Pub Date : 2024-12-14DOI: 10.1016/j.ajodo.2024.10.018
Brett Barton, Shea Jamieson, Marinho Del Santo, Manuel Lagravere Vich, Dawei Liu, Sumit Yadav, Shivam Yogesh Mehta
Introduction: This study aimed to evaluate the short-term and long-term skeletal and dental asymmetry with miniscrew-assisted rapid palatal expansion (MARPE), rapid palatal expansion (RPE), and control group using cone-beam computed tomography (CBCT) analysis.
Methods: A total of 180 CBCT scans were analyzed for 60 patients divided into 3 groups: MARPE (mean age 13.7 ± 1.74 years), RPE (mean age 13.9 ± 1.14 years), and control (mean age 13.3 ± 1.49 years). CBCT scans were recorded at 3 points: pretreatment (T1), postexpansion (T2), and posttreatment (T3). The anterior nasal spine, posterior nasal spine, zygomaticomaxillary point, anterior nasal cavity width, posterior nasal cavity width (PNCW), external maxillary width, palatal width, and molar inclination were measured on the left and right sides in all CBCT scans. In addition, maxillary molar width (MMW) and maxillary canine width were also evaluated on the left and right sides. Statistical analysis was performed, and the parameters were tested within the groups from T1 to T2 and T1 to T3 using a paired t test. The mean changes were then compared among the 3 groups by a mixed analysis of variance test.
Results: The RPE group showed significantly greater MMW on the left and right sides at T2 (P <0.05). MARPE and RPE led to a significant increase in the anterior nasal spine (right and left), zygomaticomaxillary point (right and left), anterior nasal cavity width (right and left), PNCW (right and left), external maxillary width (right and left), palatal width (right and left), MMW (right and left), maxillary canine width (right and left), and posterior nasal spine (left) at T2 compared with control (P <0.05). RPE led to a significant increase in the molar inclination (right and left) compared with MARPE and controls at T2. In the long term, the PNCW (right and left) was greater in MARPE compared with RPE and controls (P <0.05).
Conclusions: Within-group comparisons showed that there was no significant asymmetry in the MARPE and control group in the short and long term. The asymmetry for the RPE group was isolated to the MMW in the short term but not observed in the long term, and the magnitude of the asymmetry was clinically not significant.
{"title":"Long-term assessment of skeletal and dental asymmetry after conventional and mini-implant-assisted rapid palatal expansion.","authors":"Brett Barton, Shea Jamieson, Marinho Del Santo, Manuel Lagravere Vich, Dawei Liu, Sumit Yadav, Shivam Yogesh Mehta","doi":"10.1016/j.ajodo.2024.10.018","DOIUrl":"https://doi.org/10.1016/j.ajodo.2024.10.018","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the short-term and long-term skeletal and dental asymmetry with miniscrew-assisted rapid palatal expansion (MARPE), rapid palatal expansion (RPE), and control group using cone-beam computed tomography (CBCT) analysis.</p><p><strong>Methods: </strong>A total of 180 CBCT scans were analyzed for 60 patients divided into 3 groups: MARPE (mean age 13.7 ± 1.74 years), RPE (mean age 13.9 ± 1.14 years), and control (mean age 13.3 ± 1.49 years). CBCT scans were recorded at 3 points: pretreatment (T1), postexpansion (T2), and posttreatment (T3). The anterior nasal spine, posterior nasal spine, zygomaticomaxillary point, anterior nasal cavity width, posterior nasal cavity width (PNCW), external maxillary width, palatal width, and molar inclination were measured on the left and right sides in all CBCT scans. In addition, maxillary molar width (MMW) and maxillary canine width were also evaluated on the left and right sides. Statistical analysis was performed, and the parameters were tested within the groups from T1 to T2 and T1 to T3 using a paired t test. The mean changes were then compared among the 3 groups by a mixed analysis of variance test.</p><p><strong>Results: </strong>The RPE group showed significantly greater MMW on the left and right sides at T2 (P <0.05). MARPE and RPE led to a significant increase in the anterior nasal spine (right and left), zygomaticomaxillary point (right and left), anterior nasal cavity width (right and left), PNCW (right and left), external maxillary width (right and left), palatal width (right and left), MMW (right and left), maxillary canine width (right and left), and posterior nasal spine (left) at T2 compared with control (P <0.05). RPE led to a significant increase in the molar inclination (right and left) compared with MARPE and controls at T2. In the long term, the PNCW (right and left) was greater in MARPE compared with RPE and controls (P <0.05).</p><p><strong>Conclusions: </strong>Within-group comparisons showed that there was no significant asymmetry in the MARPE and control group in the short and long term. The asymmetry for the RPE group was isolated to the MMW in the short term but not observed in the long term, and the magnitude of the asymmetry was clinically not significant.</p>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-14DOI: 10.1016/j.ajodo.2024.10.014
Yuchao Shi, Jiayin Ren, Kaili Wang, Li Liu, Hu Wang, Meng You
Introduction
Cleidocranial dysplasia (CCD) is a genetic disorder characterized by distinctive oral manifestations, making dental anomalies a key diagnostic criterion and treatment focus.
