Active Orthodontic Treatment Research Articles

Enamel evaluation by scanning electron microscopy after debonding brackets and removal of adhesive remnants.

BackgroundThe bonding of accessories in the dental crown during the orthodontic treatment creates microporosities, thus promoting micromechanical retention of the adhesive to the enamel structure. After debonding brackets, at the end of the active orthodontic treatment, a certain amount of adhesive remnants must be mechanically removed from the enamel. The objective of this study was to compare, by means of scanning electron microscopy, three different methods to remove the adhesive remnants after orthodontic bracket removal.Material and MethodsAn experimental analytical study was conducted on human premolar specimens, extracted within a year or less. The preparation of the enamel was carried out with the application of 35% phosphoric acid and Transbond XT Light Cure Adhesive Primer® adhesive. Edgwise Standart prescription brackets, slot .022 “(Morelli Orthodontia) were glued to the enamel using Transbond XT® bonding resin. The brackets were placed on the center of the vestibular face of the clinical crown, and a 300-gram pressure was exerted against the surface of the enamel, measured with an orthodontic dynamometer. The brackets were debonded with adhesive removing pliers, and the samples were divided into groups, according to the protocol used for adhesive remnant removal: high-speed multi-laminated drill bit, low-speed multi-laminated drill bit, and low-speed glass fiber. After removal of the adhesive remnants, the samples went through scanning electron microscopy, obtaining electro micrographs with a magnification range of 150 X, 500 X, and 2,000 X.ResultsThe tested method showed that the best effectiveness for the removal of the adhesive remnants after bracket debonding was the use of a tungsten carbide multi-laminated high speed, followed by the use of a tungsten carbide multi-laminated, low-rotation drill. The use of fiberglass drill alone has proved to be inefficient for clinical use, given the large amounts of adhesive remnants it leaves on the enamel.ConclusionsAll methods evaluated in this study proved to be inefficient for total removal of adhesive remnants from the enamel. Key words:Dental enamel, microscopy, orthodontics.

An in vivo spectrophotometric evaluation of Vivera® and Essix® clear thermoplastic retainer discolouration

Abstract Aim To assess the in vivo colour alterations of two different clear thermoplastic retainers. Methods Thirty patients were randomly allocated into two Groups (N = 15) following the completion of active orthodontic treatment. Group 1 received Vivera® and Group 2 Essix® C+ thermoplastic retainers. Each patient was provided with two fabricated retainers (one for use and the other to serve as a control). The CIELAB parameters of the patients’ upper central incisors were measured with a SpectroShade™ spectrophotometer immediately after retainer placement (T0) and again after 15 days (T1), one month (T2) and three months (T3). The measurements were also performed on teeth without the retainer in place. ΔE differences were calculated. Methods ΔE changes from T0 to Tp T2 or T3 showed no statistically significant differences between Groups 1 and 2 within any combination of measurements or teeth. ΔEļŢ3-Ţ0ļ changes for used retainers were 1.55 times higher than control appliances (p = 0.002) and 1.44 times higher than for teeth-only (p = 0.004). For used retainers, changes between T3 and T0 were 1.56 times higher than between T and T0 and 1.47 higher than between T2 and T0 (p < 0.001). There were no statistically significant differences in ΔE between teeth 11 and 21. Results Used retainers exhibited greater colour change than control appliances or teeth-only readings, and increased commensurate with the duration of use. Vivera® and Essix® retainers exhibited similar colour stability. All differences observed were considered clinically acceptable (ΔE < 3.7), although prolonged use could cause clinically significant colour changes.

Diagnosis of the Auditory System of a CCD Case Treated Surgically and Orthodontically

Cleidocranial dysplasia (CCD) represents a rare genetic disease characterized by disturbances in osseous structures, face dysmorphia, hypoplasia or aplasia of clavicles and numerous supranumerary teeth causing permanent teeth impaction. The study aimed at presenting a case of 12-year-old girl with CCD at the phase of active orthodontic treatment, involving successive extraction of multiple supranumerary teeth and repositioning of additional teeth using elastic traction. The patient was also subjected to a complex auditory examination which detected a hearing loss. Patients with CCD from their youngest years should be covered by a broad diagnosis and therapy, involving a comprehensive collaboration of multiple specialities.

