The Angle orthodontist最新文献

Objectives: To evaluate the impact of maxillary advancement by distraction osteogenesis (DO) on the pharyngeal airway including the following parameters in patients with cleft lip and palate (CLP), with a secondary focus on long-term changes ≥1 year: palatal pharyngeal space, superior posterior pharyngeal space, middle pharyngeal space, inferior pharyngeal space, epiglottic pharyngeal space, velar angle, velar length, and need ratio.

Materials and methods: A comprehensive search was conducted in Medline through PubMed, Scopus, Cochrane databases, Embase, and Directory of Open Access Journals through October 2024. Studies were assessed for pharyngeal airway changes at three time points: pre-DO (T1), post-DO (T2), and ≥1-year post-DO (T3). Quality was assessed using the National Institute of Health tool for before-after (pre-post) studies with no control group. Meta-analysis was conducted using Cochrane Review Manager (RevMan) Version 5.3. A random effect model assessed the mean difference (MD) in parameters representing the pharyngeal airway at T1, T2, and T3. GRADE criterion assessed the certainty of evidence. The protocol is officially registered with PROSPERO (CRD42023444533). In this systematic review, we followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

Results: The meta-analysis included 10 studies with 135 patients. The included studies ranged from fair to good quality. Significant increases were observed in pharyngeal space post-DO, particularly in superior and middle pharyngeal regions. Slight relapse was noted after 1 year, but overall, airway improvement remained significant. Evidence certainty by GRADE assessment revealed high to moderate evidence except for need ratio (low).

Conclusions: Maxillary advancement by DO significantly improves pharyngeal airway in CLP patients, with minimal relapse after 1 year.

Objectives: To assess the relationship between the condyle and fossa in idiopathic condylar resorption (ICR) patients with severe Class II skeletal deformities who achieved stable functional and esthetic outcomes.

Materials and methods: ICR patients receiving orthodontic-orthognathic treatment with more than 2 years of follow-up were included in this retrospective study. Post-treatment changes in Y-axis-B of less than 2 mm were considered indicative of achieving a stable treatment outcome. Anterior joint space (AJS), superior joint space (SJS), and posterior joint space (PJS) on computed tomography (CT) and magnetic resonance images (MRI) were measured.

Results: After screening, a total of 20 patients with 40 condyles were included. 12 patients were included in the Stable group and eight patients were included in the Relapse group. In the Stable group, mean AJS, SJS, and PJS linear measurements during follow-up on CT images were 1.82 ± 0.34, 1.78 ± 0.38, and 1.81 ± 0.33 mm, respectively. Ratio of AJS:SJS:PJS was 1.0:0.97:1.0. Mean AJS, SJS, and PJS linear measurements on MRI images were 1.71 ± 0.50, 1.82 ± 0.50, and 1.70 ± 0.51 mm, respectively. Ratio of AJS:SJS:PJS was 1.0:1.06:1.0. In the Relapse group, no constant ratio of joint spaces was found on CT or MRI images.

Conclusions: A relationship exists between the condyle and fossa in ICR patients with stable treatment outcomes, as the AJS:SJS:PJS ratio was close to 1:1:1. This condyle-fossa relationship provides clinicians with an assessment criterion and may be an alternative treatment goal for patients with ICR.

Objectives: To investigate the relationship between body dysmorphic disorder (BDD), orthodontic parameters, and the level of depression.

Materials and methods: A total of 205 adolescents (142 females, 63 males; aged 12-18) completed the Body Dysmorphic Disorder Questionnaire (BDDQ) and the Beck Depression Inventory (BDI). Orthodontic parameters, including skeletal malocclusion type, maxillary and mandibular anterior crowding, and Index of Treatment Need (IOTN) scores, were recorded. Associations were analyzed using appropriate statistical methods.

Results: BDDQ positivity was observed in 69.8% (n = 143) of participants. BDDQ-positive individuals had significantly higher BDI scores compared to BDDQ-negative individuals (P < .001). No significant group differences were found in terms of age, crowding, IOTN scores, or skeletal malocclusion type. However, correlation analysis showed a weak but statistically significant negative association between malocclusion type and BDDQ positivity (r = -0.146, P = .042), and a moderate positive correlation between BDDQ positivity and BDI scores (r = 0.317, P < .001).

Conclusions: BDD was significantly associated with depression levels. Although most orthodontic variables showed no direct relationship with BDD, malocclusion type demonstrated a weak but significant correlation.

Objectives: To assess the acceleratory effect of locally administered injectable platelet-rich fibrin (i-PRF) on overall treatment duration (OTD) and root resorption.