Methods
We retrospectively enrolled 32 patients diagnosed with CCD with detailed dental records (19 males and 13 females; mean age, 20.5 years). The detailed characteristics of impacted permanent teeth and supernumerary teeth were analyzed, and treatment considerations and outcomes for the abnormal dentition were summarized.
Results
Among permanent teeth, 43.53% were impacted. A significant variation in the likelihood of tooth impaction was observed depending on the tooth position. On the basis of nonlinear regression analysis, this study identified a clear trend correlating the probability of impacted teeth with the sequence of permanent tooth eruption, with this probability exhibiting a distinct increase followed by a decrease (with R2 values in female and male patients of 0.65 and 0.84, respectively). In addition, 27 patients (84.4%) had supernumerary teeth, with 206 supernumerary teeth identified, predominantly of the supplemental premolar type (75.73%). There was a correlation between the morphology of supplemental teeth and their locations in the dentition. Among 10 patients with follow-up periods of >2 years, 117 impacted teeth were recorded, 61 teeth were involved in the treatment, 16 (26.23%) erupted after the extraction of retained deciduous or supernumerary teeth, and 33 teeth (54.10%) were successfully erupted through orthodontic traction. However, orthodontic treatment requires an extended period, and the periodontal conditions of treated teeth may require long-term maintenance.
Conclusions
This study reveals a potential relationship between tooth impaction and the sequence of tooth eruption. It also distinguishes the distribution and morphologic characteristics of supernumerary teeth in patients with CCD from those in the general population. In addition, by analyzing clinical data, this study provides a summary of treatment considerations and outcomes for abnormal dentition in patients with CCD.
{"title":"Exploring the complexities of cleidocranial dysplasia: Dental anomalies and treatment interventions","authors":"Yuchao Shi, Jiayin Ren, Kaili Wang, Li Liu, Hu Wang, Meng You","doi":"10.1016/j.ajodo.2024.10.014","DOIUrl":"10.1016/j.ajodo.2024.10.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Cleidocranial dysplasia (CCD) is a genetic disorder characterized by distinctive oral manifestations, making dental anomalies a key diagnostic criterion and treatment focus.</div></div><div><h3>Methods</h3><div>We retrospectively enrolled 32 patients diagnosed with CCD with detailed dental records (19 males and 13 females; mean age, 20.5 years). The detailed characteristics of impacted permanent teeth and supernumerary teeth were analyzed, and treatment considerations and outcomes for the abnormal dentition were summarized.</div></div><div><h3>Results</h3><div>Among permanent teeth, 43.53% were impacted. A significant variation in the likelihood of tooth impaction was observed depending on the tooth position. On the basis of nonlinear regression analysis, this study identified a clear trend correlating the probability of impacted teeth with the sequence of permanent tooth eruption, with this probability exhibiting a distinct increase followed by a decrease (with <em>R</em><sup>2</sup> values in female and male patients of 0.65 and 0.84, respectively). In addition, 27 patients (84.4%) had supernumerary teeth, with 206 supernumerary teeth identified, predominantly of the supplemental premolar type (75.73%). There was a correlation between the morphology of supplemental teeth and their locations in the dentition. Among 10 patients with follow-up periods of >2 years, 117 impacted teeth were recorded, 61 teeth were involved in the treatment, 16 (26.23%) erupted after the extraction of retained deciduous or supernumerary teeth, and 33 teeth (54.10%) were successfully erupted through orthodontic traction. However, orthodontic treatment requires an extended period, and the periodontal conditions of treated teeth may require long-term maintenance.</div></div><div><h3>Conclusions</h3><div>This study reveals a potential relationship between tooth impaction and the sequence of tooth eruption. It also distinguishes the distribution and morphologic characteristics of supernumerary teeth in patients with CCD from those in the general population. In addition, by analyzing clinical data, this study provides a summary of treatment considerations and outcomes for abnormal dentition in patients with CCD.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"167 3","pages":"Pages 319-330.e2"},"PeriodicalIF":2.7,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-14DOI: 10.1016/j.ajodo.2024.10.015
Abdelhak Ouldyerou , Peter Ngan , Khaled Alsharif , Ali Merdji , Osama M. Mukdadi
Introduction
Microimplant-assisted rapid palatal expansion appliances have been used for the treatment of orthodontic patients with maxillary deficiency. A new design named ATOZ (applicable from A to Z) was recently introduced to expand the scope of treatment in early permanent dentition. The objective of this study was to analyze the biomechanical performance of the ATOZ expander with various microimplants configurations using finite-element method.
Methods
Nine ATOZ models were designed based on the number of microimplants configurations on the palate. For skeletal maturation, stage B midpalatal suture (MPS) maturation classification was chosen. A displacement along the sagittal axis, parallel to the MPS, of 0.15 mm was applied on each side of the device to simulate a 1 jackscrew turn of 0.3 mm.
