Anterior Dental Crowding Research Articles

Prophylactic third molar removal: are oral surgeons and orthodontists aligned in preventive approaches?

BackgroundThere is a general consensus among dental professionals regarding the extraction of impacted third molars in the presence of clinical symptoms. However, there is less agreement on the management of asymptomatic third molars. The objective of this study is to compare the perspectives of oral surgeons and orthodontists regarding the indications for the extraction of asymptomatic third molars. It is possible that healthcare professionals from different specialties may approach the extraction of these teeth in different ways.MethodsIn this cross-sectional study, a web-based questionnaire has been employed to collect data by inquiring about the reasons why participants prefer the extraction of asymptomatic third molars. Descriptive statistics were employed to evaluate the data obtained. The level of significance was set at P < 0.05.ResultsProphylactic extraction of partially impacted molars was more favored among the participants (P < 0.05). The orthodontists preferred prophylactic extraction due to the risk of late anterior dental crowding (LADC); however, the oral surgeons preferred pre-pregnancy extractions (P < 0.05). The extraction decision for partial impaction was higher in females when the risk of distal caries was considered. For fully impacted ones, it was higher in males when the risk of caries and pericoronitis were considered (P < 0.05).ConclusionsOrthodontists preferred extraction because of the risk of LADC and caries, while oral surgeons focused on preventing pericoronitis, pathology, focal infection, and symptoms during pregnancy. This divergence between the participants may inform the guidelines for prophylactic management of third molars. These findings may be pertinent in gender medicine.Clinical relevanceThis study has been enlightening for departments to consult each other before the extraction of a patient’s asymptomatic third molar.

Validation of amathematical-geometrical model to calculate the length of an individual anterior arch.

For resolving anterior dental crowding or spacing, it is of key interest in personalised orthodontic diagnostics and treatment planning to predict the extent of space gained or lost in the anterior dental arch by changing incisor inclination or position. To facilitate the determination of anterior arch length (AL) and to predict its alterations following tooth movements, amathematical-geometrical model, based on athird-degree parabola, was established. The aim of this study was to validate this model and assess its diagnostic precision. This retrospective diagnostic study evaluated 50randomly chosen dental casts taken before (T0) and after (T1) orthodontic treatment with fixed appliances. Plaster models were digitally photographed, allowing two-dimensional digital measurements of arch width, depth and length. Acomputer programme based on the mathematical-geometrical model to be validated was created to calculate AL for any given arch width and depth. Mean differences and correlation coefficients as well as Bland-Altman plots were used to compare the measured and the calculated (predicted) AL, evaluating the precision of the model. Inter- and intrarater reliability tests showed reliable measurements of arch width, depth and length. Measured and calculated (predicted) AL revealed high concordance according to concordance correlation coefficient (CCC), intraclass correlation coefficient (ICC), and Bland-Altman analyses and negligible differences between the mean values. The mathematical-geometrical model calculated anterior AL without significant difference to the measured AL, indicating its validity. The model can thus be used clinically for predicting alterations of AL following therapeutic changes of incisor inclination/position.

The Effect of Anterior Crowding Toward Oral Hygiene Index-Simplified and Gingival Index Score

Dental crowding is one form of malocclusion characterized by disparities between the size of the tooth and the arc dimension. It is commonly found in the anterior region. Keeping the crowded and misaligned tooth is hard, leading to more plaque accumulation and increasing the risk of gingival inflammation. This research aims to find the effects of anterior dental crowding on the Oral Hygiene Index-Simplified (OHI-S) and Gingival Index scores of Poltekkes Kemenkes Kupang students. This is a cross-sectional study performed by observational analytical study design. The population was the student of Poltekkes Kemenkes Kupang with anterior crowding. Using 70 samples were chosen using purposive sampling technique. The result showed that most of the students had moderate anterior crowding (45.7%), followed by mild crowding (30%) and severe crowding (20%). The chi-square test showed a significant effect of anterior crowding toward OHI-S (p=0.03) and GI scores (p=0.04). While Socio-economical aspect also showed a significant effect (p=0.00) on OHI-S scores. A significant effect of socioeconomic status was also recorded on GI score (p=0.00). An observation of the students' oral hygiene intention showed that they mostly had a moderate intention (72.9%) to keep their mouth clean, and the rest, 27.1% had high oral hygiene intention. This aspect also significantly affects their scores of OHI-S (p=0.00) and GI (p=0.01). This study concluded that anterior crowding, socioeconomic status, and oral hygiene intention can affect OHI-S and GI scores of the students of Poltekkes Kemenkes Kupang

