Adult Orthodontics Research Articles

INDIRECT BONDING IN LINGUAL ORTHODONTICS - A REVIEW

This is the era of adult orthodontics as more and more adult patients are willing to get done the orthodontic treatment and with this the demand for invisible bracket system and lingual orthodontics as increased considerable. Bonding of brackets in lingual orthodontics is the major concern owing to the fact of poor visibility leading to faulty bracket positioning, which may result in poor post treatment results. Thus indirect bonding is upcoming trend in lingual orthodontics and this article will review the same in detail.

Dentoalveolar surgery corticotomies in rapid orthodontics

Dentoalveolar surgery includes osteotomies and corticotomies of individual teeth to accelerate orthodontic tooth movement. This presentation includes the history of this technique and the more current applications. It has long been known that bone manipulation that includes osteotomy increases the bone metabolism/turnover rate. During a 2–6-week time frame the rapid movement of teeth that are orthodontically activated occur in response to this increase in bone turnover and increased metabolism. The hard and soft tissue response at this time is increased enough to allow changes not seen without this approach. In adult orthodontics this can be extremely helpful in movements that would normally not occur without this assistance or would be extremely slow. Comparison of the technique of each procedure will be reported. The biologic concepts and flap design for each technique are essential to successful use of these procedures. Care must be exercised to preserve blood supply to both the hard and soft tissues to avoid loss of teeth and the surrounding soft tissue component. Applications in the maxilla and mandible can yield unusual tooth movements in adults or the adolescent patients that require individual changes to finalize occlusal position in case completion. Patient presentation and outcomes will be presented to complete the review of these procedures and their applications in contemporary dentoalveolar surgery.

Early Orthognathic Surgery With Three-Dimensional Image Simulation During Presurgical Orthodontics in Adults

To correct dentofacial deformities, three-dimensional skeletal analysis and computerized orthognathic surgery simulation are used to facilitate accurate diagnoses and surgical plans. Computed tomography imaging of dental occlusion can inform three-dimensional facial analyses and orthognathic surgical simulations. Furthermore, three-dimensional laser scans of a cast model of the predetermined postoperative dental occlusion can be used to increase the accuracy of the preoperative surgical simulation. In this study, we prepared cast models of planned postoperative dental occlusions from 12 patients diagnosed with skeletal class III malocclusions with mandibular prognathism and facial asymmetry that had planned to undergo bimaxillary orthognathic surgery during preoperative orthodontic treatment. The data from three-dimensional laser scans of the cast models were used in three-dimensional surgical simulations. Early orthognathic surgeries were performed based on three-dimensional image simulations using the cast images in several presurgical orthodontic states in which teeth alignment, leveling, and space closure were incomplete. After postoperative orthodontic treatments, intraoral examinations revealed that no patient had a posterior open bite or space. The two-dimensional and three-dimensional skeletal analyses showed that no mandibular deviations occurred between the immediate and final postoperative states of orthodontic treatment. These results showed that early orthognathic surgery with three-dimensional computerized simulations based on cast models of predetermined postoperative dental occlusions could provide early correction of facial deformities and improved efficacy of preoperative orthodontic treatment. This approach can reduce the decompensation treatment period of the presurgical orthodontics and contribute to efficient postoperative orthodontic treatments.

Stress distribution analysis during an intermaxillary dysjunction: A 3-D FEM study of an adult human skull

Background:With the increased interest in adult orthodontics, maxillary width problems in the nongrowing patients have been encountered with greater frequency. In view of the negative outlook for successful nonsurgical palatal expansion in adult patients it seemed appropriate to evaluate the biomechanical effects of nonsurgical rapid maxillary expansion (RME) in adults using the finite element method (FEM).Objectives:To evaluate the biomechanical effects of RME on the craniofacial complex as applied to three-dimensional (3D) model of an adult human skull using the finite element method.Settings and Design:The Department of Orthodontics and Dentofacial Orthopedics at Government Dental College and Hospital, Nagpur. The study was done on an analytical model developed from a dry human skull of an adult female with an approximate age of 20 years.Materials and Methods:A 3D finite element analysis of the craniofacial complex was developed from sequential computed tomography scan images. Known transversal (X) displacement with magnitudes of 1, 3, and 5 mm were applied and the displacement and Von-Mises stresses in different planes were studied on different nodes located at various structures of the craniofacial complex.Results:Transverse orthopedic forces not only produced an expansive force at the intermaxillary suture but also high forces on various structures of the craniofacial complex, particularly at the base of the sphenoid bone and frontal process of the zygomatic bone. Lateral bending of the free ends of the pterygoid plates were noted.Conclusion:RME must be used judiciously in adults because of its far-reaching effects involving heavy stresses being noted at the sphenoid bone, zygomatic bone, nasal bone, and their adjacent sutures.