Results
Configurations 1, 2, 6, and 7 achieved a quasi-parallel skeletal movement with a uniform distribution of displacement in the maxilla. The highest posterior nasal spine to anterior nasal spine ratio of 95.95% was found with configuration 6, indicating an optimum quasi-parallel expansion. For configuration 2, microimplants 1 and 2 exhibited stresses of 619.18 MPa and 656.49 MPa, respectively, whereas microimplants 7 and 8 showed stresses of 609.64 MPa and 658.30 MPa, respectively. Maximum stress in zygomatic bone was 0.69 MPa. Higher stresses were more distributed in the zygomaticofrontal suture than in zygomaticotemporal and zygomaticomaxillary sutures.
Conclusions
In terms of posterior nasal spine to anterior nasal spine ratio, skeletal-to-dental ratio, and MPS deformation, ATOZ with configurations 1, 2, and 6 outperform other configurations, and thus, they can be recommended for correction of maxillary deficiency in patients with skeletal maturation of stage B or earlier.
{"title":"Biomechanical performance of ATOZ expander: Finite-element analysis","authors":"Abdelhak Ouldyerou , Peter Ngan , Khaled Alsharif , Ali Merdji , Osama M. Mukdadi","doi":"10.1016/j.ajodo.2024.10.015","DOIUrl":"10.1016/j.ajodo.2024.10.015","url":null,"abstract":"<div><h3>Introduction</h3><div>Microimplant-assisted rapid palatal expansion appliances have been used for the treatment of orthodontic patients with maxillary deficiency. A new design named ATOZ (applicable from A to Z) was recently introduced to expand the scope of treatment in early permanent dentition. The objective of this study was to analyze the biomechanical performance of the ATOZ expander with various microimplants configurations using finite-element method.</div></div><div><h3>Methods</h3><div>Nine ATOZ models were designed based on the number of microimplants configurations on the palate. For skeletal maturation, stage B midpalatal suture (MPS) maturation classification was chosen. A displacement along the sagittal axis, parallel to the MPS, of 0.15 mm was applied on each side of the device to simulate a 1 jackscrew turn of 0.3 mm.</div></div><div><h3>Results</h3><div>Configurations 1, 2, 6, and 7 achieved a quasi-parallel skeletal movement with a uniform distribution of displacement in the maxilla. The highest posterior nasal spine to anterior nasal spine ratio of 95.95% was found with configuration 6, indicating an optimum quasi-parallel expansion. For configuration 2, microimplants 1 and 2 exhibited stresses of 619.18 MPa and 656.49 MPa, respectively, whereas microimplants 7 and 8 showed stresses of 609.64 MPa and 658.30 MPa, respectively. Maximum stress in zygomatic bone was 0.69 MPa. Higher stresses were more distributed in the zygomaticofrontal suture than in zygomaticotemporal and zygomaticomaxillary sutures.</div></div><div><h3>Conclusions</h3><div>In terms of posterior nasal spine to anterior nasal spine ratio, skeletal-to-dental ratio, and MPS deformation, ATOZ with configurations 1, 2, and 6 outperform other configurations, and thus, they can be recommended for correction of maxillary deficiency in patients with skeletal maturation of stage B or earlier.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"167 3","pages":"Pages 331-344"},"PeriodicalIF":2.7,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-10DOI: 10.1016/j.ajodo.2024.10.011
Çağrı Yeşildağ, Fundagül Bilgiç Zortuk
Introduction
This cross-sectional case-control observational study aimed to use lateral cephalometric radiographs to examine the 1-year follow-up results of 3 different treatment methods during Class II correction.
Methods
The authors evaluated the lateral cephalometric records of patients treated with the Forsus fatigue-resistant device (group 1, n = 28), cervical headgears (CHG; group 2, n = 28), and maxillary first premolar extraction with fixed orthodontic appliances (group 3, n = 28). Each group was followed at pretreatment, posttreatment, and 1-year posttreatment. The data obtained were analyzed using the 1-way analysis of variance and Kruskal-Wallis methods.
Results
At posttreatment, the ANB angle decreased significantly (P = 0.001) in the CHG group compared with the Forsus and extraction groups. The lower and upper facial heights of the CHG group were significantly increased (P <0.001) at posttreatment compared with the other groups. The mandibular incisor protrusion in the Forsus group was significantly higher (P = 0.005) than in the extraction patients, and extrusion of the mandibular incisors was significantly higher (P = 0.002) in the CHG group than in the Forsus group at posttreatment.
Conclusions
All 3 methods were effective in correcting Class II malocclusion, mainly at the dentoalveolar level, but some amount of relapses occurred after 1-year of follow-up. Distance of mandibular incisors and the mandibular plane changed significantly, increasing in CHG and extraction groups after 1-year of follow-up.
