The Angle orthodontist最新文献

Objectives: To analyze and summarize the current scientific evidence regarding the clinical predictability of mesiodistal movements of upper and lower molars in patients treated with clear aligners without auxiliary aid.

Materials and methods: This review followed PRISMA guidelines and was registered in PROSPERO (CRD42022357639). Databases were searched up to September 2024. Data extraction was performed independently by two reviewers, risk of bias was assessed using the ROBINS-I tool, and certainty of evidence was evaluated qualitatively using the GRADE tool.

Results: 919 articles were identified, and six prospective and retrospective studies met the inclusion criteria, predominantly using the Invisalign system. Upper molar predictability was 61.1 ± 9.1% for movements ranging from 0.45 to 3.2 mm. Lower molar distalization showed lower predictability and molar mesial movement had median predictability rates of 85.6 ± 1.1%. Moderate to serious risk of bias and very low quality of evidence was found.

Conclusions: Upper molar distalization using clear aligners appears to be predictable for distalization from 1.5 to 3.2 mm. Anchorage reinforcement or overcorrection should be considered when planning mesiodistal movements. Standardization of the measurement method is necessary to improve efficacy of these systems.

In this case report, we present the treatment of a 28-year-old patient with lip incompetence and vertical maxillary excess (VME), using a combination of a midpalatal miniscrew-anchored cantilever clip appliance and submerged buccal shelf miniscrews. The patient exhibited a convex profile, long face, gummy smile, and protrusion, with a Class II skeletal relationship and mentalis strain. The patient declined conventional orthognathic surgery, leading to an orthodontic camouflage treatment plan involving extraction of four first premolars, maximum retraction, and active vertical control with skeletal anchorage devices. Treatment included the use of infrazygomatic crest miniscrews, anterior subapical miniscrews, and a cantilever clip appliance for molar intrusion, resulting in significant improvement in facial profile, reduction of gummy smile, resolution of lip incompetence, and alleviation of mentalis strain. This case demonstrates the effectiveness of a nonsurgical orthodontic intervention in managing a complex case of VME and lip incompetence.

Objectives: To evaluate changes in glenoid fossa morphology before, during, and after orthodontic treatment with extractions.

Materials and methods: Eighty-four cone-beam computed tomograms from 28 adult female patients with Angle Class II, division 1 malocclusion, who underwent orthodontic treatment involving premolar extraction and mini-implant insertion, were collected at three time points: before treatment (T0), during treatment (just before extraction space closure, T1), and after treatment (T2). Changes in the morphology of the glenoid fossa and the relationship of the anterior teeth among T0, T1, and T2 were recorded.

Results: Inclination of the articular eminence (AEI-BFL and AEI-TRL) increased from T1 to T2 and from T0 to T2, whereas the width of the glenoid fossa (GFW) decreased from T1 to T2 and from T0 to T2. Changes in depth of the glenoid fossa (GFD) and the ratio of GFW to GFD were observed only in T0-T2. The height of the articular eminence (AEH) showed no significant differences among the three time points. Except for incisor overbite, which decreased from T0 to T1 and then to T2, all other dental parameters showed differences only in T1-T2 and T0-T2.

Conclusions: Orthodontic treatment with extractions can induce adaptive morphological changes in the glenoid fossa, primarily during the stage of extraction space closure. These changes are mainly characterized by a steeper AEI and a reduction in GFW.

Objectives: To compare orthodontic treatment cooperation between Generation Y and Generation Z teenagers and evaluate influence of age on compliance.

Materials and methods: This was a retrospective cohort study analyzing records of 124 patients (62 from each generation) treated at Tel Aviv University Dental School between 2007 and 2021. Patient cooperation was assessed through weighted noncompliance scores incorporating elastic or headgear wear, oral hygiene, appointment attendance, appliance breakage, and new caries development. Each noncompliance incident was weighted (1.0 point for major incidents, 0.5 for minor) and standardized by treatment duration. Multiple regression analysis accounted for age differences.

Results: Mean age differed significantly between Generation Y (15.5 ± 1.7 years) and Generation Z (13.1 ± 1.6 years; P < .001). Initial noncooperation scores were similar (Generation Y: 36.8% ± 16.4%; Generation Z: 35.8% ± 15.8%; P = .732). After age adjustment, regression analysis revealed significantly higher noncooperation in Generation Y (B = 8.29; P = .014). Age independently influenced cooperation, with each year increase associated with a 3% decrease in noncooperation scores (B = -3.04; P < .001).

Conclusions: Generation Z teenagers exhibited better orthodontic treatment cooperation than Generation Y after age adjustment. Age independently predicted cooperation, with older teenagers showing better compliance regardless of generation. Treatment planning should consider both generational differences and individual patient factors when selecting compliance-dependent treatment options.

