Journal of Orofacial Orthopedics-Fortschritte Der Kieferorthopadie最新文献

Background: As the demands on esthetic orthodontic devices continue to increase, discoloration of colored elastomeric modules is still a concern for patients and orthodontics. Thus, we performed an in vivo study evaluating discoloration of stretched colored elastomeric modules (i.e., white, gray, and pink).

Materials and methods: In all, 90 elastomeric modules of three different colors (white, gray and pink; 30 elastics from each color) were placed around brackets. The elastomeric modules were distributed and arranged randomly in the patients' four dental quadrants, and were removed after 1, 2, and 4 weeks. Color measurements were made before and after insertion into each patient's mouth. Digital images were taken with the camera of a mobile phone (iPhone X, Cupertino, CA, USA), and the variations in color were characterized using the Commission Internationale de l'Eclairage (CIE) color space system (L*a*b*) offered by Photoshop (Adobe, San Jose, CA, USA). Analysis of variance (ANOVA) and least significant difference (LSD) tests were used for statistical analyses.

Results: The white elastomeric modules were most prone to discoloration, followed by the pink and then finally by the gray colored modules. The amount of discoloration resulting from a random diet practiced by the patients increased gradually (but was not significant) for all elastomeric modules studied and reach a peak after 2 weeks for the white and gray elastomeric modules, while discoloration of the pink elastomeric modules plateaued after 1 week.

Conclusion: Colored elastomeric modules (e.g., white, gray, and pink) discolor to variable degrees over time. Thus, patients should be advised that the consumption of food and drinks may result in discoloration of the elastomeric modules.

Purpose: To analyze the effects of children's malocclusions and associated quality of life on family relationships by evaluating psychometric characteristics of the Family Impact Scale (FIS) in adolescents seeking orthodontic treatment.

Materials and methods: Included were 334 participants (children aged 11-14 years; 53% female and 47% male) and their parents (84% mothers, 16% fathers) who were recruited at two dental clinics in Croatia. The Child Perception Questionnaire, Parental-Caregiver Perception Questionnaire, and FIS were administered. Malocclusion severity was estimated using the Index of Orthodontic Treatment Need Dental Health Component. The presence of caries was also recorded. Factor analysis, t‑test, Pearson correlation, and multiple linear regression analysis were used for statistical analysis.

Results: Unidimensional FIS measuring global family impacts had higher internal consistency (α = 0.73-0.81) compared to the specific dimensions of family impacts (α = 0.60-0.69). Global family impacts were higher in children with more severe malocclusions and existing dental caries, primarily influencing parental activity, and parental emotions dimensions (p < 0.05). In multiple regression, parental perception of child's emotional well-being, oral symptoms, and social well-being (p < 0.001) were significant predictors of global family impacts, whereas child's quality of life perception, malocclusion severity, or child sex were not. Reduction of an increased overjet by orthodontic treatment affected changes in the global family impacts, mainly by reducing the emotional issues of parents (p < 0.05).

Conclusions: The child's malocclusion influenced the family, primarily parental emotions. Family influences were mostly determined by parental perception of the child's altered psychosocial well-being. The FIS had adequate psychometric properties.

Purpose: To better understand the side effects of fixed lingual retainers by means of an in vitro study in a two-tooth model determining the three-dimensional (3D) force-moment components acting at adjacent teeth combined with different composite-wire interfaces.

Methods: Triple-stranded round retainer wires were embedded in cured disks of flowable composite. At one side the composite-wire interface was untreated and checked to be absolutely fix. At the other side the composite-wire interface was configured as either an isolated compound with (1) petroleum jelly coating, or an adhered compound with (2) no manipulation, (3) ethanol degreasing or (4) ethanol degreasing and rectangular bending of the wire ends. The 3D force-moment components were registered, while the intertooth distance was increased in steps of 0.01 mm leading to increasing tension of the wire. Measurements were repeated after artificially aging the specimens.