{"title":"Comparison of 1-year follow-up results of Forsus, headgear, and extraction treatment in Class II malocclusion","authors":"Çağrı Yeşildağ, Fundagül Bilgiç Zortuk","doi":"10.1016/j.ajodo.2024.10.011","DOIUrl":"10.1016/j.ajodo.2024.10.011","url":null,"abstract":"<div><h3>Introduction</h3><div>This cross-sectional case-control observational study aimed to use lateral cephalometric radiographs to examine the 1-year follow-up results of 3 different treatment methods during Class II correction.</div></div><div><h3>Methods</h3><div>The authors evaluated the lateral cephalometric records of patients treated with the Forsus fatigue-resistant device (group 1, n = 28), cervical headgears (CHG; group 2, n = 28), and maxillary first premolar extraction with fixed orthodontic appliances (group 3, n = 28). Each group was followed at pretreatment, posttreatment, and 1-year posttreatment. The data obtained were analyzed using the 1-way analysis of variance and Kruskal-Wallis methods.</div></div><div><h3>Results</h3><div>At posttreatment, the ANB angle decreased significantly (<em>P</em> = 0.001) in the CHG group compared with the Forsus and extraction groups. The lower and upper facial heights of the CHG group were significantly increased (<em>P</em> <0.001) at posttreatment compared with the other groups. The mandibular incisor protrusion in the Forsus group was significantly higher (<em>P</em> = 0.005) than in the extraction patients, and extrusion of the mandibular incisors was significantly higher (<em>P</em> = 0.002) in the CHG group than in the Forsus group at posttreatment.</div></div><div><h3>Conclusions</h3><div>All 3 methods were effective in correcting Class II malocclusion, mainly at the dentoalveolar level, but some amount of relapses occurred after 1-year of follow-up. Distance of mandibular incisors and the mandibular plane changed significantly, increasing in CHG and extraction groups after 1-year of follow-up.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"167 3","pages":"Pages 273-281"},"PeriodicalIF":2.7,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-06DOI: 10.1016/j.ajodo.2024.10.016
Hasan Camcı , Zeynep Çoban Büyükbayraktar
Annual plastic production worldwide has reached unprecedented levels, whereas the amount of plastic being recycled remains significantly low compared with production rates. This trend is similarly reflected in the use of clear aligners, which are becoming increasingly popular. The purpose of this review, which was one of the topics discussed at the AAO 2023 Winter Conference, is to raise awareness among patients and orthodontists regarding the environmental impact of aligners, assess whether aligners pose a threat to our planet, and propose potential solutions to the existing challenges.
{"title":"Aligners from another perspective: Could they be a long-term environmental threat? Problems and potential remedies","authors":"Hasan Camcı , Zeynep Çoban Büyükbayraktar","doi":"10.1016/j.ajodo.2024.10.016","DOIUrl":"10.1016/j.ajodo.2024.10.016","url":null,"abstract":"<div><div>Annual plastic production worldwide has reached unprecedented levels, whereas the amount of plastic being recycled remains significantly low compared with production rates. This trend is similarly reflected in the use of clear aligners, which are becoming increasingly popular. The purpose of this review, which was one of the topics discussed at the AAO 2023 Winter Conference, is to raise awareness among patients and orthodontists regarding the environmental impact of aligners, assess whether aligners pose a threat to our planet, and propose potential solutions to the existing challenges.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"167 3","pages":"Pages 256-260"},"PeriodicalIF":2.7,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-04DOI: 10.1016/j.ajodo.2024.10.010
Tugce Ergul, Aysegul Gulec
Introduction
This study aimed to compare the efficiency of maxillary protraction achieved through facemask treatment with either a hybrid-hyrax (HH) or an acrylic cap splint (ACS) appliance when used in conjunction with alternate rapid maxillary expansion and constriction (Alt-RAMEC) or conventional rapid maxillary expansion (RME) protocols.
Methods
This study analyzed a total of 60 patients in 4 groups of 15 patients each and treated with HH-Alt-RAMEC protocol (HH-Alt, aged 10.38 ± 1.19 years), ACS-Alt protocol (aged 10.43 ± 0.99 years), HH-RME protocol (aged 9.74 ± 1.05 years) and ACS-RME protocol (aged 10.70 ± 0.98 years). Lateral cephalograms were taken before and after the facemask were compared. A 1-way analysis of variance with a Tukey honest significant difference post-hoc test was used for intergroup comparisons, whereas a paired sample t test was employed for intragroup comparisons.
Results
Correction of Class III skeletal malocclusion was achieved in all groups. HH-Alt showed significantly more maxillary protraction with an increase in AVRP of 4.02 mm compared with 2.65 mm in ACS-Alt and 2.3 mm in ACS-RME (P <0.001). HH-RME also showed a significantly more maxillary protraction in AVRP of 3.58 mm compared with 2.3 mm in ACS-RME (P <0.001). The rate of protraction was higher in HH-Alt (0.61 ± 0.16) and HH-RME (0.56 ± 0.29) than in ACS-RME (0.31 ± 0.12). The maxilla showed significantly more rotation in ACS-Alt (−1.66° ± 1.13°) and ACS-RME (−1.97 ± 1.75°) than in HH-Alt (−0.49° ± 1.18°) and HH-RME (−0.35° ± 1.86°), whereas the mandible showed significantly more clockwise rotation in ACS-RME (2.08 ± 1.71) than in HH-Alt (0.80 ± 0.94) and HH-RME (0.63 ± 1.82). The maxillary skeletal effect in the overjet correction was greater in HH-Alt (71.0%).