Growth of Palate in Unilateral Cleft Lip and Palate Patients Undergoing Two-stage Palatoplasty and Orthodontic Treatment.

The purpose of this study was to investigate the long-term effects of two-stage palatoplasty on the morphology of the maxillary alveolar arch and occlusion using plaster models of the maxilla and mandible obtained from patients with unilateral complete cleft lip and palate who also underwent orthodontic treatment. A total of 20 patients undergoing two-stage palatoplasty by Perko's method (Group T) were enrolled. Plaster models of the maxilla and mandible were obtained from each patient at Time 1, on commencement of orthodontic treatment in the mixed dentition period; at Time 2, on that of orthodontic treatment in the permanent dentition period; and at Time 3, on completion of active orthodontic treatment. Analysis of occlusion and morphological analysis were performed using a 3-dimensional measuring system. The results were compared with 15 patients who underwent one-stage palatoplasty by the push-back method using a mucoperiosteal flap (Group P). Alveolar morphology and the relationship between the maxilla and mandible were satisfactory in Group T. The palates in Group T were deeper and larger than those in Group P. Alveolar collapse in Group T was milder, and impairment of the alveolar morphology less notable than in Group P, as surgical invasion to the anterior alveolar region was avoided during the palatal growth period. These results suggest that two-stage palatoplasty is advantageous for jaw development.

Aktif Sabit Ortodontik Tedavi Sırasında Meydana Gelen Dental Travma: Vaka Raporu

The purpose of this case report was to present the treatment of a patient suffering from accidental dental trauma during fixed orthodontic treatment. A 16-year-old girl that was receiving fixed orthodontic therapy in our clinic for 5 months came back two days later after a dental trauma. She revealed that she had a syncope and fell down in her house with the effect of syncope. Extraorally, lower lip laceration was observed. Intraorally, lateral luxation associated with extrusion for lower central incisors (31,41) was diagnosed. Root canal treatment was delayed because it was not possible to determine the definite result of pulp vitality response of traumatized teeth immediately after the injury. After trauma, active orthodontic force was removed from both of traumatized teeth. After 7 months, it was determined that pulp vitality of traumatized tooth was remained. Then levelling and alignment was performed with light orthodontics forces. An esthetic smile and ideal occlusion was achieved as it was planned initially. Twelve months after the end of active orthodontic treatment, sectional pulp obliteration was examined in perapical radiographs of both mandibular central incisors. Rutine clinical and radiographic examination is needed in every 6 months.

An Audit On Waiting Period For Alveolar Bone Graft (ABG) After Pre-ABG Orthodontic Treatment In Abdul Samad Orthodontic Clinic

Introduction: The timing of ABG procedure in a cleft patient is crucial to provide room and bony support for the eruption of canine. However, there seems to be a delay in execution of this procedure in certain centres. Material and Methods: Sample consists of records of cleft patients treated from 2000-2016. The date and age for commencement of active orthodontic treatment, date referred for ABG and date ABG done were retrieved. The centres that conducted these surgeries identified. Results: The mean age at start of treatment was 11.03 for males and 11.47 for females. Average waiting period for ABG was 11.75 months with the shortest was 12 days and the longest was 35 months. Conclusion(s): Delay in ABG increase the risks associated with prolonged wear of fixed orthodontics. Distribution of burden of care among the surgical centres to reduce this waiting time should be taken into consideration for the benefit of patients.

Efficiency and Duration of Orthodontic/Orthognathic Surgery Treatment.

