Journal of Orofacial Orthopedics-Fortschritte Der Kieferorthopadie最新文献

Objectives: This study aimed to evaluate the feasibility and accuracy of using magnetic resonance imaging (MRI) for the three-dimensional (3D) localization of tooth germs. A MRI 3D dataset was compared to a cone-beam computed tomography (CBCT) dataset, which is the current gold standard method in the localization of tooth germs. In this proof-of-concept study, the potential of eliminating the exposure of patients to ionizing radiation for tooth germ localization was evaluated.

Methods: A halved pig head (Sus scrofa domestica) was imaged with MRI and CBCT. The MRI data were manually segmented using InVesalius 3.1.1 (Centro de Tecnologia da Informação Renato Archer, Campinas, Brazil) to generate a 3D model, later processed in OnyxCeph3™ (Image Instruments GmbH, Chemnitz, Germany). The CBCT data were directly imported into OnyxCeph3™ for processing. Both datasets were combined with intraoral scans, and 12 raters took measurements to compare the ability to localize tooth germs with the help of the two modalities.

Results: A total of 144 measurements were obtained (2 modalities × 6 measurement sections × 12 raters). The interrater reliability was high (intraclass correlation coefficients [ICCs] ≥ 0.99 for both modalities). The average differences between CBCT and MRI measurements ranged between -0.43 mm (Bonferroni-Holm-corrected 90% confidence interval [-0.69 mm, -0.16 mm]) and 0.48 mm [0.34 mm, 0.63 mm] and were equivalent with respect to a margin of -1 mm to 1 mm in all measurement sections (Bonferroni-Holm-corrected P < 0.01 in all sections).

Conclusion: MRI demonstrates high potential as a nonionizing alternative to CBCT for 3D localization of impacted and displaced teeth, particularly in children and adolescents. The fluid-filled dental follicle provides excellent contrast in MRI, aiding precise localization. Future clinical studies with larger sample sizes are essential for validation.

Purpose: Craniofacial disorders (CD) affect the Oral Health Impact Profile (OHIP). Therefore, this study evaluates the OHIP in orthodontic patients with cleft lip and/or palate or Robin sequence compared to healthy controls (C).

Methods: A prospective, cross-sectional study was conducted. Oral health-related quality of life (OHRQoL) was assessed using the OHIP-14 questionnaire, with responses categorized into functional and psychological well-being items. In addition, the study considered the influence of crossbite, orthodontic appliance type, oral hygiene, and speech therapy. A high OHIP score represents a good quality of life. The Mann-Whitney test was used for nonparametric quantitative variables; statistical significance was set at p < 0.05.

Results: The study included 119 participants (ages 7-21 years; 61 male, 58 female), divided into a CD group consisting of patients with cleft lip and/or palate or Robin sequence (n = 42) and a control group (C; n = 77; mean age 13.5 ± 5.2 and 14.3 ± 3.3 years, respectively). Both groups showed comparable OHIP-14 scores. The CD group reported significantly higher satisfaction regarding nutritional intake (p = 0.03), while the social and psychological dimensions were reduced (p = 0.04). Factors like crossbite, orthodontic appliance and speech therapy did not have a significant impact on OHIP. CD patients with good oral hygiene showed significantly superior self-reported psychological OHIP (p = 0.04).

Conclusion: Patients with cleft lip and/or palate or with Robin sequence exhibited OHIP scores comparable to healthy individuals despite their underlying condition. Early guidance on dental care and tooth-friendly nutrition has the potential to improve OHRQoL. Additionally, providing supplemental psychological support during orthodontic treatment is advisable.

Purpose: Interleukin (IL)-17 expression in the periodontal ligament is associated with orthodontically induced inflammatory root resorption (OIIRR). Seeking a convenient, rapid, and non-invasive IL-17 detection approach could help predict OIIRR. In this study, we assessed the potential of the IL-17 level in gingival crevicular fluid (GCF) to be an indicator of OIIRR.

Methods: To enable tooth movement, 8‑ to 10-week-old male Wistar rats were subjected to 20 g/60 g orthodontic force for up to 14 days. GCF and peripheral blood were collected for the IL-17 enzyme-linked immunosorbent assay (ELISA). Histological changes and the expression of IL-17, receptor activator of nuclear factor κB ligand (RANKL), and osteoprotegerin (OPG) in periodontal tissue were evaluated by hematoxylin-eosin and immunohistochemistry staining, respectively. Osteoclasts were visualized by tartrate-resistant acid phosphatase (TARP) staining.

Results: GCF IL-17 level rapidly rose in the early phase of orthodontic loading, accompanied by bone and tooth root destruction. At the later stage, the GCF IL-17 level gradually decreased, while the inflammatory destruction was reduced and the periodontal tissue began to repair. GCF IL-17 expression generally tended to be coincident with the periodontal tissue reaction: GCF IL-17 was robustly correlated to the RANKL/OPG ratio (r_s = 0.72, p = 0.002) or osteoclast number (r_s = 0.84, p < 0.001). Additionally, the GCF IL-17 level was correlated to serum IL-17 (r_s = 0.61, p = 0.016) or periodontal IL-17 (r_s = 0.84, p < 0.001).