Materials and methods: Patients with anterior crowding requiring extraction of all four first premolars were randomized into i-PRF and control groups, both treated with fixed appliances. The i-PRF group received submucosal injection of i-PRF distal to all canines on the buccal and palatal sides, and canine retraction was performed using sectional mechanics. A second i-PRF injection was administered in the anterior interradicular region, followed by alignment up to 0.018 × 0.025″ stainless steel and space closure with NiTi closed coil springs (150 g). Control patients underwent the same protocol without i-PRF injections. Treatment duration was calculated; root resorption was assessed using cone-beam computed tomography, and volumetric analysis was accomplished using MIMICS software.

Results: All 30 enrolled patients (17 females, 13 males; mean age 16.6 ± 2.7 years) completed the study, with 15 patients in each group. The mean OTD was 338.6 ± 37.8 days for the i-PRF group and 374.3 ± 49.3 days for the control group (P = .107). The percentage root volume loss for the central incisor was 3% and 4% in the intervention and control groups (P = .122), respectively, and 5% and 6% for the lateral incisor in the intervention and control groups (P = .767). Both the treatment duration and root volume loss in both groups were statistically and clinically nonsignificant.

Conclusions: The use of i-PRF did not significantly reduce OTD or affect root resorption compared with the control group.

Objectives: To investigate the impact of living in a war zone on acceleration of skeletal maturation and development of permanent teeth.

Materials and methods: A total of 272 Israeli children and adolescents aged 9-15 years participated in this study. The Gaza group included 106 participants from the Gaza envelope area (within 7 km of the Gaza Strip border), while the central group consisted of 166 participants from central Israel. Skeletal maturation and dental development were assessed using lateral cephalometric and panoramic radiographs, respectively.

Results: Significant differences were observed in all maturation variables, including skeletal maturation as well as maturation of the upper and lower second molars (right and left) and upper canines. The Gaza envelope group exhibited more advanced and accelerated maturation than the central group (P < .0005). Positive correlations were identified among tooth maturation, chronological age, and skeletal development (0.519 < r < 0.599). Linear regression analysis revealed that the maturation of the lower left second molar accounted for 47.8% of variance in skeletal maturation.

Conclusions: In this study, we confirm that children living under the stress of a conflict zone exhibited earlier skeletal maturation and accelerated eruption of permanent second molars and upper canines than their peers. The early eruption of second molars and canines, particularly the lower left second molar, may serve as a predictive marker for pubertal progression.

Objectives: To compare the effectiveness of clear aligner (CA) vs removable inclined plane (RP) in improving the dentofacial changes and oral health-related quality of life (OHRQoL) in children with anterior crossbite in the mixed dentition.

Materials and methods: Twenty-four pseudo-Class III patients in the mixed dentition (8-12 years) were randomly allocated into two equal groups: the CA group treated with clear aligners, and the RP group treated with removable inclined planes. Lateral cephalometric analysis and OHRQoL questionnaires were conducted immediately before and after 4 months of intervention. The primary outcome included cephalometric changes, whereas the CPQ8-10 (children's perception questionnaire) was the secondary outcome. Data analysis included paired t-tests, independent t-tests, the Shapiro-Wilk test, the Wilcoxon signed-rank test, and the Mann-Whitney test.

Results: Significant differences were observed between the two groups for changes in U1-SN, IMPA, L1-NB angles, and L1-NB (mm) (P < .05). However, there was no significant difference in improving the OHRQoL of patients between the CA and RP groups (P > .05).

Conclusions: Both treatment approaches resulted in similar improvement in the patients OHRQoL. However, the CA group resulted in more significant proclination of the upper incisors, while the RP group showed more significant retroclination of the lower incisors.

Objectives: To evaluate agreement between the tooth landmark localization patterns of artificial intelligence (AI) and those from human examiners.

Materials and methods: Three-dimensional (3D) digital dental model images were obtained from 284 participants. On a total of 5583 permanent teeth, six landmarks per tooth were manually identified and annotated using custom-made 3D annotation software. To develop an AI model capable of automatically identifying tooth landmarks, a deep-learning algorithm was applied to a training dataset consisting of 4519 teeth. To select the optimal AI model, datasets of 556 and 508 teeth were used as validation and test datasets, respectively. For intraexaminer and interexaminer reliability tests, 280 teeth from 10 participants were randomly selected, and two human examiners identified the same six landmarks on two separate occasions.