Results: Retainer wire specimens with adhered compound (2, 3, 4) showed negative vestibulo-oral moments ranging maximally each between -0.3 and -0.9 Nmm in opposite direction to positive moments of 1.9 Nmm for specimens with isolated compound 1. Significant tipping moments occurred in the group with isolated compound at lower forces than in those groups with adhered compound. Similar effects were observed after artificial aging.

Conclusion: Side effects emerge under specific circumstances: an altered adhesive compound combined with the presence of oral forces. Compounds with lost adhesion at the composite-wire interface showed rotational moments in the direction of the wire windings even during low tensile forces similar to those that may occur in clinical settings. Opposite rotational moments leading to unwinding of the wire may occur in cases with adhered compounds at higher tensile forces. Utilization of round triple-stranded retainer wires without bent ends are of higher risk to induce inadvertent side effects.

Objective: To compare the effect of maxillary incisor intrusion and retraction with controlled tipping (CT) versus bodily movement (BM) in extraction cases on alveolar bone height and thickness, using cone-beam computed tomography (CBCT). Correlations between changes in alveolar dimensions and crown or root retraction, incisor inclination, and intrusion were also investigated.

Materials and methods: In all, 144 incisors of 36 women were retrospectively evaluated. All patients were treated with anterior intrusion and retraction with either controlled tipping (CT) (group 1) or bodily movement (BM) (group 2). CBCT scans were taken before and after retraction and intrusion and measurements of alveolar bone height and thickness at the level of mid-root and root apex were measured. The prevalence of dehiscence was also calculated.

Results: Labial bone thickness (BT) increased at the level of the root apex with increased total BT in the CT group (p < 0.05). The BM group showed decreased palatal BT. Significant vertical bone loss with an increased incidence of dehiscences occurred on the palatal side in both groups. Changes in palatal bone area was negatively correlated with the amount of root apex retraction, while the total BT at the level of root apex was positively correlated with amount of intrusion.

Conclusions: Bodily retraction can result in reduced palatal bone dimensions and an increase risk of iatrogenic sequelae following anterior retraction in extraction cases. Vertical bone loss and an increased incidence of dehiscences is to be expected following anterior retraction. Careful attention must be paid to the bone boundary conditions to avoid moving the incisors out of the alveolar housing.

Purpose: The goal was to investigate whether the application of antiseptics and fluorides during orthodontic treatment affects the biomechanics of the levelling of dental arches by changing the working properties of nickel-titanium (NiTi) archwires.

Methods: The sample consisted of 60 individuals aged 12-22 years (53% females). There were 20 individuals in each experimental group: (I) individuals conducted regular oral hygiene, (II) individuals used a high concentration of fluorides for intensive prophylaxis for the first month; and (III) individuals used chlorhexidine in the same manner. NiTi alloy archwires (dimensions 0.508 × 0.508 mm) were analyzed 3 months after intraoral exposure and compared to as-received NiTi wires. Elastic modulus, yield strength, springback ratio, and modulus of resilience were calculated. Dimensions of the dental arches were analyzed when NiTi alloy (T1) was placed intraorally and after 3 months (T2). Change was quantified as the difference in dimensions (T2-T1). Anterior width-to-length ratio was used as a measure for dental arch shape.

Results: Intraoral exposure reduced elastic modulus, yield strength, springback ratio, modulus of resilience, loading, and unloading forces of NiTi wires (p ≤ 0.021). Chlorhexidine mouthwash and gel with high concentration of fluorides did not change these properties more than saliva with regular hygiene. The amount of change of dental arch shape in the maxilla and mandible did not differ significantly between the experimental groups.

Conclusion: Using antiseptics or a high concentration of fluorides during orthodontic treatment does not significantly affect the mechanical properties of NiTi wires and would not have clinical implications in changing orthodontic biomechanics.

Background: The aim of the study was to assess the accuracy and efficiency of a new artificial intelligence (AI) method in performing lateral cephalometric radiographic measurements.