To investigate the combined orthodontic-orthognathic treatment times at an academic hospital in the UK and to consider the level of occlusal change in delivering this treatment by the way of comparing peer assessment rating (PAR) scores pre- and post-treatment. It was a retrospective longitudinal study of orthognathic patients between 2010 and 2013 who had completed orthognathic treatment. Analysis of records of 50 patients was carried out. Age, gender malocclusion, and skeletal pattern, extraction/nonextraction of teeth, duration of active orthodontic treatment, number of appointments, transfer of patients between orthodontists mid-treatment, and PAR scores pre and post-treatment were recorded for each patient. The skeletal pattern was III in 70% of and II in 28% of patients. Mean duration of active orthodontic treatment was 27.9 months. Age, gender, malocclusion, and skeletal pattern did not seem to affect treatment times. Extraction of teeth and transfer of operators increased treatment times. The mean PAR reduction was 89% with the PAR efficiency factor (reduction in PAR scores divided by duration of treatment in months) of 1.61. Younger patients, those with class III malocclusions and patients starting with higher PAR scores, achieved greater PAR reductions. Gender, number of appointments, extractions, transfer of operators, and total duration of treatment were not shown to affect the PAR % reduction. Combined orthodontic-orthognathic treatment has been effective in treating patients with severe skeletal discrepancies. Transfer of operators and extractions protracted treatment times. Younger patients and those with class III malocclusions achieved higher PAR % reduction.

Interdisciplinary dental treatment of a patient with incontinentia pigmenti exhibiting oligodontia and skeletal Class III malocclusion

Incontinentia pigmenti is a rare X-linked genetic disorder characterized by various abnormalities of the skin, eyes, teeth, hair, and central nervous system. Among them, congenitally missing teeth and abnormal tooth morphology frequently cause occlusal problems. This case report shows an interdisciplinary dental treatment performed by orthodontic, prosthodntic and oral surgery clinics for a 13-year-old female patient with incontinentia pigmenti by temporary anchorage device (TAD) mechanics. She exhibited oligodontia and skeletal Class III malocclusion with counterclockwise rotation of the mandible and a short face caused by sagittal and vertical maxillary deficiency. Firstly, an occlusal splint was placed in the maxillary arch, and a partial denture was placed in the mandibular arch, respectively, for provisional restoration to increase her occlusal vertical dimension. After achieving a further increase in the vertical dimension by adjusting the maxillary splint, a preadjusted edgewise appliance was placed in the mandibular arch and the anterior teeth were retracted using TADs. After active orthodontic treatment, an overdenture and partial denture were placed in maxillary and mandibular arches, respectively, and functional occlusion was obtained. Her facial esthetics improved without clinical evidence of TMJ pathology or symptoms. This case report demonstrates that interdisciplinary dental treatment including orthodontic treatment with TADs can improve the occlusal function and the esthetic problems in patients with incontinentia pigmenti exhibiting oligodontia and skeletal Class III malocclusion.

Methodologies in Orthodontic Pain Management: A Review

Introduction:Patients experience pain and discomfort during active orthodontic treatment with fixed appliances. Pain is considered a subjective response to noxious stimuli. It can vary from person to person and is influenced by certain factors such as age, gender, previous pain experiences, stress or anxiety, and type of appliance.Objective:The objective of this literature review was to discuss conventional versus recently introduced treatment modalities used in pain management for orthodontic patients.Discussion:According to the reviewed articles, both pharmacological and non-pharmacological methods were introduced in orthodontic pain management. However, orthodontists must use their best professional judgment to assess each case individually and select an appropriate treatment modality based on pain threshold level of an individual.Conclusion:Nevertheless, further investigations are required in this field.

Open versus closed surgical exposure of canine teeth that are displaced in the roof of the mouth.

