sample. Provider personal and practice demographics were captured. Patient demographics, treatment goals, dentofacial characteristics, and reasons for not accepting the recommended plans were recorded. Adjusted regression models were used to identify associations between patient characteristics and the likelihood of accepting the most highly recommended plan.

Results

Approximately 78% of patients accepted the most highly recommended treatment plan. 60% of the patients who were recommended surgical plans accepted them. Patients with a history of orthodontics and a concave profile were more likely to accept the most highly recommended plan. Insurance coverage for orthognathic surgery was associated with a higher acceptance rate for surgery. Severe crowding was associated with a lower acceptance of surgery. The most common reasons for declining the recommended plan were not wanting jaw surgery and considering the treatment to be too invasive, risky, and/or costly.

Conclusions

Patient acceptance is less common at higher levels of invasiveness of treatment. Prior orthodontic treatment, concave profile, and insurance coverage for surgery were associated with accepting treatment. Most patients accepted a surgical plan when it was the most recommended option.

简介：正畸医生有许多治疗前牙开合咬合的技术，必须让患者参与治疗决策。本研究旨在调查美国成年人前牙开合咬合患者对正畸治疗方案的接受程度，并确定治疗接受程度与患者人口统计学和颌面部特征之间的关联：一项前瞻性、观察性队列研究招募了 91 家正畸医疗机构的患者。共有 345 名成年人被纳入样本。研究人员采集了提供者的个人和诊所人口统计数据。记录了患者的人口统计学特征、治疗目标、牙面特征以及不接受推荐方案的原因。使用调整回归模型来确定患者特征与接受最推荐方案的可能性之间的关联：结果：约 78% 的患者接受了最强烈推荐的治疗方案。60%的患者接受了推荐的手术方案。有正畸史和凹面轮廓的患者更有可能接受最强烈推荐的方案。正颌外科手术的保险范围与较高的手术接受率有关。严重拥挤与接受手术的比例较低有关。拒绝接受推荐方案的最常见原因是不想做颌骨手术，以及认为治疗创伤太大、风险太高和/或费用太高：结论：患者接受侵入性较高的治疗的比例较低。之前的正畸治疗、凹面轮廓和手术保险与接受治疗有关。当手术方案是最推荐的选择时，大多数患者都会接受。

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引用次数: 0

Does planned molar intrusion with aligners assist with closure of anterior open bite? 使用矫治器进行有计划的臼齿嵌入是否有助于前方开放性咬合的闭合？

IF 2.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

American Journal of Orthodontics and Dentofacial Orthopedics

Pub Date : 2024-10-01 DOI: 10.1016/j.ajodo.2024.04.016

Introduction

This study aimed to determine whether prescribed molar intrusion, with or without virtual occlusal bite-blocks (BB), resulted in actual molar intrusion and assisted with anterior open bite (AOB) correction in adult patients treated with Invisalign clear aligners (Align Technology, Santa Clara, Calif).

Methods

A retrospective study was conducted with 36 adult patients with AOB. Subjects were divided into 2 treatment groups: planned molar intrusion (PMI) and no-PMI (No-PMI). PMI was obtained from the tooth movement tables in the ClinCheck software. Patients with PMI were further categorized by the presence or absence of virtual posterior BB (PMI-BB and PMI-No BB, respectively). Treatment success was determined on the basis of positive vertical incisor overlap in posttreatment cephalograms. Treatment changes were assessed using pretreatment and posttreatment cephalometric radiographs (Welch 2-sample t test, 95% confidence interval, P = 0.05). Finally, treatment stability was assessed at least 1-year posttreatment using the Photographic Open Bite Severity Index (POSI).

Results

There were 15 patients with No-PMI and 21 without PMI (total n = 36). The mean overbite change was 2.5 ± 1.0 mm for No-PMI and 3.2 ± 1.8 mm for patients with PMI (P = 0.12). All patients had positive vertical incisor overlap in posttreatment cephalograms, indicating 100% treatment success. Open bites were corrected primarily by incisor retroclination and extrusion in both treatment groups. The average measured molar intrusion for the PMI group was 0.71 mm greater than the change for the No-PMI group, but the difference was not statistically significant after controlling for potentially confounding variables (P = 0.074). A total of 14 patients from the original sample were assessed for stability using the POSI analysis. Of those, 12 (85.7%) had a POSI score of 0.