Conclusions
All treatment options achieved maxillary protraction. In the short term, hybrid groups (HH-Alt and HH-RME) provide more effective maxillary skeletal protraction than ACS-RME and demonstrate superior control in the vertical dimension than in tooth-borne groups. The Alt-RAMEC protocol improved the amount of maxillary protraction of the tooth-borne appliance group. The choice of anchorage of the appliance (skeletal or tooth-borne) is found to be more critical than the expansion method (RME or Alt-RAMEC).
简介：本研究旨在比较面罩治疗与交替快速上颌扩张和收缩（Alt-RAMEC）或常规快速上颌扩张（RME）方案联合使用时，混合hyrax （HH）或丙烯酸帽夹板（ACS）治疗获得的上颌牵引效率。方法：本研究共分析4组患者60例，每组15例，采用HH-Alt- ramec方案（HH-Alt，年龄10.38±1.19岁）、ACS-Alt方案（年龄10.43±0.99岁）、HH-RME方案（年龄9.74±1.05岁）和ACS-RME方案（年龄10.70±0.98岁）治疗。比较蒙面前后的侧位脑片。组间比较采用单因素方差分析和显著性差异事后检验，组内比较采用配对样本t检验。结果：所有组均能矫正III类骨错。与ACS-Alt组的2.65 mm和ACS-RME组的2.3 mm相比，HH-Alt组明显增加上颌前伸，AVRP增加4.02 mm (P)。在短期内，混合组（HH-Alt和HH-RME）比ACS-RME提供更有效的上颌骨骼拉伸，并且在垂直尺寸上的控制优于牙源组。Alt-RAMEC方案提高了牙载矫治器组上颌伸出量。矫治器锚定的选择（骨骼或牙齿）被发现比扩展方法（RME或Alt-RAMEC）更为关键。
{"title":"Comparison of the effectiveness of skeletal and tooth-borne protraction methods with or without alternate rapid maxillary expansion and constriction protocol in patients with Class III malocclusion","authors":"Tugce Ergul, Aysegul Gulec","doi":"10.1016/j.ajodo.2024.10.010","DOIUrl":"10.1016/j.ajodo.2024.10.010","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to compare the efficiency of maxillary protraction achieved through facemask treatment with either a hybrid-hyrax (HH) or an acrylic cap splint (ACS) appliance when used in conjunction with alternate rapid maxillary expansion and constriction (Alt-RAMEC) or conventional rapid maxillary expansion (RME) protocols.</div></div><div><h3>Methods</h3><div>This study analyzed a total of 60 patients in 4 groups of 15 patients each and treated with HH-Alt-RAMEC protocol (HH-Alt, aged 10.38 ± 1.19 years), ACS-Alt protocol (aged 10.43 ± 0.99 years), HH-RME protocol (aged 9.74 ± 1.05 years) and ACS-RME protocol (aged 10.70 ± 0.98 years). Lateral cephalograms were taken before and after the facemask were compared. A 1-way analysis of variance with a Tukey honest significant difference post-hoc test was used for intergroup comparisons, whereas a paired sample <em>t</em> test was employed for intragroup comparisons.</div></div><div><h3>Results</h3><div>Correction of Class III skeletal malocclusion was achieved in all groups. HH-Alt showed significantly more maxillary protraction with an increase in AVRP of 4.02 mm compared with 2.65 mm in ACS-Alt and 2.3 mm in ACS-RME (<em>P</em> <0.001). HH-RME also showed a significantly more maxillary protraction in AVRP of 3.58 mm compared with 2.3 mm in ACS-RME (<em>P</em> <0.001). The rate of protraction was higher in HH-Alt (0.61 ± 0.16) and HH-RME (0.56 ± 0.29) than in ACS-RME (0.31 ± 0.12). The maxilla showed significantly more rotation in ACS-Alt (−1.66° ± 1.13°) and ACS-RME (−1.97 ± 1.75°) than in HH-Alt (−0.49° ± 1.18°) and HH-RME (−0.35° ± 1.86°), whereas the mandible showed significantly more clockwise rotation in ACS-RME (2.08 ± 1.71) than in HH-Alt (0.80 ± 0.94) and HH-RME (0.63 ± 1.82). The maxillary skeletal effect in the overjet correction was greater in HH-Alt (71.0%).</div></div><div><h3>Conclusions</h3><div>All treatment options achieved maxillary protraction. In the short term, hybrid groups (HH-Alt and HH-RME) provide more effective maxillary skeletal protraction than ACS-RME and demonstrate superior control in the vertical dimension than in tooth-borne groups. The Alt-RAMEC protocol improved the amount of maxillary protraction of the tooth-borne appliance group. The choice of anchorage of the appliance (skeletal or tooth-borne) is found to be more critical than the expansion method (RME or Alt-RAMEC).</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"167 3","pages":"Pages 282-295"},"PeriodicalIF":2.7,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142787637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-30DOI: 10.1016/j.ajodo.2024.10.013
David W. Chambers , Nicholas M. Vermette
Introduction
Norms for mandibular growth are well-established, but they have large variances, and no research has been conducted on how practitioners use them in clinical judgment to guide the treatment of individual patients.
