The Angle orthodontist最新文献

Objectives: To evaluate nasal septum changes after rapid maxillary expansion (RME) during the mixed dentition and to verify the association between quantitative and qualitative assessments of nasal septum deviation (NSD) by ear, nose, and throat (ENT) specialists.

Materials and methods: The sample comprised 24 patients (11 male, 13 female) with a mean age of 7.62 ± 0.92 years with maxillary transverse deficiencies. Cone-beam computed tomography (CBCT) images were obtained before and after RME. Three CBCT coronal sections passing through the maxillary first molars, 5 mm anterior and 5 mm posterior, were used for quantitative assessment. NSD was calculated using the ratio of nasal cavity height to nasal septum contour. Additionally, five ENT professionals evaluated NSD qualitatively using scores from 1 to 3 through CBCT sequential axial and coronal sections. Absent NSD was scored as zero. Interstage changes were assessed using Wilcoxon tests. Spearman correlation and linear regression were performed to evaluate the association between quantitative and qualitative analyses (P < .05).

Results: No significant change was observed in the NSD ratio. In pre-expansion CBCT images, absence of NSD and scores 1, 2, and 3 for NSD were found for 45.8%, 41.7%, 12.5%, and 0%, respectively. In the qualitative assessment, no significant change in NSD was observed after expansion. A strong association was found between NSD ratio and ENT score (r = 0.750).

Conclusions: In the mixed dentition, no significant change was observed in the NSD ratio. Qualitative analysis of NSD was associated with quantitative assessment of the ratio between nasal septum contour and nasal cavity height.

Objectives: To evaluate the effect of orthodontic movement on traumatized teeth treated with the regenerative endodontic procedure (REP).

Materials and methods: The increase of the radiographic root area (RRA) of each REP tooth was measured at each follow-up visit after the end of orthodontic treatment. The study included two experimental groups of patients aged 7-17 with REP-treated teeth. The Ortho REP group consisted of eight patients who underwent orthodontic treatment, whereas the second group (no Ortho REP group) included seven patients who did not receive orthodontic treatment. The control groups comprised the same patients and their homologous or adjacent healthy teeth that did not undergo REP treatment.

Results: Orthodontic treatment did not negatively affect root development of immature, traumatized REP-treated teeth during the treatment or retention periods. Additionally, the increase in RRA in regenerated teeth was age-dependent, with the greatest RRA increase in young patients.

Conclusions: Close collaborative endodontic-orthodontic follow-up is recommended to ensure favorable results. The findings suggest that REP-treated teeth may undergo orthodontic treatment without adverse effects.

Objectives: To examine tooth root length and root volume in cone beam computed tomography (CBCT) images in patients with skeletal Class II and III anomalies who have undergone single-jaw (SJ) and double-jaw (DJ) orthognathic surgery, and to compare the changes between jaws with and without osteotomy.

Materials and methods: This study was conducted on the archive records of a total of 60 adults: 36 women and 24 men with an average age of 21.1 ± 3.1 years, whose CBCT images were recorded just before orthognathic surgery and within 6-12 months after surgery. The sample was divided into four groups with 15 individuals in each: Class II SJ (mandibular advancement only), Class II DJ (maxillary advancement and impaction with mandibular advancement), Class III SJ (maxillary advancement and impaction), and Class III DJ (maxillary advancement and impaction with mandibular setback).

Results: Within groups, statistically significant decreases in root length and root volume were found in the period between preorthognatic and postorthognathic surgery (P < .05). No statistically significant differences were found in comparisons between groups (P > .05).

Conclusions: Regardless of the type of skeletal anomaly in the sagittal direction and the orthognathic surgery performed, a statistically significant but clinically insignificant decrease was found in tooth root length and root volume during the postorthognathic surgery period, both in jaws with and without osteotomy.

Objectives: To compare differences in craniofacial growth prediction results for Korean and American children according to growth prediction models developed using Korean and American longitudinal growth data.