Results: The mean error in tooth landmark localization of the AI model ranged from 0.01 mm to 1.68 mm. The intraclass correlation coefficient between the AI model and human examiner for all landmarks was excellent, ranging from 0.97 to 1.0. The landmark localization error from the AI model was smaller than human interexaminer differences for mesial and distal proximal points. However, errors for the cusp tip and facial axis points were greater in the AI model than the interexaminer differences.

Conclusions: AI exhibited localization accuracy for tooth landmarks comparable with that of human examiners for specific measurements related to tooth size. Nonetheless, its accuracy still needs improvement to match that of orthodontic clinicians in identifying cusp tips and facial axis points.

Objectives: To evaluate esthetic outcomes of four treatment options for missing maxillary lateral incisors-canine substitution, canine substitution with buildup, resin-bonded fixed dental prostheses (RBFDPs), and dental implant-and to compare with a control group with sound lateral incisors after orthodontic treatment.

Materials and methods: A total of 144 digital intraoral photographs from clinical expert archives was analyzed, including the control group. Esthetic outcomes were assessed using ImageJ software based on the recurring esthetic dental (RED) proportion, vertical position, black triangles, gingival zenith, color, and apparent contact dimension (ACD). Statistical analyses were conducted to identify significant differences among groups.

Results: RED proportion was more favorable in both canine substitution groups than with RBFDPs. Vertical position favored RBFDP over canine substitution with buildup. Black triangles were less frequent in both canine substitution and the control group than with RBFDPs. Gingival zenith was less favorable in both canine substitution groups than the control and with RBFDPs. The control group showed best color outcomes, outperforming all treatment groups except for dental implant. ACD central-lateral incisors was better in the canine substitution with buildup and control group than canine substitution without buildup. ACD lateral incisor-canine was superior in both canine substitution and control groups than with RBFDPs and dental implants.

Conclusions: No single treatment excelled across all parameters, emphasizing the need for individualized treatment plans based on patient priorities. Collaborative decision-making is crucial for optimizing esthetic outcomes.

Objectives: To determine the most effective ways to correct lower lip sucking in preschool children, minimizing impacts on their Oral Health-Related Quality of Life (OHRQoL) and improving malocclusion.

Materials and methods: 83 children aged 3-6 years were divided into behavioral therapy (Group A, n = 27), lip bumper therapy (Group B, n = 27), and Twin Block therapy (Group C, n = 29) groups. After 6 months of treatment, oral exams, model analysis, cephalometrics, and the Early Childhood Oral Health Impact Scale (ECOHIS) were used for assessment.

Results: Success rates in Groups A, B, and C were 33.33%, 73.08%, and 96.43%, respectively (P < .05). Groups A and B had no significant measurement differences (P > .05). Group C showed significant changes in overjet, SNA, SNB, ANB, U1SN, and L1MP (P < .05). The ECOHIS scores of all groups first rose, then fell (P < .05).

Conclusions: Twin Block appliances are highly effective for correcting lower lip sucking. They have a higher success rate than other methods and can reduce skeletal malocclusion severity in children with specific dental conditions.

Objectives: To compare the profile attractiveness of skeletal Class III patients treated with either a surgery-first approach (SFA) or a conventional surgery approach (CSA), as perceived by surgeons, orthodontists, and laypersons.

Materials and methods: Thirty-four patients were assigned to either the SFA or CSA group retrospectively based on the surgical protocol performed and were evaluated by three distinct groups: oral and maxillofacial surgeons, orthodontists, and laypersons (n = 23 per group). Profile images before (T1) and after orthodontic-surgical treatment (T2) were analyzed using a 5-point Likert scale. Then participants answered the following question: "Which surgical technique was used, CSA or SFA?" Statistical analyses including the Spearman correlation coefficient, the Friedman test, the κ test, independent t-tests, and one-way analysis of variance were conducted to assess correlations and comparisons among evaluator groups (P < .05).

Results: A high and positive correlation (r = 0.86, P < .001) was demonstrated for scores between surgeons and orthodontists, and a low correlation was demonstrated between laypeople and specialists (r = 0.55, P = .01 and r = 0.48, P = .03). No statistically significant relationships were found between esthetic perceptions and the surgical approach regardless of the level of expertise of the evaluators, and it was also not possible to differentiate between the surgical approaches used.

Conclusions: In this study, we indicate that the choice of orthognathic surgical protocol, whether surgery-first or conventional, did not significantly influence the perceived facial profile attractiveness of skeletal Class III patients. These findings support the clinical viability of the SFA protocol, particularly in cases where treatment time or patient preference are factors in decision-making.