Methods
Co-Pog projections of mandibular growth were combined from the Burlington and Michigan growth studies following statistical adjustments. Cervical measures were also evaluated. Photographs of complete records for 2 males and 2 females aged approximately 12 years with mandibular length matched age and sex norms were presented to 29 practicing orthodontics. Initial treatment plans and changes in treatment, if any, were noted across a projected range in 2-year mandibular growth.
Results
A large variance was noted in the growth norms. Stepwise multiple regression found insignificant improvements in predictions when cervical vertebral maturation scores were added to age and sex. Comparably large variation was also observed across practitioners in their initial treatment plans given common patient information. Moreover, 4 in 10 practitioners would not change their initially proposed treatment, given growth projections varying between 0-7 mm over 2 years. Others were sensitive only to small or large changes or used a range smaller than the variance in the norms. Between a quarter and a third of the variance in changed treatment plans was a function of differences between practitioners, whereas almost none was attributable to expected growth in patients.
Conclusions
This study represents the integration of the established literature with practitioner experience called for in the American Dental Association concept of evidence-based dentistry. It was found that there was substantial variance in both established norms for mandibular growth and the role claimed for precise estimates of growth play in treatment planning. The latter appears to be the larger of the two.
{"title":"Bridging from research evidence to treatment decisions: The case of treatment based on predicted mandibular growth","authors":"David W. Chambers , Nicholas M. Vermette","doi":"10.1016/j.ajodo.2024.10.013","DOIUrl":"10.1016/j.ajodo.2024.10.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Norms for mandibular growth are well-established, but they have large variances, and no research has been conducted on how practitioners use them in clinical judgment to guide the treatment of individual patients.</div></div><div><h3>Methods</h3><div>Co-Pog projections of mandibular growth were combined from the Burlington and Michigan growth studies following statistical adjustments. Cervical measures were also evaluated. Photographs of complete records for 2 males and 2 females aged approximately 12 years with mandibular length matched age and sex norms were presented to 29 practicing orthodontics. Initial treatment plans and changes in treatment, if any, were noted across a projected range in 2-year mandibular growth.</div></div><div><h3>Results</h3><div>A large variance was noted in the growth norms. Stepwise multiple regression found insignificant improvements in predictions when cervical vertebral maturation scores were added to age and sex. Comparably large variation was also observed across practitioners in their initial treatment plans given common patient information. Moreover, 4 in 10 practitioners would not change their initially proposed treatment, given growth projections varying between 0-7 mm over 2 years. Others were sensitive only to small or large changes or used a range smaller than the variance in the norms. Between a quarter and a third of the variance in changed treatment plans was a function of differences between practitioners, whereas almost none was attributable to expected growth in patients.</div></div><div><h3>Conclusions</h3><div>This study represents the <em>integration</em> of the established literature with practitioner experience called for in the American Dental Association concept of evidence-based dentistry. It was found that there was substantial variance in both established norms for mandibular growth and the role claimed for precise estimates of growth play in treatment planning. The latter appears to be the larger of the two.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"167 3","pages":"Pages 309-318"},"PeriodicalIF":2.7,"publicationDate":"2024-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-21DOI: 10.1016/j.ajodo.2024.09.016
Carolina Rojo Sanchis , Juan Carlos Pérez-Varela , Natalia Zamora-Martínez , Verónica García-Sanz , Beatriz Tarazona-Álvarez , Vanessa Paredes-Gallardo
Introduction
The infrazygomatic bone crest and other extraalveolar regions represent a viable option for the placement of temporary anchorage devices when distalizing the maxillary arch. This approach allows for the movement of the dentition without concern for potential collisions among dental structures. Nevertheless, it is of the utmost importance to conduct a thorough examination of the anatomy of this region before the placement of mini-implants to prevent potential injuries, such as maxillary sinus perforations. The objective of this study was to quantify the depth of the infrazygomatic crest and evaluate its correlations with age, gender, skeletal classification, and vertical pattern.
Methods
The study sample of this cross-sectional, retrospective study consisted of 201 cone-beam computed tomography scans collected from patients treated at the Master’s program in orthodontics at the University of Valencia and at a private dental clinic. The cone-beam computed tomography scans were collected for 5 years, from January 2017 to May 2022. The total and intraalveolar lengths were defined and measured at 3 points: the distal roots of the maxillary second molars, the distal roots of the maxillary first molars, and the mesial roots of the maxillary first molars. These measurements were taken on both the right and left sides using the Carestream 3D Imaging System (Atlanta, Ga).
Results
The total length (TL) at the mesiobuccal level of the first molars was found to be significantly longer on both sides (P = 0.001). The intraalveolar length exhibited statistically significant differences between the right and left sides, with those of the left side exhibiting greater length (P <0.001). The normodivergent patterns demonstrated lower TL values than hypodivergent (P = 0.006) and hyperdivergent patterns (P = 0.033).