Conclusions

Regardless of whether the molar intrusion was planned or not, the modality of AOB correction with Invisalign clear aligners was primarily incisor extrusion and retroclination. Overall, aligners are an effective appliance for the treatment of adult AOB. Based on our limited sample, treatment stability was similar to that reported for fixed appliances.

简介：本研究旨在确定在使用隐适美透明矫治器（Align Technology, Santa Clara, Calif）治疗的成年患者中，有无虚拟咬合阻滞（BB）的情况下，规定的臼齿内嵌是否会导致实际的臼齿内嵌，并有助于前开放性咬合（AOB）的矫正：方法：对 36 名患有前开放性咬合的成年患者进行了一项回顾性研究。受试者被分为两个治疗组：计划臼齿内侵（PMI）组和无计划臼齿内侵（No-PMI）组。PMI是从ClinCheck软件的牙齿移动表中获得的。PMI 患者根据是否存在虚拟后 BB 进一步分类（分别为 PMI-BB 和 PMI-No BB）。治疗成功与否的判断依据是治疗后头相图中垂直切牙重叠是否为阳性。治疗变化通过治疗前和治疗后的头颅X光片进行评估（Welch 2样本t检验，95%置信区间，P = 0.05）。最后，使用照相开放性咬合严重程度指数（POSI）评估治疗后至少一年的治疗稳定性：结果：15 名患者无PMI，21 名患者无PMI（共36 人）。无PMI患者的平均咬合过度变化为2.5 ± 1.0毫米，PMI患者的平均咬合过度变化为3.2 ± 1.8毫米（P = 0.12）。所有患者在治疗后的头影照片中都有垂直切牙重叠，表明治疗成功率为 100%。在两个治疗组中，开合咬合主要通过切牙后倾和挤压得到矫正。PMI组的臼齿内陷平均测量值比无PMI组的变化值大0.71毫米，但在控制了潜在的混杂变量后，差异无统计学意义（P = 0.074）。使用 POSI 分析法对原始样本中的 14 名患者进行了稳定性评估。其中 12 人（85.7%）的 POSI 得分为 0.结论：无论臼齿侵入是否在计划之内，隐适美透明矫治器矫正AOB的方式主要是切牙挤压和后倾。总的来说，矫治器是治疗成人AOB的有效矫治器。根据我们有限的样本，治疗的稳定性与固定矫治器的报告相似。

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引用次数: 0

Concerns about the conclusion that clear aligner mandibular advancement provides better vertical control in growing patients with Class II 对 "透明对齐下颌前突矫正器能更好地控制成长中的 II 类患者的下颌垂直度 "这一结论表示担忧。

IF 2.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

American Journal of Orthodontics and Dentofacial Orthopedics

Pub Date : 2024-10-01 DOI: 10.1016/j.ajodo.2024.07.012

引用次数: 0

Directory: AAO Officers and Organizations 目录：AAO 官员和组织

IF 2.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

American Journal of Orthodontics and Dentofacial Orthopedics

Pub Date : 2024-10-01 DOI: 10.1016/S0889-5406(24)00376-7

引用次数: 0

Patients’ perceptions matter: Risk communication and psychosocial factors in orthodontics 患者的看法很重要：牙齿矫正中的风险沟通和社会心理因素。

IF 2.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

American Journal of Orthodontics and Dentofacial Orthopedics

Pub Date : 2024-10-01 DOI: 10.1016/j.ajodo.2024.06.011

Introduction

Effective risk communication is essential for achieving patient-centered oral health care, but the limited understanding of patients’ subjective perceptions of orthodontic-related risks hinders this process. This study aimed to investigate adults’ awareness, concerns, and risk-avoidance behaviors about long-term orthodontic risks, exploring their relationship with psychosocial factors.

Methods

We included 498 adult patients (mean age, 27.3 ± 6.8 years; women, 75.5%) during their initial visits to the orthodontic department at a hospital in Chengdu, China. Participants’ understanding of orthodontic risks was gauged before and after exposure to the Oral Health Education Comics (OHEC), a specifically designed digital tool. Concurrently, we used logistic regression models to investigate the associations between patients’ depression, anxiety, self-esteem, perfectionism, and dentofacial esthetics with risk perceptions.

