The Angle orthodontist最新文献

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 evaluate factors influencing the prediction error of artificial intelligence (AI) that predict craniofacial growth and to identify an optimal AI training condition to improve the predictive performance of the AI model.

Materials and methods: Original growth data were collected from the Mathews longitudinal serial growth study. From the original data consisting of 1257 datasets from 33 growing children of northern European descent, 60 data subsets were generated using random resampling procedures to include 12, 18, and 24 subjects, with data sizes of 100, 200, 300, 400, and 500 datasets. The resampling procedures were repeated four times. Each subset was used to train and create a total of 60 AI models. The prediction accuracy of these models was evaluated using growth prediction errors at the lower lip landmark, labrale inferius, as a benchmark indicator. The prediction errors of the 60 AI models were analyzed according to the number of subjects and data sizes.

Results: Prediction error decreased as the data size increased. However, increasing the number of subjects within the growth data led to higher prediction errors. Notably, the increase in prediction error caused by adding more subjects was more substantial than the improvement achieved by increasing the data size.

Conclusions: The findings suggest that developing highly accurate AI-based craniofacial growth prediction models remains a significant challenge, even with extensive datasets.

Objectives: To evaluate and compare the accuracy of four AI chatbots, ChatGPT-3.5, ChatGPT-4.0, Copilot, and Gemini, in response to orthodontic emergency scenarios.

Materials and methods: Forty frequently asked questions related to orthodontic emergencies were posed to the chatbots. These questions were categorized as fixed orthodontic treatment, clear aligner treatment, eating and oral hygiene, pain and discomfort, general concerns, retention, and sports and travel. The responses were evaluated by three orthodontic experts using a five-point Likert scale, and statistical analysis was conducted to assess variations in accuracy across chatbots.

Results: Statistical analysis revealed significant differences among the chatbots. Gemini and ChatGPT-4.0 demonstrated the highest accuracy in response to orthodontic emergencies, followed by Copilot, whereas ChatGPT-3.5 had the lowest accuracy scores. Additionally, the "Fixed Orthodontic Treatment" category showed a statistically significant difference (P = .043), with Gemini outperforming the other chatbots in this category. However, no statistically significant differences were found in other categories.

Conclusions: AI chatbots show potential in providing immediate assistance for orthodontic emergencies, but their accuracy varies across different models and question categories.

Objectives: To compare differential changes in nasal patency and dentoskeletal morphology after rapid palatal expansion (RPE) vs hybrid miniscrew-assisted rapid maxillary expansion (MARPE).

Materials and methods: Thirty patients presenting with bilateral crossbite were randomized into RPE or hybrid MARPE treatment groups. MARPE patients were treated using the two-point hyrax appliance and RPE patients were treated using the conventional hyrax appliance. Nasal patency was evaluated using rhinomanometry and dentoskeletal changes were evaluated using cone beam computed tomography images.

Results: The success of suture opening was 53% and 60% in the RPE (mean age: 17.36 ± 1.80) and MARPE groups (mean age: 18.52 ± 1.80), respectively. The MARPE group showed significantly increased nasal airflow and decreased nasal resistance during inspiration and expiration compared to the RPE group after 4 months of treatment. The RPE group demonstrated nonsignificant changes in the same parameters after 4 months. Although significant differences between groups were observed in nasal flow during inspiration and expiration for both nostrils, intergroup differences in nasal resistance were not significant (P > .05). The MARPE group exhibited greater expansion in nasal, maxillary basal, and alveolar widths compared to the RPE group. A more pronounced decrease in buccal bone thickness was observed in the RPE group. The buccal inclination of the first premolars and molars significantly increased in both groups.

Conclusions: Although similar success rates for sutural opening were observed between MARPE and RPE, MARPE facilitated more pronounced changes in nasal patency and skeletal maxillary expansion compared to conventional RPE.

The incidence of maxillary canine impaction is estimated at approximately 1.7% of the population and is multifactorial in etiology. Several case reports suggest a potential relationship between canine impaction and root dilaceration of the adjacent premolar, indicating mechanical interference due to their proximity. In such cases, when avoiding tooth extractions is desired, it is crucial to consider specific clinical approaches to prevent contact with the dilacerated root during traction. This case report describes traction of an impacted maxillary canine in a female patient resulting from severe palatal root dilaceration of the adjacent first premolar. The canine was surgically exposed and traction was initiated after endodontic therapy and root sectioning of the affected premolar. After 24 months of orthodontic treatment, the results were satisfactory, with adequate gingival contour, 2 mm overjet and overbite, and a Class I relationship of canines and molars. No apparent root resorption was observed, and bone structure was preserved. A multidisciplinary approach is fundamental for the success of treatment in such cases, enabling achievement of a functionally and esthetically stable occlusion while avoiding tooth extractions.

Objectives: To compare the effect of three different maxillary retainers: round multi-strand stainless steel (SS), rectangular white gold-plated SS, and vacuum-formed (VF) retainers on treatment stability, retainer integrity, and gingival health over 12 months.