Materials and methods: A total of 200 lateral cephalometric radiographs were assessed for quality and included. Three methods were used to perform the cephalometric measurements: (1) the AI method using WebCeph software (AssembleCircle Corp., Gyeonggi-do, Republic of Korea), (2) the modified AI method using WebCeph software after manual modification of the landmarks' position, and (3) using OnyxCeph software (Image Instruments GmbH, Chemnitz, Germany) by manual landmark identification and digital measurements generation. The results of the measurements produced by the three methods were compared, in addition to comparing the time required for the measurements' generation required for each method.

Results: Statistically significant differences were detected between the measurements resulting from the three used methods. Fewer differences were detected between the modified AI method and the OnyxCeph method. The AI method produced the measurements the fastest followed by the modified AI method and then the OnyxCeph method.

Conclusions: Considering the used AI software, AI followed by manual tuning of the landmarks' position might be an accurate method in lateral cephalometric analysis. AI alone is still not fully reliable at locating the different landmarks on the lateral cephalometric radiographs.

Purpose: Adequate control of the vertical dimension is of great importance in orthodontic treatment. Although existing evidence is very limited, extraction of four premolars is thought to contribute towards improved control of anterior facial height compared with non-extraction treatment protocols. Thus, the aim of this retrospective cohort study was to compare the effect of fixed-appliance treatment with extraction of four premolars to non-extraction treatment on the skeletal vertical dimension.

Methods: A consecutive sample of 76 children with skeletal hyperdivergence (49% male; mean age 11.9 years) was divided into two groups for treatment with either non-extraction (n = 31) or extraction of four premolars (n = 45). Baseline characteristics were comparable: overjet 5.1 ± 2.5 mm, overbite 2.4 ± 1.9 mm, ANB angle 4.6 ± 2.3°, and SN-ML angle 40.2 ± 3.5°. Patients were treated with standard edgewise fixed appliances with closing loops/sliding mechanics. Vertical skeletal and dental outcomes were measured on lateral cephalograms before and after treatment. Data were analyzed with linear regression at 5%.

Results: Compared to non-extraction treatment, treatment with premolar extractions had no significant effect on the SN-ML angle (difference (Δ) = 0.07°; 95% confidence interval -0.90 to 1.01°; P = 0.88). Statistically significant changes between the extraction and non-extraction groups were only found for the parameters SNA (Δ -1.47°; P = 0.003), ANB (Δ -1.17°; P = 0.004), SN-OP (Δ -1.48°; P = 0.04), and L1-ML (Δ -6.39°; P < 0.001).

Conclusion: Orthodontic treatment of children with skeletal hyperdivergence using systematic extraction of four premolars had minimal effects on the vertical facial dimension compared to non-extraction treatment.

Purpose: This study aims to evaluate the efficacy of occlusal splint and botulinum toxin (BTX) therapies for improving the pain scores and mouth opening in patients with temporomandibular disorders (TMD) with sleep bruxism (SB).

Materials and methods: A retrospective cohort study was conducted based on clinical record reviews of patients with TMD symptoms (e.g., temporomandibular joint [TMJ] pain, masticatory muscle pain, TMJ internal derangements, joint sounds, and limited mouth opening) and SB. The patients were divided into two groups: occlusal splint group and BTX group. Maximum unassisted mouth opening (MMO) and pain score on a visual analogue scale (VAS) before treatment and at 1‑, 3‑, and 6‑month follow-up were analyzed to evaluate the clinical outcomes.

Results: A total of 60 patients (49 women and 11 men, mean age 34.63 ± 11.85 years) were enrolled. Each group had 30 patients. The comparisons of the groups at 1 and 3 months after treatment indicated that the BTX group had higher MMO values (P = 0.013 and 0.034, respectively) and lower VAS scores than the occlusal splint group (P = 0.000 and 0.001, respectively). No difference between the two groups was observed 6 months after treatment (P > 0.05).