Palatally displaced canines or PDCs are upper permanent canines, commonly known as 'eye' teeth, that are displaced in the roof of the mouth. This can leave unsightly gaps, cause damage to the surrounding roots (which can be so severe that neighbouring teeth are lost or have to be removed) and, occasionally, result in the development of cysts. PDCs are a frequent dental anomaly, present in 2% to 3% of young people.Management of this problem is both time consuming and expensive. It involves surgical exposure (uncovering) followed by fixed braces for two to three years to bring the canine into alignment within the dental arch. Two techniques for exposing palatal canines are routinely used in the UK: the closed technique and the open technique. The closed technique involves uncovering the canine, attaching an eyelet and gold chain and then suturing the palatal mucosa back over the tooth. The tooth is then moved into position covered by the palatal mucosa. The open technique involves uncovering the canine tooth and removing the overlying palatal tissue to leave it uncovered. The orthodontist can then see the crown of the canine to align it. To assess the effects of using either an open or closed surgical method to expose canines that have become displaced in the roof of the mouth, in terms of success and other clinical and patient-reported outcomes. Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 24 February 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (in the Cochrane Library, 2017, Issue 1), MEDLINE Ovid (1946 to 24 February 2017), and Embase Ovid (1980 to 24 February 2017). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases. We included randomised and quasi-randomised controlled trials assessing young people receiving surgical treatment to correct upper PDCs. There was no restriction on age, presenting malocclusion or type of active orthodontic treatment undertaken. We included unilaterally and bilaterally displaced canines. Two review authors independently screened the results of the electronic searches, extracted data and assessed the risk of bias in the included studies. We attempted to contact study authors for missing data or clarification where feasible. We followed statistical guidelines from the Cochrane Handbook for Systematic Reviews of Interventions for data synthesis. We included three studies, involving 146 participants. Two studies were assessed as being at high risk of bias.The main finding of the review was that the two techniques may be equally successful at exposing PDCs (risk ratio (RR) 0.99, 95% confidence interval (CI) 0.93 to 1.06; three studies, 141 participants analysed, low-quality evidence).One surgical failure was due to detachment of the gold chain (closed group). One study reported on complications following surgery and found two in the closed group: a post-operative infection requiring antibiotics and pain during alignment of the canine as the gold chain penetrated through the gum tissue of the palate.We were unable to pool data for dental aesthetics, patient-reported pain and discomfort, periodontal health and treatment time; however, individual studies did not find any differences between the surgical techniques (low- to very low-quality evidence). Currently, the evidence suggests that neither the open or closed surgical technique for exposing palatally displaced maxillary canine teeth is superior for any of the outcomes included in this review; however, we considered the evidence to be low quality, with two of the three included studies being at high risk of bias. This suggests the need for more high-quality studies. Three ongoing clinical trials have been identified and it is hoped that these will produce data that can be pooled to increase the degree of certainty in these findings.

THE EFFECTIVNESS OF CHRONIC GINGIVITES TREATMENT IN PATIENTS WITH NON-REMOVABLE ORTHODONTIC APPARATUS ACCORDING TO THE RESULTS OF PERIODONTAL TISSUES INDEX ASSESSMENT

Background. The risk of chronic gingivitis is increased in patients who undergo orthodontic treatment. It is known that the gingivitis is closely correlated with the level of hygiene.Objective. The study involved 123 orthodontic patients with chronic catarrhal and hypertrophic gingivitis that developed during the first two months of active orthodontic treatment. We chose VITIS ORTНODONTIС (DENTAID INTERNATIONAL, Spain) that contains active ingredients we need to support healthy state of oral cavity. All studied patients were 12-15 years old.Methods. For dental examination we used health indices OHI-S according to Greene-Vermillion (1964). Gums bleeding was determined according to a modified SBI index by Muhlemann (1971), inflammation of the gingival margin was assessed by PMA index Parma (1960).Results. Therapeutic treatment consisted of the following: all patients underwent correction of oral hygiene, removal of dental plaque. Vitis ORTHODONTIC was prescribed due to the manufacturer's recommendations: rinse 15 ml for 30 seconds after normal procedures of oral hygiene. Eating or drinking is not recommended during the next 30 minutes after using this product. The results proved a high anti-inflammatory efficacy of the treatment schemes.Conclusions. The complex therapy of early manifestations of inflammation in periodontal had a positive effect on the subjective feelings of patients and health performance rate, gum inflammation and bleeding.

Interdisciplinary case of multiple congenitally missing permanent teeth.