Adult orthodontics — who’s doing what?

To estimate the number of adults currently being treated by specialist orthodontists in the UK, both within the National Health Service (NHS) and privately, together with the factors relating to adults undergoing orthodontic treatment, their malocclusions and details of treatment undertaken. Self-administered postal questionnaire. All individuals entered on the General Dental Council's Specialist List in Orthodontics, registered within the UK. A questionnaire was sent to all those on the General Dental Council's Specialist List in Orthodontics to ascertain the numbers of adult patients being treated by specialist orthodontists and factors relating to their treatment. This included age and gender of adults being treated, sources of referral, type of orthodontic treatment carried out, disciplines involved in multidisciplinary treatment, appliance types used and issues which practitioners felt affected adult treatment. Adults undergoing orthognathic treatment were excluded from this study. The questionnaire yielded a response rate of 70%. Those respondents working in combined hospital/university posts treated the largest proportion of adults within the NHS and those working in specialist orthodontic practice treated the largest number privately. Within 1 year, the estimated mean number of adult cases started by specialist orthodontists within the NHS was 20.9 and privately was 28.2. The majority of adults treated were reported to be within the 26-35 year age group. Most adult patients were referred for orthodontic treatment by their general dental practitioners and over 70% of treatment provided was orthodontic-only. Adults' concerns regarding the appearance of orthodontic appliances was quoted by orthodontists as being the most commonly occurring potentially complicating factor with regards to both NHS and private treatment. Although there are reports in the literature that the number of adult orthodontic patients is increasing, there are no comprehensive figures regarding the number of adults previously treated within the NHS and privately in the UK to compare our data with. This paper presents initial data relating to practitioners' estimates of the numbers of adults being treated in the UK.

Adult Orthodontics Versus Adolescent Orthodontics: An Overview

ABSTRACTThe scope of orthodontics has widened to include not only children and adolescents but also adults, thereby abolishing the upper age limit. With growing esthetic conscience among the society, a great number of young adults are seeking orthodontic treatment primarily for esthetic reasons. They undergo comprehensive orthodontic treatment involving major occlusal changes to get the utmost esthetically pleasing face. The older adults with poor dental conditions requiring perio-restorative treatment undergo adjunctive orthodontic treatment to attain a long-term prognosis. The orthodontist faces challenges to practice adult orthodontics due to various issues being under considerations, which are quite different than routine orthodontic treatment oriented to children and adolescents. This article highlights the difficulties and limitations faced by the orthodontist while practicing adult orthodontics with remedies to overcome them.

Pediatric and Adult Orthodontics

Pediatric and Adult Orthodontics

Orthodontic treatment for adults: part I. Special treatment considerations and general process for adult orthodontics

在正畸治疗发展进程中,尽管早期的正畸学者,如Kingsley(1880年)、Case(1921年)等曾分别报道个别的成人正畸病例,但正畸治疗对象主要是生长发育期的儿童和青少年患者.对成人正畸治疗的重视和迅速拓展是在20世纪70年代以后.咎其原因,一方面是近30年基础研究对非生长期牙移动及骨重建的认识更深入,矫治技术更科学、精细,矫治材料不断更新发展.另一方面,得益于社会经济的高速增长,人们对生活质量要求的提高,以及成年人面对社交压力,在经济条件改善和生活稳定后有条件弥补过去未能治疗的遗憾。

Limitations in Adult Orthodontics: A Review

ABSTRACTAdults seeking orthodontic treatment have been increased considerably over the years as society is gradually becoming more esthetic oriented. These adults have already completed growth of craniofacial complex and treatment modality of growth modification is not an option for them. Many biological and psychosocial factors associated with adults need a change in biomechanics and treatment approach than that in growing adolescents. The present article attempts to explore the limitations in adult orthodontics.

An Update in Adult Orthodontics

The number of adults undertaking fixed orthodontic treatment has grown significantly in recent years. Improved appliance aesthetics, treatment mechanics and social acceptability are some of the contributing factors involved in this increase. This article intends to discuss adult orthodontic treatment and the difficulties involved. It will then present the innovations in treatment modality that have made orthodontics more acceptable to adults and discuss appliance advances that have adjusted the treatment possibilities for adults. The general dental practitioner should be aware of the differences in adult and adolescent orthodontic treatment with the help of knowledge of innovations in aesthetics orthodontic appliances and treatment mechanics that have recently become available in orthodontics.

