American Journal of Orthodontics and Dentofacial Orthopedics最新文献

Introduction: Increased preoperative anxiety may have an adverse impact on the patient experience. This qualitative study therefore aimed to explore those factors affecting anxiety in the approach to orthognathic surgery.

Methods: A total of 28 orthognathic patients who had completed their presurgical orthodontic treatment and were within 8 weeks before their surgery underwent one-to-one in-depth interviews. The interviews explored their experience in the preoperative period, with the focus on aspects relating to anxiety. Interviews were audio-recorded and transcribed verbatim, and data were then analyzed using a thematic framework approach.

Results: Eight themes and associated subthemes were identified. The first theme related to time and described the approach to the surgery and the transience of the side effects. The second theme discussed control and how the need for control may affect anxiety; the third focused on fear related to the surgery and the element of "the unknown." The fourth theme highlighted the importance of trust between patients and clinicians, whilst the fifth focused on information and its delivery, which was crucial for managing uncertainty. The sixth theme centered on expectations about the surgery and the patient's ability to cope, and the seventh discussed coping strategies that were effective in alleviating anxiety. The final theme focused on the benefits of a strong, effective support system in reducing anxiety. No distinct typologies emerged from the data. Recommendations for consideration by clinicians are presented.

Conclusions: The findings provide a novel insight into the multifactorial nature of preoperative anxiety in orthognathic patients and also highlight the important role of the clinical team in creating a supportive environment to help reduce patient anxiety.

Introduction: This study aimed to evaluate the midpalatal suture (MPS) maturation stages using the cone-beam computed tomography classification method in Chinese children aged 5-10 years, adolescents aged 11-15 years, and postadolescents aged 16-20 years and identify a correlation between maturation stage and age and sex.

Methods: Axial sections of tomographic images from 717 participants (369 female and 348 male participants) aged 5-20 years were used to classify the maturation stage of the MPS (stages A, B, C, D, and E). Kappa statistics were used to evaluate the measurement error. The chi-square test was applied to analyze the differences in the distribution of MPS stages by age group and by sex among all participants, as well as the adolescent group. The Fisher exact test was employed to assess the differences in MPS stage distribution by sex among children aged 5-10 years and among the postadolescent group. The Mann-Whitney U test was used to assess the potential variance in age distribution between stages C and D.

Results: The most prevalent maturation stage was stage C (40.3%). Of the total population, 69.4% had MPS in stages A, B, or C. A significant difference in age distribution was observed between stage C and stage D (P <0.001). The distribution of the MPS maturation stage significantly varied by age group (P <0.001) and sex (P <0.001).

Conclusions: The distribution of participants in advanced maturation stages increases with age. Female patients generally experience earlier MPS maturation than male patients, particularly between the ages of 11-20 years.

Introduction: This study aimed to compare the transfer accuracy of indirect bonding trays of different thicknesses and numbers of pieces.

Methods: Digital indirect bonding was performed on 56 printed resin models, divided into 4 groups with 14 models in each: 1-mm 1-piece tray (OPT), 2-mm OPT, 1-mm 3-piece tray (TPT), and 2-mm TPT. The trays were designed using Appliance Designer (3Shape A/S, Copenhagen, Denmark). Angular (torque, tip, or angulation) and linear (mesiodistal, buccolingual, occlusogingival, or vertical) differences were compared by using open-source GOM Inspect software (GOM GmbH, Braunschweig, Germany).

Results: In the buccolingual direction, the 1-mm TPT (0.180 ± 0.041 mm) was significantly more accurate than the 1-mm OPT (0.240 ± 0.032 mm). In the vertical direction, significant differences were seen between the 1-mm and 2-mm OPTs (1-mm OPT: 0.220 ± 0.043 mm; 2-mm OPT: 0.428 ± 0.143 mm; P = 0.003) and between the 1-mm and 2-mm TPTs (1-mm TPT: 0.210 ± 0.072 mm; 2-mm TPT: 0.340 ± 0.062 mm; P = 0.004) in the total region. In the tip angle, significant differences were seen between the 1-mm and 2-mm OPTs and between the 1-mm OPT and TPT. In the torque angle, a significant difference was seen between the 1-mm TPT (2.815°±0.350°)and 2-mmTPT (2.368° ± 0.245°; P = 0.017).

Conclusions: Both the thickness and the splitting of the trays impacted the bracket bonding accuracy. The 1-mm trays were more accurate than the 2-mm trays. Despite a few statistically significant differences between the 1-mm OPT and TPT, the 1-mm OPT was recommended for clinical use, considering the designing and placing of the trays.

Introduction: Orthodontic tooth movement (OTM) is a biological process that can affect the vascularization of the dental pulp. The forces exerted on the teeth may increase periapical pressure that could compress the arterioles, which in turn affects pulpal blood flow (PBF). The study aimed to investigate how OTM affects PBF during orthodontic space closure.

Methods: A total of 22 adolescent participants who required orthodontic space closure in mandibular posterior sectors were enrolled in a prospective clinical study. The same sliding mechanics, wires, and active elements were used. Patients were observed before OTM, after leveling before space closure, and at the 4th, 7th, 21st, and 28th during active space closure. PBF was measured with laser Doppler (LD) flowmetry. Dental models were obtained with an intraoral scanner.

Results: The LD flow values decreased significantly during the observation period (2-way repeated measures analysis of variance, P <0.001). There was a significant difference in LD flow between tooth categories (2-way repeated measures analysis of variance, P <0.001). During space closure, the most pronounced LD flow reduction was observed in single-rooted teeth closest to the residual space. A higher speed of OTM was associated with a greater decrease in LD flow on day 4 of OTM (Pearson correlation, P = 0.0299).

Conclusions: Orthodontic space closure reduced PBF; it was lowest in the early stages of space closure and showed a tendency to increase during the first month. Anterior teeth closer to the interdental space that experiences more OTM and teeth that move faster during initial OTM had a higher risk of reduced blood flow.