Background: Patients presenting with congenitally missing teeth are relatively common and the aim of the dental team is to create a functional, healthy, and aesthetically acceptable dentition. The consequences of missing teeth include an abnormal occlusion or an altered facial appearance which may lead to psychological distress in some patients.Methods: The present case report describes a 23 year old patient with non-syndromic, congenitally missing permanent teeth (CMMPT). Clinical and radiographic examinations revealed agenesis of eight permanent teeth including the third molars. Following interdisciplinary treatment planning, the patient was treated with mechano therapy to correct a class III incisal relationship by space closure in the lower arch. In the upper arch, the right canine was substituted for a missing lateral incisor and space was opened for a prosthetic left lateral incisor (a mini implant).Results: Active orthodontic treatment was completed in 19 months. The management of CMMPT requires an interdisciplinary approach to achieve improved occlusal function and aesthetics.Conclusion: A combined orthodontic-implant-prosthodontic treatment approach can achieve an improved functioning occlusion, and favorable aesthetics.Bangladesh Journal of Medical Science Vol.16(3) 2017 p.467-473

Stability of orthodontic treatment outcome in relation to retention status: An 8-year follow-up.

Our aim was to evaluate the stability of orthodontic treatment outcome and retention status 7 or more years after active treatment in relation to posttreatment or postretention time, type of retention appliance, and duration of retainer use. The subjects were former patients who completed orthodontic treatment with fixed appliances from 2000 to 2007. The pretreatment eligibility criteria were anterior crowding of 4mm or more in the maxilla or the mandible and Angle Class I or Class II sagittal molar relationship. Acceptable pretreatment and posttreatment dental casts were required. A total of 67 patients participated, 24 men and 43 women, with a mean age of 24.7years (range, 20.0-50.0years). All participants had a follow-up clinical examination, which included impressions for follow-up casts, and each completed a questionnaire. Data were obtained from pretreatment, posttreatment, and follow-up (T2) casts as well as from the patients' dental records. Treatment stability was evaluated with the peer assessment rating (PAR) index and Little's irregularity index. The participation rate was 64%. The average posttreatment time was 8.5years (range, 7.0-11.0). All participants had received a retainer in the mandible, maxilla, or both after active treatment. At T2, the PAR score showed a mean relapse of 14%. The majority (78%) of participants still had a fixed retainer at T2 (retainer group), and 22% had been out of retention for at least 1year (postretention group). The relapse according to the PAR did not differ significantly between participants with and without a retainer at T2. From posttreatment to T2, the irregularity of the mandibular incisors increased almost 3 times more in participants with no retainer in the mandible compared with those with an intact retainer at T2 (P=0.001). In the maxilla, no corresponding difference was found. Our results suggest that occlusal relapse can be expected after active orthodontic treatment irrespective of long-term use of fixed retainers. Fixed canine-to-canine retainers seem effective to maintain mandibular incisor alignment, whereas in the maxilla a fixed retainer may not make any difference in the long term.

Rinsing effect of 60% bay leaf (Syzygium polyanthum wight) aqueous decoction in inhibiting the accumulation of dental plaque during fixed orthodontic treatment

Background: Fixed orthodontic appliance patients have a high risk to increasing plaque accumulation in tooth surface due to the presence of fixed appliance components. Using mouthwash with antibacterial agent from herbal material can control dental plaque accumulation. Bay leaf (BL) contains active compounds such as essential oil, tannin and flavonoid that have been known as an antibacterial agent. Purpose: The purpose of this study was to determine the effect of rinsing with 60% of BL aqueous decoction to the accumulation of dental plaque in fixed orthodontic appliance patients. Method: This research was an experimental clinical research with pretest and post-test control group design conducted on 20 subjects with age ranged between 18-25 years old. All subjects were undergoing the last stage (finishing) of fixed active orthodontic treatment. The subjects were instructed to rinse with 60% of BL aqueous decoction and 0.2% chlorhexidine as a control. Wash out period that needed between rinsing with 60% of BL aqueous decoction and rinsing with 0.2% chlorhexidine was 7 days. Each mouthwash used routinely for 7 days with same duration and intensity. Plaque scoring was measured before and after each treatment using Orthodontic Plaque Index (OPI). Result: One-way Anova test showed that there was a significant difference in the plaque index before and after treatment between the group of rinsing with 60% of BL aqueous decoction and group of rinsing with chlorhexidine (p<0.05). Conclusion: Rinsing with 60% BL aqueous decoction can decrease the accumulation of dental plaque in fixed orthodontic appliance patients.