Pre-and post-orthodontic treatment for orthognathic surgery patients

正颌外科的术前术后正畸治疗是成人正畸(adult orthodontics)中的一类特殊问题,既有成人正畸的特点,又有别于单纯的成人正畸治疗.鉴于此,口腔正畸医师不仅要掌握成人正畸的方法、特点和规律,同时要紧密结合正颌外科矫正设计方案,以满足外科手术移动颌骨后建立良好咬合关系的目的.现代正颌外科是颌面外科和口腔正畸两大学科紧密结合的产物,只有通过两者的密切配合,通过序列的术前正畸治疗、外科手术和术后正畸治疗,才能取得满意的矫治效果[1]。

Review Article: A Review Of Adult Orthodontics – Role Of The General Dental Practitioner

There has been an increase awareness of orthodontic treatment for adults in the last 20 years. In it possible for all adult patients to benefit from orthodontic therapy?. The purpose of this paper is to review adult orthodontic treatment so that general Dentists will be better prepared to recognize and also refer adult patients that can benefit form orthodontic therapy. A review of previous studies done on adult orthodontic treatment needs was undertaking. Adult orthodontic treatment was compared with adolescent orthodontic treatment. A review of treatment outcome of adult orthodontic patients showed that most patients felt satisfied with the treatment. Some report appliance discomfort which eased off 2 to 3 days after treatment. Adjunctive and comprehensive orthodontic treatments are the main types of orthodontic therapy recommended for adult malocclusion. The orthodontic therapy and refer to the specialist appropriately. KEY WORDS: Review, Adult Orthodontics, General Dental Practitioner. Nigerian Journal of Clinical Practice Vol.7(1) 2004: 37-40

Automated custom-manufacturing technology in orthodontics

The ability to consistently fabricate dimensionally accurate, custom-made, removable orthodontic appliances in large quantities is a manufacturing challenge that has only recently been met through advances in scanning and automation technology. The production of the Invisalign orthodontic appliance 1 Wong B. Invisalign A to Z. Am J Orthod Dentofacial Orthop. 2002; 121: 540-541 Abstract Full Text Full Text PDF PubMed Scopus (91) Google Scholar , 2 Miller R.J. Derakhshan M. The Invisalign system case report of a patient with deep bite, upper incisor flaring, and severe curve of Spee. Semin Orthod. 2002; 8: 43-50 Abstract Full Text PDF Scopus (19) Google Scholar , 3 Miller R.J. Duong T. Derakhshan M. Lower incisor extraction treatment with the Invisalign system. J Clin Orthod. 2002; 36: 95-102 PubMed Google Scholar , 4 Boyd R.L. Miller R.J. Vlaskalic V. Three-dimensional diagnosis and orthodontic treatment of complex malocclusions with the Invisalign appliance. Semin Orthod. 2001; 7: 274-293 Abstract Full Text PDF Scopus (74) Google Scholar , 5 Miethke RR (editor), Boyd R, Brachwitz J, John HD, Kuo E, Kuch A, et al. Sonderheft Invisalign. Kieferorthopadie 2001;15:3-58 Google Scholar , 6 Owen III, A.H. Accelerated Invisalign treatment. J Clin Orthod. 2001; 35: 381-384 PubMed Google Scholar , 7 Vlaskalic V. Boyd R.L. Orthodontic treatment of a mildly crowded malocclusion using the Invisalign system. Aust Orthod J. 2001; 17: 41-46 PubMed Google Scholar , 8 Boyd R.L. Miller R.J. Vlaskalic V. The Invisalign system in adult orthodontics mild crowding and space closure cases. J Clin Orthod. 2000; 34: 203-212 Google Scholar (Align Technology, Inc, Santa Clara, Calif) is a complex process that uses innovative solutions to accurately and efficiently fabricate orthodontic appliances.

Periodontic and orthodontic treatment in adults

The purpose of this article is to provide an update of the interrelationship between periodontics and orthodontics in adults. Specific areas reviewed are the reaction of periodontal tissue to orthodontic forces, the influence of tooth movement on the periodontium, the effect of circumferential supracrestal fiberotomy in preventing orthodontic relapse, the effect of orthodontic treatment on the periodontium, microbiology associated with orthodontic bands, and mucogingival and esthetic considerations. In addition, the relationship between orthodontics and implants (eg, using dental implants for orthodontic anchorage) is discussed. (Am J Orthod Dentofacial Orthop 2002;122:420-8)

Adult Orthodontics and Lingual Treatment

Adult Orthodontics and Lingual Treatment

The effect of different porcelain conditioning techniques on shear bond strength of stainless steel brackets