Conclusion: The IL-17 level in GCF during orthodontic treatment is associated with OIIRR and, thus, could be an early indicator for developing OIIRR. The advantages of being a convenient, rapid, and non-invasive GCF IL-17 measurement make it a promising method for early detection of OIIRR.

Purpose: The scope of the present study was to create a new harmony box by adding two diagnostically and clinically important cephalometric variables, the gonial and interincisal angles, while also considering the effect of sex and age for a growing Swiss population.

Methods: A healthy sample with an overjet and overbite between 2 and 4 mm, and 1.5 and 4.5 mm, respectively, of the Zurich Craniofacial Growth Study was considered. Pairwise correlations between the cephalometric angles were evaluated with the Pearson correlation coefficient (r). Regression models were built for each cephalometric variable serving as the dependent one. The Akaike Information Criterion and the Bayesian Information Criterion were used to structure and select the final multivariable regression model. Bland-Altman plots and the Lin's concordance correlation coefficient were used to assess inter- and intraexaminer agreement.

Results: The sample consisted of 301 individuals with a mean age of 13.4 years. Measurement concordance was confirmed both within and between examiners. The strongest correlations were observed between the angles SNB and SNA (r = 0.81), ArGoMe and SN-ML (r = 0.57), and SN-ML and SNB (r = 0.56). The SNB angle qualified as the dependent variable in the multivariable regression that framed the newly provided harmony box, with the predictor variables age (p < 0.001) and the angles SNA (p < 0.001), SN-ML (p < 0.001), SN-NL (p = 0.005), NSBa (p = 0.001), and ArGoMe (p < 0.001). The interincisal angle did not increase the robustness of the model and was excluded (p > 0.05).

Conclusion: Contrary to the interincisal angle, gonial angle and age qualified for inclusion in the new harmony box for individualized cephalometrics in a sample of healthy schoolchildren from Zurich, Switzerland.

Background: Mouth breathing is related to morphological and functional alterations in growing individuals. Understanding early events that can lead to these changes can prevent or decrease the need for orthodontic treatment.

Objective: The goal was to assess the prognosis for dental alterations evidenced by changes in the incisor inclination and arch width after surgical intervention to normalize the mode of breathing in growing patients.

Data sources: Databases were searched based on the guidelines of the Preferred Report Items for Systematic Reviews and Meta-Analysis (PRISMA statement), with no restrictions on language or year of publication.

Study selection: Seven non-randomized studies were selected, with follow-up times ranging from 12 to 60 months. Differences in the inclination of the upper and lower incisors, intercanine and intermolar maxillary widths between the initial and final measurements were the primary and second outcomes.

Data extraction: Two independent authors extracted the data independently. The Quality in Prognosis Studies tool (QUIPS tool) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) were used to assess the risk of bias and the quality of evidence.

Data synthesis: Although four studies presented a similar methodology and significant results regarding incisor inclination, the meta-analysis did not provide statistical evidence favoring surgical interventions for these variables (p = 0.12). No significant changes in the transverse dimension of the maxillary arch were found in the primary dentition (95% confidence interval [CI], 0.231 [-0.394/0.857], p = 0.4690).

Conclusions: Four separate studies provided acceptable but low evidence that interventions to relieve mouth breathing in growing individuals favor normalization of lower incisor inclination. In the primary dentition, no significant changes were found in the arch width.

Purpose: The aim of this study was to examine the effect of methylphenidate, prescribed for individuals with attention deficit hyperactivity disorder (ADHD), on orthodontic tooth movement (OTM) and root resorption.

Methods: In all, 30 rats were divided into (1) control (C), (2) constant (MCD), and (3) increasing dose of methylphenidate (MID) groups and 2 subgroups for each of them (nonorthodontic (30 days)/orthodontic (44 days)). After receiving saline or methylphenidate for 30 days, rats in the nonorthodontic groups were euthanized (n = 5/group). Subsequently, 50 g of orthodontic force was applied to the remaining rats' first molars for 14 days (orthodontic groups). Quantitative micro-computed tomography (micro-CT) and immunohistochemical analyses were conducted. For statistical analyses Kruskal-Wallis and Dunnet tests were applied with a significance set at p < 0.05.