Materials and methods: Growth prediction models based on cephalometric landmarks were built for each population using longitudinally taken lateral cephalograms of Korean children and American children of northern European origin. The sample sizes of the serial datasets were 679 and 1257 for Korean and American children, respectively. On each cephalogram, 78 cephalometric landmarks were identified. The prediction models were based on the partial least squares method with 160 input and 154 output variables. For each group, growth was predicted by applying the prediction models developed using data from the same and different populations. The growth prediction results were compared and analyzed.

Results: The growth prediction results obtained with the prediction model developed using data from the same population were more accurate (P < .0001). The results distinctively visualized the discrepancies in the growth prediction results if different population types were not considered.

Conclusions: Applying a growth prediction model generated using data from the same population may be desirable.

Objectives: To evaluate the treatment effects of the modified miniscrew-assisted rapid palatal expander (MARPE) and rapid palatal expander (RPE) with distalizers in patients with Class II malocclusion and maxillary crowding.

Materials and methods: The sample comprised 28 skeletal Class I adolescents with dental Class II malocclusion and maxillary crowding of >4 mm who received nonextraction treatment. Fourteen patients were treated with a modified MARPE with distalizer (MMD), while another 14 patients were treated with a modified RPE with distalizer (MRD). Lateral cephalograms and study casts were taken at pretreatment (T1) and after expansion, distalization, and at the initiation of alignment (T2). Twenty-nine variables were compared using a Bonferroni-adjusted independent t-test and a Mann-Whitney U-test.

Results: From T1 to T2, the maxillary first molars in the MMD group exhibited distalization of 3.0 mm and 2.4 mm at the crown and root (P < .001) compared with 2.1 mm and 1.4 mm in the MRD group. However, no significant difference was found in distalization between the two groups. The first molars in the MRD group showed a significantly greater distal tipping of 2.8° than in the MMD group (P < .001).

Conclusions: Although both groups showed maxillary molar distalization, the MMD group had no distal molar tipping, while there was significant molar tipping in the MRD group. It can be useful to plan nonextraction treatment with maxillary expansion and molar distalization in patients with Class II malocclusion and a narrow maxillary arch.

Objective: A 26-year-old woman came for orthodontic treatment to improve her profile with protrusive lips. Diagnosed as bimaxillary protrusion, extraction followed by anterior retraction was indispensable for the case. However, her left upper lateral incisor was absent, the left upper canine had moved mesially and replaced the adjacent incisor, and the original canine location was restored with a long implant, which was in good condition. Surgical removal of the implant would be tricky and might lead to atrophy of the alveolar bone. In addition, the upper left central incisor had a short, curved root, which could not undergo significant movement.

Materials and methods: After crucial discussion between orthodontists and implantologists, based on digital setup, an innovative treatment plan was developed. Four incisors were extracted followed by clear aligner therapy for anterior retraction. An individualized zirconia abutment was installed on the upper left implant in a retroclined direction, cemented with a zirconia crown to replace the upper lateral incisor. Minimally invasive veneers were made to reshape the other upper incisors for better esthetics.

Results: Finally, the patient had her profile greatly improved and the teeth well aligned without removal of the implant.

Conclusion: Thus, the seemingly mission impossible was accomplished with a satisfactory outcome, thanks to imaginative treatment planning and delicate interdisciplinary collaboration based on digital simulation.

In this case report, we show a strategic approach to prolonging the lifespan of pathologically migrated maxillary canines with a hopeless prognosis in a 57-year-old female patient, highlighting the potential of orthodontic management for middle-aged patients to enhance both occlusion and facial esthetics while minimizing the need for extensive prosthetic treatment. According to the visual treatment objective, the nonextraction treatment plan showed advantages in the type of orthodontic tooth movement and final occlusal relationship. Therefore, considering the favorable periodontal treatment results and single-root teeth, the hopelessly migrated maxillary canines were relocated, eliminating the existing trauma from occlusion. Segmental tooth movement was performed, and orthodontic temporary skeletal anchorage devices were used to support strategic orthodontic tooth movement. After 27 months of treatment, proper occlusion was established with a significant improvement in facial esthetics. The periodontally compromised teeth were preserved with adequate periodontal support. The patient expressed satisfaction with the results, and the 30-month follow-up records confirmed the stability of treatment outcomes.