Results

Approximately 79.5% of participants initially reported low awareness of orthodontic risks, with most knowledge from online sources. Notably, the percentage of participants with high awareness increased to 64.8% after OHEC. The negative facial soft-tissue change was most concerning for participants: 53.4% showed high concerns, and 28.1% showed high avoidance. Furthermore, linear regression indicated positive associations between depression (β = 0.42 [95% confidence interval {CI}, 0.07-0.77]) and anxiety (β = 0.76 [95% CI, 0.35-1.18]) with orthodontic risk concerns, whereas risk avoidance was positively associated with depression (β = 0.62 [95% CI, 0.27-0.97]), anxiety (β = 1.09 [95% CI, 0.68-1.50]), and perfectionism (β = 0.24 [95% CI, 0.02-0.46]).

Conclusions

Findings emphasize the imperative of streamlined risk communication in orthodontics. By incorporating comprehensible tools such as OHEC and integrating psychosocial evaluations, more refined patient-practitioner communication and psychosomatic-based dental care can be achieved.

导言：有效的风险沟通对于实现以患者为中心的口腔健康护理至关重要，但由于对患者对牙齿矫正相关风险的主观认知了解有限，阻碍了这一进程。本研究旨在调查成年人对长期正畸风险的认识、担忧和风险规避行为，并探讨它们与社会心理因素的关系：我们纳入了 498 名初次到中国成都一家医院正畸科就诊的成年患者（平均年龄为 27.3 ± 6.8 岁，女性占 75.5%）。在接触口腔健康教育漫画（OHEC）这一专门设计的数字工具之前和之后，我们对参与者对正畸风险的理解进行了评估。同时，我们使用逻辑回归模型研究了患者的抑郁、焦虑、自尊、完美主义和牙面美学与风险认知之间的关联：大约 79.5%的参与者最初表示对牙齿矫正风险的认识不足，其中大部分知识来自网络。值得注意的是，在OHEC之后，高认知度参与者的比例增加到了64.8%。参与者最担心的是面部软组织的负面变化：53.4%的人表示高度关注，28.1%的人表示高度回避。此外，线性回归表明，抑郁（β = 0.42 [95% 置信区间{CI}，0.07-0.77]）和焦虑（β = 0.76 [95% CI，0.35-1.18]）与正畸风险呈正相关。18]）正相关，而风险规避与抑郁（β = 0.62 [95% CI, 0.27-0.97]）、焦虑（β = 1.09 [95% CI, 0.68-1.50]）和完美主义（β = 0.24 [95% CI, 0.02-0.46]）正相关：研究结果强调了在正畸学中简化风险交流的必要性。结论：研究结果表明，在正畸学中简化风险交流是非常必要的。通过结合OHEC等易懂的工具和社会心理评估，可以实现更精细的患者与执业医师的交流和以心身医学为基础的牙科护理。

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引用次数: 0

The American Board of Orthodontics: A brief history and update of the orthodontic certification process 美国牙科正畸委员会：正畸认证程序的简史和更新。

IF 2.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

American Journal of Orthodontics and Dentofacial Orthopedics

Pub Date : 2024-10-01 DOI: 10.1016/j.ajodo.2024.07.001

The American Board of Orthodontics (ABO) has updated its clinical examination process to remove barriers to the case-based examination and to distinguish board-certified orthodontists from uncertified dental practitioners who provide orthodontic care. In 2017, the ABO took the bold step of adopting a new clinical examination format (a scenario-based examination), thereby, addressing the challenges that were inherent in the former case-based examination format. The coronavirus disease 2019 pandemic forced the scenario-based clinical examination scheduled for July 2020 to be canceled. This caused the ABO to regroup and adapt the scenario-based clinical examination to a format that could be administered worldwide in a testing center environment, eliminating the need to travel to St Louis, Missouri. The ABO-written examination remained unaltered.

Since the scenario-based format was adopted, 63% of the AAO members are now board-certified, and the trend is upward. In support of our mission to elevate the quality of orthodontics through certification, education, and professional collaboration, the ABO is responsible for certifying orthodontists in a fair, reliable, and valid manner. This requires continuous evaluation and review of our certification process to ensure that our examination reliably evaluates the ability of orthodontists to provide the highest level of patient care.