Objectives: To compare a slow, rapid activation protocol for miniscrew-assisted maxillary expansion in adults.

Materials and methods: Fifteen consecutive adult patients underwent miniscrew-assisted slow palatal expansion (MASPE) using a bone borne device. A control group treated with miniscrew-assisted rapid palatal expansion (MARPE) was matched for initial demographic data and expansion need.

Results: No statistically significant differences in bispinal expansion were observed between the MASPE and MARPE groups at the anterior, middle, or posterior levels.

Conclusions: MASPE successfully achieved skeletal expansion of the maxilla in 86.7% of adult patients treated. The expansion pattern and results were comparable to MARPE.

Objectives: To evaluate the influence of personalized aligner replacement, with or without physical methods of acceleration using low-frequency vibration combined with a low-level laser, on the tooth movement rate and accuracy of clear aligners.

Materials and methods: Forty participants were randomly allocated to three groups. Fourteen participants used the standard replacement protocol in Group A, Group B included 14 participants using a personalized replacement protocol, and 12 participants in Group C followed the personalized replacement protocol and used a physical device that combined low-frequency vibration and low-level laser. Aligner replacement cycles of the first 12 steps were recorded, and GOM inspect suite software 2022 (GOM; Braunschweig, Germany) was used to evaluate maxillary molar movement accuracy using digital models collected before treatment and at the end of the 12th step.

Results: No significant difference was found in the accuracy of maxillary molar movement between Groups A and B, but the tooth movement rate in Group B was significantly greater. The accuracy of maxillary molar movement was similar in Groups B and C, and the tooth movement rate in Group C was significantly increased.

Conclusions: The personalized replacement protocol decreased the number of aligner replacement cycles without impacting the accuracy of tooth movement. With personalized replacement, a physical method of acceleration combining low-level laser and low-frequency vibration significantly accelerated orthodontic tooth movement and had little influence on the accuracy of tooth movement.

Objectives: To compare mandibular incisor root length (RL) and root volume (RV) changes after 6 months of wearing either a removable anterior bite plane (RABP) during meals (F + M) or not during meals (F - M). Additionally, changes in incisal maximum bite force (IMBF) and their correlation with RL and RV changes were assessed.

Materials and methods: Thirty-six children with deep bite using RABPs full time were randomly assigned in equal numbers to either the F + M group or F - M group. Cone-beam computed tomographic radiographs and IMBF were recorded at baseline (CT0) and after 6 months (CT1). Within and between group comparisons of RL and RV were performed (P = .05) with Bonferroni correction applied for segmental RV differences (P = .008). Relationships between IMBF changes and RL and RV changes were analyzed (P = .05).

Results: Both groups showed significant reductions in RL and RV. RL decrease in the F + M group (0.25 ± 0.14 mm) was significantly greater than in the F - M group (0.21 ± 0.14 mm). Reduction in RV was not significantly different between the groups, but IMBF significantly increased in both groups. Significant correlations were observed between IMBF changes and RL (r = 0.56) and RV (r = 0.86) changes.

Conclusions: Deep bite correction using RABPs for 6 months with F + M protocol resulted in a greater decrease in mandibular incisor RL compared to the F - M protocol. However, RV changes were comparable between protocols. IMBF may influence the degree of RL and RV changes.

This case report describes correction of maxillary constriction using a maxillary skeletal expander (MSE) in a 15-year-old female with a skeletal Class III pattern and asymmetry. The maxillary expansion device with four mini-implants was used to correct the constricted maxilla, bilateral crossbite of the posterior teeth, and crowding of the dentition. Comparison of cone-beam computed tomography scans before and after treatment showed that the majority of maxillary expansion was orthopedic, with minimal alveolar bone bending and tooth tipping. Fixed appliances were used to correct the crowding and malocclusion. Stable and satisfactory maxillary expansion was obtained by using MSE non-urgically.

Objectives: To assess case outcomes using the American Board of Orthodontics (ABO) Objective Grading System (OGS) in patients treated with lower incisor extraction.

Materials and methods: Discrepancy indices (DI) were used to stratify patients into mild, moderate, and complex categories and overjet, overbite, and buccal occlusion were examined. Nineteen subjects were included in the study, among which 52.6% were females.

Results: The average (SD) age was 28.5 (15.1) years, and the average (SD) DI was 15.2 (8.6) with an even distribution of mild, moderate, and complex cases. The mean post-treatment OGS was 31, with 52.6% of the patients achieving passing ABO clinical scores. 31.6% achieved normal post-treatment overjet. A total of 52.6% achieved normal post-treatment overbite, and 84.2% achieved normal post-treatment buccal occlusion.

Conclusions: An increase in overbite and overjet, and a decrease in buccal occlusion measurement, were found after lower incisor extraction treatment. The ABO-OGS scores obtained were high, indicating that they may not pass the ABO criteria established.

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.