Objectives: To develop a systematic review of patient perspectives on the treatment of obstructive sleep apnea syndrome (OSAS) after undergoing orthognathic advancement surgery.

Materials and methods: This systematic review adhered to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines, and Patient, Intervention, Comparison, and Outcome (PICO) methodology was employed to formulate the research question. A literature search was performed using the following databases: Cochrane Library (Trials), PubMed via MEDLINE, Embase, and Web of Science (all databases). The Newcastle-Ottawa Scale was used to assess quality of the studies.

Results: Initially, 1407 articles were retrieved from diverse databases, and these were subjected to initial scrutiny. Subsequently, 17 articles were selected for thorough quality analysis and 6 studies for quantitative analysis. Most studies were classified as good quality. Maxillomandibular advancement surgery appeared to enhance patient satisfaction in cases of moderate to severe adult OSAS.

Conclusions: Maxillomandibular advancement surgery significantly improves patients' subjective overall quality of life, improving by 6.36 points in questionnaire ratings and demonstrating long-term stability.

Objectives: To compare the accuracy and chair time of self-ligating brackets using direct bonding, traditional indirect bonding (IB), and computer-aided design/computer-aided manufacturing (CAD/CAM) IB techniques after orthodontic leveling and alignment.

Materials and methods: Forty-five patients were randomly assigned to three bonding groups (G1 [n = 15], G2 [n = 15], and G3 [n = 15]). Evaluation after the alignment and leveling phases used two parameters of the objective grading system of the American Board of Orthodontics for root parallelism and posterior marginal ridges, assessed using panoramic radiographies (PR I and PR II), a digital model, and a plaster model. Blinding was only applied for outcome assessment. No serious harm was observed except for gingivitis associated with plaque accumulation.

Results: Although G3 showed better numerical results, they were not statistically significant in the radiographic or model evaluations (P > .001). Mean chair time was significantly shorter in G3 (1.1 ± 11.8 min) vs. G1 (56.7 ± 7.3 min) and G2 (52.8 ± 8.3 min; P < .001).

Conclusions: The CAD/CAM IB system for self-ligating brackets was as effective as conventional methods, with a shorter chair time.

Objectives: To evaluate the eruptive angle, mesiodistal position and height of permanent maxillary canines in patients with agenesis of the permanent maxillary lateral incisor (AL) from the mixed to the permanent dentition.

Materials and methods: The sample was composed of orthodontic records of subjects with and without AL. The agenesis group comprised 11 patients, 7 with bilateral and 4 with unilateral AL (8.6 ± 1.6 years, 4 males, 7 females). The control group comprised 9 patients (8.5 ± 1.0 years, 2 males, 7 females) without AL. Panoramic radiographs were analyzed at three timepoints: inter-transitional period (T1), second transitional period (10.1±0.9 years, T2) and permanent dentition (11.9±1.1 years, T3). The long axis angle of the permanent maxillary canine (α and β), the mesiodistal distance (d) in relation to the central incisor, and the height (H) from the cusp tip of the canine to the occlusal plane were evaluated. Intergroup comparisons were performed with t-tests, Mann-Whitney, and Chi-square tests (P < 0.05).

Results: A mesial position of the canine cusp tip relative to the distal of the permanent maxillary central incisor was observed for the agenesis group at T1, T2 and T3. From T1 to T2, the agenesis group showed greater occlusal displacement of the canine tooth germ.

Conclusions: In patients with AL, canine tooth germs showed more mesial displacement and erupted a mean of 4.5 mm closer to the maxillary central incisors. Eruption of maxillary canines tended to be accelerated during the late mixed dentition in patients with AL.