Results: Micro-CT analysis demonstrated a statistically significant increase in tooth displacement with higher doses of methylphenidate compared to control and lower-dose groups, though no significant difference was detected between MID-44 and MCD-44 groups. Orthodontic force led to a significant increase in root resorption, peaking in the coronal region and diminishing toward the apex. The highest amount of resorption was observed in the MID groups, with a significant difference between nonorthodontic MID-30 and C‑30 groups. No significant changes in bone parameters were noted in the tension zone, but numerical reductions in trabecular thickness (Tb.Th), bone volume fraction (BV/TV), and bone mineral density (BMD) were observed. In nonorthodontic cohorts, VEGF and RANK levels were significantly elevated in the MID-30 group, along with increased TRAP expression, indicating bone resorption. Orthodontic cohorts exhibited a significant increase in RANK- and TRAP-positive cells with methylphenidate administration. Reductions in OPG and elevations in RANK, RANKL, VEGF, and TRAP were noted, primarily between orthodontic and nonorthodontic groups.

Conclusion: The present rat model suggests a weak potential for methylphenidate to increase root resorption. However, increased doses of methylphenidate accelerated OTM.

Purpose: To investigate the reusability of ceramic brackets in terms of shear bond strength, friction behavior, slot dimension, fracture strength, and color stability.

Methods: A total of 90 conventionally debonded and 30 by an Er:YAG laser debonded ceramic brackets were collected. All the used brackets were inspected under a stereomicroscope at 18 × magnification and sorted according to their adhesive remnant index (ARI). Five groups were formed (n = 10): (1) new brackets as a control group, (2) flamed and sandblasted, (3) flamed and acid bathed, (4) laser-reconditioned, and (5) laser-debonded brackets. The bracket groups were tested regarding different properties such as shear bond strength, friction behavior, slot size, fracture strength, and color stability. Analysis of variance (ANOVA) and nonparametric Kruskal-Wallis tests were used for statistical analysis (significance level: p < 0.05).

Results: Shear bond strength values of the acid reconditioned brackets were significantly lower (8.0 ± 3.1 MPa) compared to the control group (12.9 ± 2.9 MPa). Laser-reconditioned (32.8 ± 2.7%) and laser-debonded (30.9 ± 2.4%) brackets showed the lowest force loss due to friction (control group 38.3 ± 3.0%). No significant differences were observed between groups regarding slot size and fracture strength. All groups had color differences of ${∆E}_{ab}^{*}$ < 10. Scanning electron microscope images and ARI scores indicated that most of the residues on the bracket bases were removed.

Conclusion: All reconditioning methods yielded adequate results regarding bracket properties. Yet, focusing on the need to protect the enamel and the bracket base, laser debonding seems to be the most suitable method for reconditioning ceramic brackets.

Although substantial progress has been made in dentistry in terms of diagnosis and therapy, current treatment methods in periodontology, orthodontics, endodontics, and oral and maxillofacial surgery, nevertheless, suffer from numerous limitations, some of which are associated with a dramatic reduction in the quality of life. Many general mechanisms of inflammation and immunity also apply to the oral cavity and oral diseases. Nonetheless, there are special features here that are attributable, on the one hand, to developmental biology and, on the other hand, to the specific anatomical situation, which is characterized by a close spatial relationship of soft and hard tissues, exposure to oral microbiota, and to a rapid changing external environment. Currently, a comprehensive and overarching understanding is lacking about how the immune system functions in oral tissues (oral immunology) and how oral immune responses contribute to oral health and disease. Since advances in translational immunology have created a game-changing shift in therapy in rheumatology, allergic diseases, inflammatory bowel disease, and oncology in recent years, it is reasonable to assume that a better understanding of oral immunology might lead to practice-changing diagnostic procedures and therapies in dentistry and thereby also profoundly improve oral health in general.

Background: For patients with a maxillary transversal deficiency (MTD), various treatment options are available, partly based on the practitioner's experience. This study aimed to determine a cut-off age for decision making between surgically assisted rapid palatal expansion (SARPE) over orthodontic rapid palatal expansion (ORPE) based on skeletal maturation in a female population.

Methods: A total of 100 cone beam computed tomography (CBCT) images of young females were analyzed on maturation of the pterygomaxillary (PMS), zygomaticomaxillary (ZMS), transpalatal (TPS), and midpalatal (MPS) sutures. Based on the maturation of these four junctions, four independent observers had to determine whether they would prefer ORPE or SARPE to widen the maxilla.

Results: For the PMS, the results show a closure of 83-100% from 13 to 17 years. As for the TPS, a closure of 78-85% was observed from 15 years of age. For the 15- to 17-year-old females, a closed ZMS was present in 32-47%. Regarding MPS, closed sutures presented in 61% (stages D and E) of the 15-year-old females. The cut-off age at which SARPE was recommended was 15.1 years for the orthodontist observers and 14.8 years for the maxillofacial surgeon observers.

Conclusions: Significant maturation of MPS was reached at the age of 15 in a female population. The PMS, TPS, MPS, and ZMS closed sequentially. A comprehensive diagnostic approach is necessary for choosing the appropriate treatment. When in doubt, age could assist decision making in a female population, with a cut-off age of 15 years in favor of SARPE based on this study.