Connective Tissue Graft for Gingival Recession in Mandibular Incisor Area: A Case Report.

We report a case of gingival recession in the mandibular incisor region requiring a connective tissue graft. The patient was a 17-year-old girl who visited the Tokyo Dental College Chiba Hospital in 2014 with the chief complaint of gingival recession in the lower incisor region. She had received orthodontic treatment for 5 years and noticed the gingival recession on completion of active orthodontic treatment in 2013. Gingival recession in tooth #31 extended 3 mm beyond the muco-gingival junction (MGJ) and was clinically diagnosed as Miller Class II recession; probing depth was 6 mm. Following initial periodontal therapy, a connective tissue graft procedure was implemented. The connective tissue was harvested from the left palate. Healing was uneventful, and the grafted site showed a favorable outcome at 6 months postoperatively. We are continuing to carefully monitor the condition of periodontal tissue.

Features of Orthodontic Treatment during Pregnancy

Pregnancy is a special period in a woman's life, which is associated with the restructuring of the body, due to gestation. This period is a phase of active cultivation of a woman when she thinks about her appearance. Consequently, pregnancy often coincides with the phase of active orthodontic treatment in women of childbearing age, who make up a large percentage of the cohort of patients. From the above we can conclude pregnancy and orthodontic treatment often take place parallel to one another. How justified is the purpose of orthodontic treatment during pregnancy? This is important both for the patient and for the doctor to answer today.

Instability of the mandibular dental arch? Look again!

Changes in mandibular dental arch parameters have been thoroughly investigated as a function of time after removal of orthodontic appliances and instability tenets have emerged. To date, only permanent fixed retention as a posttreatment strategy has been demonstrated effective against changes in mandibular anterior alignment. No active orthodontic therapy has been shown to improve mandibular arch outcome stability except augmented corticotomy significantly reduced 5- and 10-year rate of change in mandibular irregularity index. The purposes of this study were as follows: (1) to evaluate efficacy of augmented corticotomy in stabilizing posttreatment mandibular arch widths and length and (2) to review mandibular dental arch instability data from the scholarly literature. Results demonstrated augmented corticotomy effective in the 5-year short term for stabilizing intercanine width and arch length but not 10-year long term. Data extracted from 76 separate publications representing 4250 subjects reaffirmed the consensus view that irregularity index will increase and there will be decreases in arch width and length as a function of time. It was concluded that alveolar decortication + augmentation bone grafting (PAOO) is the only active orthodontic treatment strategy that will stabilize mandibular irregularity index for at least a decade, and permanent fixed canine-to-canine retention is the only posttreatment orthodontic strategy that will preclude recrowding and intercanine width decrease in the mandibular anterior segment.

Effectiveness of bovine-derived xenograft versus bioactive glass with periodontally accelerated osteogenic orthodontics in adults: a randomized, controlled clinical trial.

