The Angle orthodontist最新文献

Objectives: To determine acceptance of potential risks in orthodontic treatment and whether it could be affected by personality traits of patients.

Materials and methods: Two hundred sixty-one adult participants consulting for orthodontic treatment were involved in this cross-sectional study. Acceptance of 18 orthodontic risks was investigated with a structured questionnaire. Personality traits of included patients were assessed with a validated Chinese version of the Big Five Inventory. Statistical analyses were performed as appropriate, and potential correlations were identified using multivariate binary logistic regression analysis.

Results: Acceptability of the investigated orthodontic risks ranged from 47.1% to 87.0%, with periodontitis being the least accepted. Length of treatment (P = .015) and relapse (P = .007) were more unacceptable to older patients. Female participants showed less tolerance to periodontitis (P = .017) than male counterparts. Among the five dimensions of personality traits, conscientiousness was significantly associated with acceptance of tooth extraction and associated risks (odds ratio [OR] = 1.131, P = .002), problems eating (OR = 1.182, P < .001), problems speaking (OR = 1.111, P = .022), and appliance breakage (OR = 1.109, P = .008), while openness was a significant predictor to the acceptance of length of treatment (OR = 1.090, P = .044).

Conclusions: Among patients seeking orthodontic treatment, periodontitis was the least accepted risk. A significant association was found between the acceptance of certain orthodontic risks and personality traits, especially conscientiousness and openness.

Objectives: To investigate the predictors of willingness to uptake orthodontic treatment and to explore the reasons for postponing its initiation in young adults.

Materials and methods: Students, aged 18-30 years old, were randomly approached at the Central Library of the Aristotle University of Thessaloniki Campus and invited to complete the study tool anonymously and voluntarily. The Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and the esthetic component of the Index of Orthodontic Treatment Need (IOTN-AC) were used to evaluate students' psychosocial impact of dental esthetics and severity of malocclusion, whereas the rationale for postponing the initiation of orthodontic treatment was recorded through an open-ended question, analyzed using thematic content analysis.

Results: In total, 270 students, 55.2% female, participated. The single statistically significant factor predicting willingness to uptake orthodontic treatment was the PIDAQ-Psychological Impact subscale (OR: 1.24; 95% CI: 1.11-1.37, P < .001). Gender and age were not associated with willingness to pursue treatment. Seven main themes emerged regarding reasons for postponement: fear of the procedure, embarrassment regarding appearance during treatment, low prioritization of esthetics, insufficient information, high cost of treatment, prolonged duration of treatment, and residential mobility.

Conclusions: The findings suggest that psychological impact of dental esthetics constitutes the main driver to pursue orthodontic treatment. A patient-centered orthodontic approach should address the possible barriers to its initiation. Increasing young adults' oral health literacy could be key in empowering them to make better informed decisions regarding their oral health-related quality of life.

Objectives: To examine retrospectively the short-term effects of a compliance-free skeletal Class III corrector (NET3-corrector) compared to rapid maxillary expansion-facemask (RME-FM).

Material and methods: Records of 20 skeletal Class III patients treated with the NET3-corrector were compared to 20 patients treated with RME-FM, mean age: 11.14 ± 1.17 years and 11.14 ± 2.06, respectively. The NET3-corrector consisted of a hybrid-expander, a lower lingual arch, and a modified PowerScope spring. The RME-FM group received an RME-facemask combination. T2 records were collected when an overjet of at least 2 mm was achieved. Differences between two timepoints within groups and differences between groups were tested using paired samples t-test and independent samples t-test, respectively (P < .05 was considered statistically significant).

Results: The treatment time was 10.5 months with NET3-corrector and 12 months with RME-FM. The NET3-corrector was well tolerated by patients and the Class III malocclusion was corrected in all patients in both groups. The overall maxillary skeletal change was greater with the NET3-corrector, with an additional 2° advancement at SNA (P < .001). Significant differences in maxillary incisor angulation were observed in the RME-FM group in comparison to NET3 (-0.37 ± 3.31 vs 4.96 ± 3.80; P < .001). The mandibular molars tipped significantly more distally in the NET3 group (7.3° more; P < .001).

Conclusions: The compliance-free tooth-bone-borne NET3-corrector, is effective in correcting Class III malocclusion with improved maxillary skeletal outcomes compared to RME-FM in the short term. These results need to be evaluated in the long term with a randomized sample.

Objectives: To evaluate the effects of rs1799750 1G/2G polymorphism of the MMP1 gene and rs1800470 T/C polymorphism of the TGF-ß1 gene on temporomandibular disk displacement and vertical facial development.

Materials and methods: Sixty-six individuals were examined radiographically prior to evaluation of the signs/symptoms of temporomandibular disorders according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Class II, hyperdivergent individuals with TMD (+) were assigned to Group 1, and individuals with TMD (-) were included in Group 2; while Class I, normodivergent individuals with TMD (-) were included in Group 3. For genetic analysis, oral mucosa swab samples were collected, and genotype analysis was performed.

Results: The incidence of 2G alleles in Group 2 (72.7%) was significantly higher than the other groups (P < .05). ANB angle and mean Wits of the 1G/1G genotype of the MMP1 gene were significantly lower than 1G/2G and 2G/2G. Mean Go-Gn of the 1G/1G genotype was significantly higher than that of 1G/2G. The mean SNB of the TGF-β1 TT genotype was significantly higher than TC. The mean Co-Gn of TT was significantly higher than CC.

Conclusions: A relationship was found between the 2G allele of rs1799750 1G/2G polymorphisms of the MMP1 gene and the risk of individuals developing disk displacement. Also, it was found that TGF-ß1 gene rs1800470 29 T/C polymorphisms had a detrimental effect on mandibular development.