美国牙科正畸委员会（ABO）更新了其临床考试流程，以消除基于病例的考试的障碍，并将获得委员会认证的正畸医师与提供正畸护理的未经认证的牙科医生区分开来。2017 年，ABO 大胆地采用了新的临床考试形式（情景模拟考试），从而解决了以前基于病例的考试形式所固有的挑战。2019年冠状病毒疾病大流行迫使原定于2020年7月举行的情景模拟临床考试被迫取消。这促使 ABO 重新组合，将情景模拟临床考试调整为可在全球范围内的考试中心环境中进行的形式，从而无需前往密苏里州圣路易斯市。ABO 的书面考试则保持不变。自采用情景模拟考试形式以来，AAO 63% 的成员已获得了委员会认证，并且呈上升趋势。我们的使命是通过认证、教育和专业合作提高正畸质量，为了支持这一使命，ABO有责任以公平、可靠和有效的方式对正畸医师进行认证。这就需要对我们的认证程序进行持续的评估和审查，以确保我们的考试能够可靠地评估正畸医师提供最高水平患者护理的能力。

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引用次数: 0

How environmentally friendly is the disposal of clear aligners? A gas chromatography-mass spectrometry study. 透明对齐器的处理有多环保？气相色谱-质谱法研究。

IF 2.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

American Journal of Orthodontics and Dentofacial Orthopedics

Pub Date : 2024-10-01 DOI: 10.1016/j.ajodo.2024.08.011

Elbe Peter, J Monisha, V P Sylas, Suja Ani George

Introduction: Used clear aligner trays are often indiscriminately disposed of with general plastic waste and incinerated. This study aimed to analyze the smoke composition from incinerating 2 common aligner materials: glycol-modified polyethylene terephthalate (PET-G) and polyurethane.

Methods: Each of the 2 materials in triplets was thermoformed. The thermoformed trays were shredded and subjected individually to open-fire combustion, ignited using a methane torch, in a specially designed combustion chamber. The resultant smoke was collected and analyzed using gas chromatography-mass spectrometry to study its in-depth composition.

Results: A total of 20 peaks, corresponding to 20 compounds, were identified from each of the 2 material samples. O-xylene (21.06%) showed the maximum concentration in the PET-G sample, whereas 1,4-dimethyl-1,3-cyclohexadiene in polyurethane (18.88%). The first peak in the PET-G sample corresponded to benzene with a relative concentration of 5.18%. Four compounds were common to both samples: 1,4-dimethyl-1,3-cyclohexadiene; 1,3-cyclohexadiene, 2,3-dimethyl-; 1-hydroxymethly-4-methylenecyclohexane; and cyclohexanemethanol, 4-methylene-.

Conclusions: Benzene, a group 1 carcinogen, was identified in the PET-G smoke sample, whereas tetrahydrofuran, a suspected carcinogen, was found in the polyurethane sample. Some compounds were hazardous, whereas most were skin, eye, and respiratory irritants. Possible mitigation strategies include proper case selection, efficient manufacturing, direct 3-dimensional printing, and developing biodegradable materials. Clinicians can set up 'used aligner collection points' to ensure responsible disposal. Proper disposal guidelines and stringent regulations are the need of the hour.

介绍：用过的透明对齐器托盘经常被随意丢弃，与一般塑料垃圾一起焚烧。本研究旨在分析焚烧乙二醇改性聚对苯二甲酸乙二酯（PET-G）和聚氨酯这两种常见对齐器材料所产生的烟雾成分：方法：将 2 种材料的三联体分别进行热成型。热成型托盘被切碎，并在专门设计的燃烧室中分别进行明火燃烧，使用甲烷火炬点燃。收集所产生的烟雾，并使用气相色谱-质谱法分析其深度成分：结果：从两种材料样品中分别鉴定出 20 个峰值，对应 20 种化合物。在 PET-G 样品中，邻二甲苯（21.06%）的浓度最高，而在聚氨酯中，1,4-二甲基-1,3-环己二烯（18.88%）的浓度最高。PET-G 样品中的第一个峰值是苯，相对浓度为 5.18%。两种样品共有四种化合物：1,4-二甲基-1,3-环己二烯；1,3-环己二烯，2,3-二甲基；1-羟甲基-4-亚甲基环己烷；以及环己基甲醇，4-亚甲基：在 PET-G 烟雾样本中发现了 1 类致癌物苯，而在聚氨酯样本中发现了疑似致癌物四氢呋喃。有些化合物是有害的，而大多数是皮肤、眼睛和呼吸道刺激物。可能的缓解策略包括正确选择病例、高效制造、直接三维打印以及开发可生物降解的材料。临床医生可以设立 "废旧矫治器收集点"，确保以负责任的方式进行处理。适当的处置指南和严格的法规是当务之急。