Conclusions
A statistically significant inverse relationship was observed between the distance from the cementoenamel junction to the vestibular bone crest and the total and intraalveolar lengths in the studied regions. The TL was greatest in the region of the mesiobuccal root of the maxillary first molars, followed by the region of the distal root of the second molars, and finally, the region of the distobuccal root of the maxillary first molars. Patients with normodivergent patterns exhibited the lowest total infrazygomatic ridge height.
{"title":"Optimal sites for mini-implant insertion into the infrazygomatic crest according to different craniofacial morphologies: A cross-sectional cone-beam computed tomography study","authors":"Carolina Rojo Sanchis , Juan Carlos Pérez-Varela , Natalia Zamora-Martínez , Verónica García-Sanz , Beatriz Tarazona-Álvarez , Vanessa Paredes-Gallardo","doi":"10.1016/j.ajodo.2024.09.016","DOIUrl":"10.1016/j.ajodo.2024.09.016","url":null,"abstract":"<div><h3>Introduction</h3><div>The infrazygomatic bone crest and other extraalveolar regions represent a viable option for the placement of temporary anchorage devices when distalizing the maxillary arch. This approach allows for the movement of the dentition without concern for potential collisions among dental structures. Nevertheless, it is of the utmost importance to conduct a thorough examination of the anatomy of this region before the placement of mini-implants to prevent potential injuries, such as maxillary sinus perforations. The objective of this study was to quantify the depth of the infrazygomatic crest and evaluate its correlations with age, gender, skeletal classification, and vertical pattern.</div></div><div><h3>Methods</h3><div>The study sample of this cross-sectional, retrospective study consisted of 201 cone-beam computed tomography scans collected from patients treated at the Master’s program in orthodontics at the University of Valencia and at a private dental clinic. The cone-beam computed tomography scans were collected for 5 years, from January 2017 to May 2022. The total and intraalveolar lengths were defined and measured at 3 points: the distal roots of the maxillary second molars, the distal roots of the maxillary first molars, and the mesial roots of the maxillary first molars. These measurements were taken on both the right and left sides using the Carestream 3D Imaging System (Atlanta, Ga).</div></div><div><h3>Results</h3><div>The total length (TL) at the mesiobuccal level of the first molars was found to be significantly longer on both sides (<em>P</em> = 0.001). The intraalveolar length exhibited statistically significant differences between the right and left sides, with those of the left side exhibiting greater length (<em>P</em> <0.001). The normodivergent patterns demonstrated lower TL values than hypodivergent (<em>P</em> = 0.006) and hyperdivergent patterns (<em>P</em> = 0.033).</div></div><div><h3>Conclusions</h3><div>A statistically significant inverse relationship was observed between the distance from the cementoenamel junction to the vestibular bone crest and the total and intraalveolar lengths in the studied regions. The TL was greatest in the region of the mesiobuccal root of the maxillary first molars, followed by the region of the distal root of the second molars, and finally, the region of the distobuccal root of the maxillary first molars. Patients with normodivergent patterns exhibited the lowest total infrazygomatic ridge height.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"167 3","pages":"Pages 261-272"},"PeriodicalIF":2.7,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/j.ajodo.2024.07.020
Tarek ElShebiny , Amanda Eden Paradis , Fred Kurtis Kasper , Juan Martin Palomo
Introduction
Digital orthodontics is here to make our specialty more efficient, and the integration of artificial intelligence (AI) is no exception. This study aimed to compare the accuracy of a workflow involving virtual bracket removal (VBR) by AI to traditional bracket removal. A secondary objective was to compare the clinical fit of thermoplastic orthodontic retainers fabricated from 3-dimensional (3D) printed models created by each method.
Methods
Thirty dental arches were scanned intraorally with the fixed labial orthodontic brackets in place, creating 30 standard tessellation language (STL) files which were labeled “pre-debond.” For each patient, all brackets and residual adhesive were then clinically removed, and an additional intraoral scan was taken and labeled “post-debond.” Each pre-debond scan was uploaded to the uDesign by uLab software (version 7.0; uLab Systems, Inc, Memphis, Tenn), which uses AI to virtually remove orthodontic brackets using 1-touch bracket identification. New STL files were created for each of the 30 arches and labeled VBR. Best fit superimpositions were performed using Geomagic Control X (3D Systems, Inc, Rock Hill, SC), and data were collected as both numerical values and color-coded deviation maps. Superimposition data were segmented for each arch (anterior, posterior right, and posterior left) to determine if the arch location was a relevant factor. All post-debond and VBR STL files were 3D printed. Thermoplastic retainers were fabricated on each 3D-printed model. Retainers were delivered to patients and clinically graded by 2 practitioners.
Results
There was a statistically significant difference in standard deviation and out-of-tolerance percentage values when comparing traditional debonded arches and virtually debonded arches when using sextant locations as a factor (anterior, posterior right, and posterior left). Grading scores for both evaluators show a statistically significant difference for the evaluation of facial surface adaptation and snap-fit acceptability between retainer fabrication methods. However, there was no correlation between out-of-tolerance values and clinical retainer fit evaluation among any of the graded variables in either the maxillary or mandibular arches.