BackgroundPeriodontally accelerated osteogenic orthodontics (PAOO) combines periodontal therapy with orthodontic therapy, which minimises treatment time. This study compared the effectiveness of a bovine-derived xenograft with that of bioactive glass when combined with PAOO for the treatment of adult patients with moderate crowding of the teeth.MethodsIn this prospective, single-masked clinical trial, 33 orthodontic patients (20 women, 13 men; mean age 21.2 ± 1.43 [18 − 27] years), were randomly allocated to one of three groups. Group 1 underwent a modified corticotomy technique on the labial side only, whereas group 2 was treated with the same technique combined with PAOO using a bovine-derived xenograft and group 3 was treated in the same way but combining PAOO with bioactive glass. The total treatment duration was recorded from the start of active orthodontic treatment, immediately after corticotomy, and at the time of debonding. Probing depth was evaluated clinically and bone density and root length were evaluated radiographically on the day of surgery (baseline, T1), post-treatment at debonding (T2), and 9 months post-treatment (T3).ResultsThe duration of orthodontic treatment was markedly reduced to an average of 11.4 ± 0.14 weeks in all groups. All probing depths were < 3 mm, the interdental papillae were well preserved, there was no loss of tooth vitality, and there was no evidence of significant apical root resorption at any time interval. All groups showed a decrease in mean bone density at T2 followed by an increase at T3. The net percentage change that occurred between baseline and 9 months post-treatment was significantly different between the three groups. Groups 2 and 3, where grafts were incorporated, demonstrated a statistically significant greater increase in bone density than group 1 at T3.ConclusionCombination of orthodontic treatment and periodontal surgery is an effective treatment for adult patients that decreases the duration of active treatment and reduces the risk of root resorption. Use of a bovine-derived xenograft with modified corticotomy provided superior benefits in terms of increased bone density than did the use of bioactive glass.Trial registrationThe study was retrospectively registered at ClinicalTrials.gov under Clinical Trial Registration Number: NCT02796911.

Postoperative mandibular stability after bilateral sagittal split ramus osteotomy based on skeletal correction in patients with facial asymmetry

ObjectiveThe objective of this study was to examine postoperative stability of the mandible after bilateral sagittal split ramus osteotomy (BSSRO) based on skeletal correction rather than occlusal correction in patients with facial asymmetry. MethodsEighteen patients with facial asymmetry were enrolled in this study. BSSRO was performed, and an intermaxillary mandibular repositioning splint was prepared using a newly developed surgical simulation system (Mandibular Motion Tracking System [ManMoS]). Chin deviation was evaluated by frontal cephalography immediately after surgery (T1) and after active orthodontic treatment (T2). Three-dimensional analysis was carried out by calculating the three-dimensional coordinates of the cranial and mandibular planes. ResultsThe mean crista galli-anterior nasal spine-menton angle was 1.11° at T1 and 0.88° at T2. The rotational change (T2–T1) was calculated as an actual number (Roll: −0.29±1.78°, Elevation: −1.31±2.44°, Azimuth: +0.41±1.64°). ConclusionsOur results suggest that the spatial orientation of the mandibular body was stable after BSSRO in the horizontal and frontal planes, while forward and upward rotation of the mandible was recognized in the sagittal plane. Thus, mandibular positioning with priority given to skeletal correction using the ManMoS is an effective therapeutic method, especially in cases of facial asymmetry.

Assessment of Knowledge, Attitude and Practice of Gingival Health among Patients under Active Orthodontic Treatment

Information and awareness on gingival health enhances knowledge and from such knowledge comes commitment and motivation for people to alter their lifestyles to prevent gingival and periodontal disease. Repeating the oral hygiene instructions on each visit, prophylactic programs and good oral home care are effective measures to prevent plaque accumulation and gingival enlargement for patients who are undergoing orthodontic treatment. This study is undertaken to assess knowledge, attitude and practice of gingival health among orthodontic patients. Materials and Methods: A cross-sectional study was carried out among 180 patients coming to the Department of Orthodontics at KIST Medical College and Teaching Hospital who are undergoing active orthodontic treatment. The questionnaire, was given to all selected patients to complete the answers, included questions about knowledge on gingival health, practices and attitude of patients regarding oral hygiene performance. Statistical analysis was done by SPSS version 21. Result: Knowledge on gingival health reveals that 62.2% of participants were aware of gingival disease. 59.4% of participants followed oral hygiene instructions very often and used interdental aids (dental floss: 58.2%,interdental brush:60.9%,toothpick 67.4%) irregularly. Only 27.8% in this survey followed the oral hygiene instructions very strictly. Use of interdental aids in various age group was found to be statistically significant. Conclusion: Successful plaque control clearly demands appropriate knowledge about gingival health, individuals’ practice and attitude to remove plaque with a long term commitment from the dental professional and the patient as cotherapist.