Materials and methods: Seventy subjects who finished fixed orthodontic treatment and required orthodontic retainers in the upper arch were randomly divided into three groups. The first group (mean age: 21.0 years) received bonded three multi-strand round (0.0175-inch) SS retainer, the second group (mean age: 20.4 years) received bonded rectangular (0.038 × 0.016-inch) white gold-plated SS retainer, the third group (mean age: 20.0 years) received removable VF retainer. Bonded retainers were extended from lateral to lateral incisor while VF retainer was extended to the most distal molar. After 1 year, all subjects were recalled. The primary outcome was to assess relapse in upper labial segment alignment. The secondary outcome was to evaluate the plaque index (PI) and gingival index (GI) of the upper labial segment teeth and retainer failure rate.

Results: There was no statistical difference in the average irregularity index (IRI), PI, and GI among the three groups (P = .667, P = .781, P = .487, respectively). Retainer failure rate was significantly higher in Group III (60.9%) compared to Group I (20.8%) and Group II (34.8%, P = .017).

Conclusions: After 1 year, anterior tooth alignment stability and gingival health parameters were not different between bonded and VF retainers. However, the VF retainer exhibited a higher failure rate compared to bonded retainers.

Objectives: To investigate the effects of buccal osteotomy angulation on surgically assisted rapid palatal expansion (SARPE) patterns.

Materials and methods: A finite element analysis (FEA) model of the maxilla with Haas expander was constructed from a cone beam computed tomography (CBCT) image using Mimics, Geomagic, and solidWorks software. One-mm-thick buccal osteotomies were created with different combinations of 0°, 10°, 20°, and 30° from the horizontal plane to simulate differences in bilateral osteotomy angulation. Springs were placed at the buccal osteotomy gaps to mimic the strain of the bone callus. After applying 150 Newton of expansion force at the level of the expander jackscrew in each FEA scenario, the expansion pattern of the hemimaxillae was evaluated in Ansys software.

Results: Scenarios with 20° (0-20°; 10-30°) and 30° (0-30°) differences resulted in significant transverse asymmetric expansion. Among the groups with 10° difference, 0-10° resulted in relatively parallel expansion, while 10-20° and 20-30° experienced V-shaped expansion with more anterior widening.

Conclusions: A larger difference between the angulations of the left and right buccal osteotomies resulted in increased asymmetry in both the transverse and vertical dimensions after expansion.

Objectives: Evaluate the changes in oral microbiota linked to orthodontic treatment by analyzing the 16S rRNA gene.

Materials and methods: A total of 22 articles was included in the systematic review. The methodological quality of these studies was assessed using the Newcastle-Ottawa Scale for nonrandomized studies and the Risk of Bias tool for randomized studies.

Results: Orthodontic appliances significantly influenced the composition of oral microbiota. Specifically, fixed orthodontic appliances were linked to an increase in periodontopathogenic bacteria associated with various systemic diseases. In contrast, transparent aligners correlated with an increase in Streptococcus species.

Conclusions: In this study, we evaluated the changes in oral microbiota associated with orthodontic treatment by analyzing the 16S rRNA gene. Results revealed significant alterations in oral microbiota following orthodontic treatment; however, significant variability among studies prevents firm conclusions. Additional research is essential to clarify the effects on oral health.

Objectives: To compare the efficacy of clear aligners and Z-spring (ZS) appliances in treating dental anterior crossbite (AC) during the mixed dentition period.

Materials and methods: Thirty patients (7-12 years) with Angle Class I occlusion and isolated pseudo-Class III AC were randomly assigned to clear aligners (Group A, n = 15) or ZS appliances (Group B, n = 15). Outcomes were evaluated based on duration, cephalometric changes, model analysis, and oral health-related quality of life (OHRQoL), assessed using the Child Oral Health Impact Profile-Short Form-19 (COHIP-SF-19).

Results: AC was successfully corrected in all patients. Treatment duration was significantly shorter in Group B (48.4 ± 27 days) than in Group A (96.3 ± 22.7 days) (P < .05). U1-NA angle increased by 5.9° and overjet by 4 mm in Group A; in Group B, U1-NA increased by 7.7° and overjet by 4.2 mm (P < .01). Intergroup cephalometric changes (ΔT1-T0) were not significant (P > .05). In Group A, incisal and gingival arch depths increased significantly (2.6 mm and 1.17 mm, respectively; P < .001), whereas no significant changes occurred in Group B (P > .05). COHIP-SF-19 scores were comparable (P > .05).

Conclusion: Clear aligners and ZS appliances were effective in treating dental AC, achieving normal overjet relationships. However, ZS appliances may cause greater tipping, whereas clear aligners facilitate tipping, alignment, and bodily movement. Treatments demonstrated comparable effects on OHRQoL of children. This study provides a foundation for future research on different appliances for managing AC in the mixed dentition.