Objectives: To determine factors associated with treatment duration in impacted maxillary canines (IMCs) using orthopantomography and cone beam computed tomography.

Materials and methods: Seventeen linear and angular measurements were evaluated using pretreatment radiographic images of 64 patients (83 IMCs). Treatment duration from surgical exposure until the canine appeared in the oral cavity and until achieving ideal alignment were recorded in months.

Results: Average treatment duration until appearance in the mouth was 14.61 ± 9.28 months and 26.98 ± 12.44 months until ideal alignment. Buccally impacted canines emerged in 6.56 ± 3.24 months and were ideally aligned in 19.44 ± 8.49 months in comparison with palatally positioned at 16.34 ± 9.19 and 28.91 ± 12.77 months, respectively. Canines localized around lateral incisors had shorter treatment times than those localized around central incisors. Canines that were inclined >30° to the sagittal medial line (SML) had significantly longer treatment time until initial appearance in the mouth (16.31 ± 9.32) compared with those inclined less (10.82 ± 8.92). Linear regression analyses demonstrated that these factors were predictors for both treatment duration until emergence and ideal alignment of the canine.

Conclusions: Treatment duration for IMCs is lengthy, particularly for palatally and mesially positioned canines and those with greater inclinations. Palatally located canines typically require twice as much time to emerge as those positioned buccally. Canines located nearer the central incisor area take twice as much time to emerge as those located in the lateral incisor area.

Objectives: To evaluate the perception of orthodontists and laypeople of facial attractiveness during aging in participants with acceptable, untreated occlusion.

Materials and methods: Frontal and profile facial photographs of 24 participants (13 male, 11 female) with acceptable, untreated occlusion, taken during adolescence (mean age = 13.3 years) and late adulthood (mean age = 61.2 years) were used. Groups of 30 orthodontists and 30 laypeople scored the facial attractiveness using a scale from 1 (unattractive face) to 10 (very attractive face). Raters indicated the apparent age at T2 and the most and least pleasing facial structures. Three-way analysis of variance was used to assess the influence of sex, age, and rater group on facial attractiveness. Mann-Whitney test was used to compare males and females regarding the apparent age perceived by raters at late adulthood (P < .05).

Results: Mature age was judged with lower scores on facial attractiveness (mean = 5.43) by both groups compared with adolescence (mean = 6.51). Facial attractiveness was not affected by sex. At late adulthood, females were considered younger by both groups of raters, while men were perceived more similar to their actual age. Laypeople were slightly more critical than orthodontists in the assessment of facial attractiveness. Thirty percent of the raters indicated the eyes as the most pleasant region and the chin and nose as the least pleasing structures.

Conclusions: Facial attractiveness slightly decreased from adolescent to mature ages. Women appeared younger than their actual age at late adulthood.

Objective: To investigate the effectiveness of early and short-term administration of lithium (Li) during orthodontic force application (OFA) in preventing orthodontically induced root resorption (OIRR) and verify the importance of the early phase of OFA in the induction of OIRR.

Materials and methods: Bilateral maxillary first molars of 10-week-old male Wistar rats were moved for 14 days using a closed coil spring inserted between the first molar and the incisor. The rats were randomly grouped into three groups: a group receiving Li for the first 4 days, a group receiving Li daily for 14 days, and a control group receiving a vehicle (saline). Orthodontic tooth movement (OTM) was measured using microcomputed tomography on day 14. The OIRR, osteoclasts, and odontoclasts were evaluated via histological analysis. Immunohistochemical staining for the receptor-activated NF-kB ligand and osteoprotegerin was also performed.

Results: The OTM distance did not differ among the three groups, and the pattern of OTM changed from tipping to bodily movement for both Li groups. Early and short-term administration of Li suppressed OIRR on day 14 as effectively as long-term administration for 14 days. The observed odontoclasts on days 4 and 14 were significantly reduced in both Li groups. Osteoprotegerin expression was significantly increased on day 14 in both groups receiving Li relative to the vehicle group.

Conclusions: Early and short-term Li administration effectively suppressed OIRR. This suggests that the early phase of OFA plays an important role in the induction of OIRR.

Objectives: To develop facial growth prediction models using artificial intelligence (AI) under various conditions, and to compare performance of these models with each other as well as with the partial least squares (PLS) growth prediction model.

Materials and methods: Longitudinal lateral cephalograms from 33 subjects in the Mathews growth collection were utilized. A total of 1257 pairs of before and after growth lateral cephalograms were included. In each image, 46 hard and 32 soft tissue landmarks were manually identified. Growth prediction models were constructed using a deep learning method based on TabNet deep neural network and partial least squares (PLS) method. Prediction accuracies of the two methods were compared.

Results: On average, artificial intelligence (AI) showed 0.61 mm less prediction error than PLS. Among the 77 predicted landmarks, AI was more accurate than PLS in 60 landmarks. When comparing AI models with varying numbers of training epochs, those with higher epochs yielded more accurate predictions. Overall, PLS and AI exhibited greater prediction errors for soft tissue and mandibular landmarks compared to hard tissue and maxillary landmarks. However, AI showed a smaller increase in prediction error in areas with greater variability.

Conclusions: AI proved to be a valuable growth prediction method, with clinically acceptable prediction errors averaging 1.49 mm for 45 hard tissue landmarks and 1.71 mm for 32 soft tissue landmarks. PLS accurately predicted landmarks with low variability. However, AI generally outperformed PLS, particularly for landmarks in the lower part of the craniofacial structure and soft tissue, where uncertainty is considerable.

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.