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引用次数: 0

A card laid is a card played 出牌就是出牌。

IF 2.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

American Journal of Orthodontics and Dentofacial Orthopedics

Pub Date : 2024-10-01 DOI: 10.1016/j.ajodo.2024.07.004

引用次数: 0

October 2024 2024 年 10 月

IF 2.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

American Journal of Orthodontics and Dentofacial Orthopedics

Pub Date : 2024-10-01 DOI: 10.1016/j.ajodo.2024.08.004

引用次数: 0

Effects of curing lights on polymerization shrinkage of composite attachments in clear aligner treatment: A microcomputed tomography study. 固化灯对透明矫治器治疗中复合附着体聚合收缩的影响：微计算机断层扫描研究。

IF 2.7 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

American Journal of Orthodontics and Dentofacial Orthopedics

Pub Date : 2024-10-01 DOI: 10.1016/j.ajodo.2024.08.012

Irmak Ocak, Muge Aksu

Introduction: This study aimed to investigate the polymerization shrinkage of composite attachments and changes in attachment templates during bonding in clear aligner treatments.

Methods: A total of 24 extracted teeth were divided into 4 groups, and plaster models were digitized. Attachment templates were produced with beveled attachments on premolars and rectangular attachments on molars. Polymerizations used a halogen curing light (800 milliwatts per square centimeter [mW/cm²] for 20 seconds) and light-emitting diode (LED) curing light in 3 modes (1000 mW/cm² for 20 seconds, 1000 mW/cm² for 10 seconds, and 3200 mW/cm² for 3 seconds). The curing distance was 5 mm, and temperature changes were recorded with a thermal camera. Microcomputed tomography scanning measured volumetric and linear attachments before and after polymerization. Statistical analyses employed a 1-way analysis of variance with Bonferroni corrected Tukey post-hoc for multiple comparisons and the Kruskal-Wallis test for temperature change.

Results: Significant differences (P <0.001) were found in temperature among curing lights. The highest temperature was in the LED unit-extra mode, and the lowest was in the halogen curing unit. The LED unit for 20 seconds caused the highest temperature change. A significant difference (P = 0.048) in occlusal attachment length was found between the LED unit for 20 seconds and the LED unit-extra mode. Polymerization resulted in increased attachment template thickness across all groups, with significant changes noted in the halogen unit, LED unit for 20 seconds, and LED unit-extra mode.

Conclusions: Temperature generated during polymerization varied between halogen and LED curing lights. Significant differences were found in attachment length at the occlusal level and template thickness postpolymerization. Preferences in attachment bonding protocols may affect the clinical precision of clear aligner treatments.

简介：本研究旨在探讨透明矫治器治疗过程中复合附着体的聚合收缩和附着模板的变化：本研究旨在探讨透明矫治器治疗过程中复合附着体的聚合收缩和附着体模板的变化：方法：将 24 颗拔牙分为 4 组，并对石膏模型进行数字化处理。制作的附着体模板前磨牙为斜面附着体，磨牙为矩形附着体。聚合时使用卤素固化灯（800 毫瓦/平方厘米 [mW/cm2] 20 秒）和发光二极管固化灯（1000 毫瓦/平方厘米 20 秒、1000 毫瓦/平方厘米 10 秒和 3200 毫瓦/平方厘米 3 秒）三种模式。固化距离为 5 毫米，用热像仪记录温度变化。显微计算机断层扫描测量了聚合前后的体积和线性附着情况。统计分析采用单因素方差分析，多重比较采用 Bonferroni 校正的 Tukey post-hoc 检验，温度变化采用 Kruskal-Wallis 检验：差异显著（P卤素灯和 LED 固化灯在聚合过程中产生的温度不同。在咬合水平的附着长度和聚合后的模板厚度方面存在显著差异。对附着粘接方案的偏好可能会影响透明矫治器治疗的临床精确度。

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