Conclusions: Both occlusal splint and BTX treatment methods were successful in treating TMD with SB. BTX provided patients with rapid relief in the early period; therefore, BTX can be recommended as a primary treatment option in patients with greater pain.

Purpose: The aim of this study was to assess objective and subjective breathing changes in adult patients who underwent maxillary skeletal expansion with the mini-implant-supported maxillary skeletal expander (MSE).

Methods: Twenty-nine patients (mean age 18.1 ± 4.3 years) who underwent expansion using the MSE were compared pre- and posttreatment and with a control group (mean age 19.9 ± 2.6 years) to assess objective and subjective functional breathing changes. Objective measurements of the airway including peak nasal inspiratory flow (PNIF) and peak oral inspiratory flow (POIF) were measured utilizing the In-Check medical device (Clement Clarke, Harlow, United Kingdom). Patients reported subjective breathing assessment utilizing the visual analog scale (VAS). Intragroup comparisons were performed with Wilcoxon tests and intergroup comparison with Mann-Whitney U tests. Spearman correlation coefficients were calculated among the studied variables (P < 0.05).

Results: Following MSE treatment, there were significantly higher values for PNIF total (P < 0.0001), PNIF right (P < 0.0001), PNIF left (P < 0.0001), and POIF (P < 0.01) compared to pretreatment and control group results. Also, patients reported a significant decrease in troubled breathing as measured by the VAS for breathing through the right nostril (P < 0.01), left nostril (P < 0.001), and both nostrils (P < 0.01). Comparing the objective and subjective variables for both the pre-MSE or post-MSE groups, the results indicated no significant correlation between total PNIF and total VAS. However, the values had significant correlations between PNIF and VAS on each side when the patients were asked to block one nostril.

Conclusions: Objective functional breathing measurements were increased immediately after treatment with MSE. Subjective functional breathing measurements changes were significantly higher after MSE treatment and compared with the control group. MSE presents a nonsurgical alternative to achieving orthopedic expansion in adult patients which may provide a benefit for patients with nasal airway obstruction.

Background and aim: In Germany, the reimbursement of orthodontic treatment costs within the framework of the statutory health insurance (GKV) was restricted on 01 January 2002 by the introduction of the orthodontic indication groups (KIG). The aim of this study was to evaluate the prevalence of findings requiring treatment in a specialist practice over a 20-year period. The results were then compared with data from existing older studies.

Patients and methods: The distribution of treatment-eligible KIG (KIG classifications grades 3-5) among patients with statutory health insurance in an orthodontic practice in North Rhine was determined over a 20-year period (2002-2021) after the introduction of the KIG system. This period was additionally scrutinized in four 5‑year periods according to the operating cycles of the practice. Findings were classified into the highest of 19 possible KIG treatment needs levels. Multiple classifications were not made.

Results: Orthodontic treatment was indicated in a total of 4537 (2393 female, 2144 male) patients according to current statutory health insurance guidelines. The KIG classification "D" (increased overjet) was the most frequent within the observed 20 years with 24.3%. Among 11 KIG classifications, 86.1% of the 6 most frequent and 13.9% of the 5 rarest findings were observed constantly over all periods. Of 19 possible indications, "D4" was the most frequent with 19.6%. Of 4537 patients, 20.7% had KIG grade 3, 63.6% KIG grade 4 and 15.7% KIG grade 5. The prevalence of sagittal deviations "D" and "M" was 35.0%, transverse "B" and "K" 17.9% and vertical "O" and "T" 3.7%. Tooth position anomalies "E" and "P" had a share of 24.6%.

Conclusions: The present study confirms existing findings as well as the nationwide data of the National Association of Statutory Health Insurance Dentists (KZBV) from 2020: The sagittal deviations "D" (increased overjet) and "M" (negative overjet) represented the most frequent findings with KIG D4 as the most common classification. The prevalence and age distribution of KIG grades 3-5 requiring treatment corresponded to nationwide comparative data.