Conclusions
VBR by AI is considered accurate enough to be used for the fabrication of clinically acceptable thermoplastic orthodontic retainers.
导言：数字化正畸技术的出现使我们的专业更加高效，人工智能（AI）的整合也不例外。本研究旨在比较人工智能虚拟托槽去除（VBR）工作流程与传统托槽去除工作流程的准确性。次要目的是比较根据每种方法创建的三维（3D）打印模型制作的热塑性正畸保持器的临床密合度：方法：在固定唇侧正畸托槽就位的情况下，对 30 个牙弓进行口内扫描，创建 30 个标有 "预粘结 "的标准网格语言（STL）文件。然后在临床上去除每位患者的所有托槽和残留粘合剂，再进行一次口内扫描，并标记为 "粘接后"。每个粘接前扫描结果都被上传到 uDesign by uLab 软件（7.0 版；uLab Systems, Inc, Memphis, Tenn）中，该软件使用人工智能技术，通过一触式托槽识别来虚拟移除正畸托槽。为 30 个牙弓中的每个创建了新的 STL 文件，并标记为 VBR。使用 Geomagic Control X（3D Systems, Inc, Rock Hill, SC）进行最佳拟合叠加，并以数值和彩色编码偏差图的形式收集数据。对每个牙弓（前牙弓、右后牙弓和左后牙弓）的叠加数据进行分割，以确定牙弓位置是否是相关因素。对所有粘接后和 VBR STL 文件进行 3D 打印。在每个 3D 打印模型上制作热塑保持器。将保持器交付给患者，并由两名医师进行临床分级：结果：当将六分仪位置作为一个因素（前方、右后方和左后方）时，比较传统脱骨牙弓和虚拟脱骨牙弓的标准偏差和超出公差百分比值时，两者之间存在显著的统计学差异。两位评价者的评分显示，不同固位体制作方法对面部表面适应性和卡合可接受性的评价存在显著的统计学差异。然而，在上颌或下颌牙弓的任何分级变量中，超出公差值与临床保持器密合度评价之间都没有相关性：人工智能 VBR 被认为足够精确，可用于制作临床上可接受的热塑性正畸保持器。
{"title":"Assessment of virtual bracket removal by artificial intelligence and thermoplastic retainer fit","authors":"Tarek ElShebiny , Amanda Eden Paradis , Fred Kurtis Kasper , Juan Martin Palomo","doi":"10.1016/j.ajodo.2024.07.020","DOIUrl":"10.1016/j.ajodo.2024.07.020","url":null,"abstract":"<div><h3>Introduction</h3><div>Digital orthodontics is here to make our specialty more efficient, and the integration of artificial intelligence (AI) is no exception. This study aimed to compare the accuracy of a workflow involving virtual bracket removal (VBR) by AI to traditional bracket removal. A secondary objective was to compare the clinical fit of thermoplastic orthodontic retainers fabricated from 3-dimensional (3D) printed models created by each method.</div></div><div><h3>Methods</h3><div>Thirty dental arches were scanned intraorally with the fixed labial orthodontic brackets in place, creating 30 standard tessellation language (STL) files which were labeled “pre-debond.” For each patient, all brackets and residual adhesive were then clinically removed, and an additional intraoral scan was taken and labeled “post-debond.” Each pre-debond scan was uploaded to the uDesign by uLab software (version 7.0; uLab Systems, Inc, Memphis, Tenn), which uses AI to virtually remove orthodontic brackets using 1-touch bracket identification. New STL files were created for each of the 30 arches and labeled VBR. Best fit superimpositions were performed using Geomagic Control X (3D Systems, Inc, Rock Hill, SC), and data were collected as both numerical values and color-coded deviation maps. Superimposition data were segmented for each arch (anterior, posterior right, and posterior left) to determine if the arch location was a relevant factor. All post-debond and VBR STL files were 3D printed. Thermoplastic retainers were fabricated on each 3D-printed model. Retainers were delivered to patients and clinically graded by 2 practitioners.</div></div><div><h3>Results</h3><div>There was a statistically significant difference in standard deviation and out-of-tolerance percentage values when comparing traditional debonded arches and virtually debonded arches when using sextant locations as a factor (anterior, posterior right, and posterior left). Grading scores for both evaluators show a statistically significant difference for the evaluation of facial surface adaptation and snap-fit acceptability between retainer fabrication methods. However, there was no correlation between out-of-tolerance values and clinical retainer fit evaluation among any of the graded variables in either the maxillary or mandibular arches.</div></div><div><h3>Conclusions</h3><div>VBR by AI is considered accurate enough to be used for the fabrication of clinically acceptable thermoplastic orthodontic retainers.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"166 6","pages":"Pages 608-615"},"PeriodicalIF":2.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/S0889-5406(24)00459-1
{"title":"Directory: AAO Officers and Organizations","authors":"","doi":"10.1016/S0889-5406(24)00459-1","DOIUrl":"10.1016/S0889-5406(24)00459-1","url":null,"abstract":"","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"166 6","pages":"Page 625"},"PeriodicalIF":2.7,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142706233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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