With the increasing demand for adult orthodontics, a growing need arises to bond attachments to porcelain surfaces. Optimal adhesion to a porcelain surface should allow orthodontic treatment without bond failure but not jeopardize porcelain integrity after debonding. In this study, 90 glazed porcelain facets were divided into three groups according to different conditioning techniques: (1) roughening with a coarse diamond; (2) hydrofluoric acid 8%; (3) microetching with 60μ aluminum oxide particles. Each group was divided into three groups and stainless steel brackets were then bonded to the conditioned porcelain with three different dental adhesives. The adhesives used were: (1) silane+Right-On; (2) silane+Concise; (3) High-Q-Bond without silane. Four additional facets (three of which conditioned as above and one intact) were analyzed macroscopically and by scanning electron microscopy. Shear bond strength was measured with an Instron universal testing machine and a macroscopic examination of the debonded porcelain surfaces was performed. Results showed that shear bond strength was highly influenced by both conditioning technique and the adhesive. Shear bond strength of the High-Q-Bond groups was significantly lower than both the silane+Right-On and the silane+Concise groups; nevertheless the shear bond strength achieved by High-Q-Bond was enough to sustain full orthodontic treatment duration (except for the group conditioned by roughening with a coarse diamond). Scanning electronic microscopy analysis revealed that diamond roughening and microetching produced only a surface-peeling pattern, whereas hydrofluoric acid conditioning produced an extensive in-depth penetrating pattern. Hydrofluoric acid preparation produced greater shear bond strength than both diamond roughening and microetching. After debonding by means of a shearing force, the percentage of damaged porcelain surfaces in the silane+Concise groups was significantly higher than the silane+Right-On and High-Q-Bond groups. (Am J Orthod Dentofacial Orthop 1998;114:387-92)

Interrelationship between periodontics and adult orthodontics.

The purpose of this review article is to provide the dental practitioner with an understanding of the interrelationship between periodontics and orthodontics in adults. Specific areas reviewed are how periodontal tissue reacts to orthodontic forces, influence of tooth movement on the periodontium, effect of circumferential supracrestal fiberotomy in preventing orthodontic relapse, effect of orthodontic bands on the periodontium, specific microbiology associated with orthodontic bands, mucogingival considerations and time relationship between orthodontic and periodontal therapy. In addition, the relationship between orthodontics and implant restorations (e.g., using dental implants as orthodontic anchorage) will be discussed.

RETENTION AND STABILITY CONSIDERATIONS FOR ADULT PATIENTS

This article gives an overview of generally accepted and special concepts of the last and often life-long treatment-phase in adult orthodontics, the retention phase. The secret of successful adult orthodontics lies in adult-specific principles of histology and physiology and the interrelation of joint, occlusion, and muscles, which helps define the requirements of proper diagnosis, mechanics, and retention. Retention in adults should include maintenance of tooth position, overall dental health, and a periodontal status that can be attained by combinations of several retention concepts: retention appliances and surgical and restorative retention procedures. Short- and long-term postretention follow-up studies have shown that there is no guarantee for long-life stability after orthodontic tooth movements in adults without an anomaly- and treatment--specific retention phase.

ORTHODONTIC PROCEDURES IMPROVING PERIODONTAL PROGNOSIS

The wide range of interrelations between orthodontics and periodontology shows that besides the preventive significance in the mixed dentition, another focal point is the comprehensive rehabilitation of periodontally affected patients. With increasing experience in the field of adult orthodontics, setting therapeutic limits becomes increasingly difficult. It is impossible in principle to define in exact metric terms the probing depth or attachment loss up to which orthodontic tooth movement is feasible. The fact is rather that the orthodontic-periodontal treatment goal can be defined only after evaluation in each individual finding a number of different factors: esthetics, function, risks of orthodontic tooth movement, biomechanical considerations, and periodontal prognosis.

Limited orthodontics for the older population: Multidisciplinary modalities

In a recent Journal of the American Dental Association article, it was reported that the older segment of the American population was increasing rapidly. 1 Meskin LH Dillenberg J Heft MW Katz RV. Economic impact of dental service utilization by older adults. J Am Dent Assoc. 1990; 120: 665-668 PubMed Scopus (32) Google Scholar It was opined that the 1989 group of 10 million Americans over 65 years old would be double by the 21st century. The older adult patients, it was pointed out, have been and will be increasingly requesting replacement of existing restorations rather than extractions as in the past. 2 Meskin LH Gooch BF Davidson GB Burtonk Oliver R. The Minnesota dental practice analysis system. J Am Dent Assoc. 1983; 6: 846-848 Google Scholar This is particularly true of those persons who have had a lifetime history of retention and maintainence of their dentitions. Treating the dentition of the older population is and will be an expanding segment of the general dentists and allied specialties practices that requires special skills, philosophies, and sophisticated multidisciplinary treatment methods. Adult orthodontic treatment can be divided into limited and complex (comprehensive) orthodontic treatment. 3 Newman GV. Adult orthodontics. Dent Survey. 1978; 54: 24-34 PubMed Google Scholar Treatment of the “elderly” for physiologic and practical reasons usually involves limited orthodontic treatment procedures. 4 Newman GV Wagenberg BD. Treatment of compromised teeth: a multidisciplinary approach. AM J ORTHOD. 1979; 76: 530-537 Abstract Full Text PDF PubMed Scopus (4) Google Scholar