Prevalence of Malocclusion in Brazilian Quilombola Adolescents

Objective: To evaluate the prevalence of malocclusion in Quilombola adolescents living in rural area in Northeastern Brazil.Material and Methods: This is a cross-sectional study in which 36 Quilombola adolescents aged 12-19 years were evaluated. Data collection was performed at home between January and April 2020 by a trained researcher using the Dental Aesthetic Index (DAI). Data were analyzed using the IBM SPSS software and presented using descriptive statistics.Results: More than two thirds of adolescents had already visited the dentist at least once in life (72.2%), with the last dental visit having occurred less than a year ago (57.7%), with predominance of public dental service (84.6%). There was higher frequency of lower anterior misalignment (86.1%) and dental crowding (83.4%) in two segments (55.6%). Almost all adolescents presented dental malocclusion (97.2%), with very severe or disabling severity (44.4%).Conclusion: The prevalence of very severe malocclusion was high in Quilombola adolescents, expressing the need for treatment of this population.

TREATMENT OF CLASS I MALOCCLUSION WITH LOWER INCISOR EXTRACTION

The extraction of the lower incisor constitutes a therapeutic alternative in treating certain anomalies. It is not a standard approach to symmetrically treating most malocclusions, but in certain clinical situations the therapeutic aims must be adjusted to individual patient needs - even when this means that achieved final occlusion is not ideal. A case report is presented with one mandibular incisor extraction treatment of a 17 year-old male with a Class I malocclusion that shows a significant mandibular arch length deficiency and mandibular tooth-size excess. In this case, the degree of mandibular anterior dental crowding, existing mandibular tooth-size excess indicated the extraction of one mandibular incisor.

The Evolution of Third Molars in Orthodontics: What about Anterior Dental Crowding? - A Systematic Review

Background: Third molar influence on anterior crowding is controversial, However, it is assumed that they play a major role in compromising dental arch space. Aim: To review the literature to clarify the role of third molars in anterior crowding and relapse after orthodontic treatment by means of a systematic review. Material and methods: A systematic search was conducted based on an electronic search of several databases (Pub Med, ScienceDirect, Cochrane Library) covering publications from 2010 to January 2022. The search was performed using the acronym PICOS, limited to the following keywords in English and French: «wisdom tooth» OR« third molar »AND «anterior teeth crowding». Results: On the basis of the keywords, 549 bibliographical references were initially identified. After the elimination of duplicate references and studies, the number of articles was reduced to 315. A review of titles and abstracts resulted in the selection of 23 articles. After reading the full text, 6 articles were included in this systematic review. Conclusion: No relationship between the incisors crowding and the presence of third molars was identified. Therefore, the indication for prophylactic removal of third molars to avoid incisor crowding is not justified.

Bacterial composition of subgingival plaque in crowded and noncrowded teeth

Patients with dental crowding, even with good oral hygiene, may show increased bacterial presence in the crowded area. This study aimed to determine the microbial composition of subgingival plaque in crowded and noncrowded dental regions. Forty dental students with anterior dental crowding, who were aware of correct brushing techniques and oral hygiene, were enrolled in this study. After orthodontic records were taken and the periodontal examination was performed, subgingival plaque samples were collected from the crowded (experimental) and noncrowded regions (control) of each patient. Colony counting was performed for Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and streptococcus species. The mean amount of Aa and Pg colonies was significantly higher in crowded areas (P<0.0001), but there was no significant difference between streptococcus species colonization and crowding. Aa and Pg colonization had a significant direct relation with the amount of crowding. (P<0.0001). Crowded dental areas, even with good oral hygiene, are more suitable environments for Aa and Pg colonization.

Management of severe maxillary discrepancy in unilateral cleft lip and palate: six year follow up in a patient with tongue graft

&lt;p class="abstract"&gt;The purpose of this original case study was to present the efficiency of combined orthodontic and distraction osteogenesis (DO) in severe maxillary hypoplasia along with importance of tongue graft for closure of large residual palatal defect. DO has been successfully chosen in lengthening and widening the maxilla transversely to relieve anterior dental crowding and transverse discrepancies between the dental arches. A UCLP (unilateral cleft lip and palate), 15 year old male with the chief complaint of esthetic and functional problems because of skeletal class III malocclusion with anterior crossbite and severe midline shift was taken up for this modality of treatment. Considering the severity of malocclusion, combined orthodontic and DO treatment was considered adequate which was likely less invasive and equally stable procedure. RED (rigid external distractor) was used for distraction after initial alignment followed by closure of residual large palatal defect with tongue graft. Result obtained was esthetically good with acceptable occlusion considering the severity with pleasing soft tissue profile. The review was done after six year which showed remarkable skeletal stability with no dehiscence of tongue graft in palate area. The combined use of DO and orthodontic correction in ULCP case had substantial skeletal stability, improving patient esthetic and self-esteem.&lt;/p&gt;

Tratamento de mordida aberta com a técnica ortodôntica fixa sem bráquetes, com tecnologia tridimensional 3DBOT (bracketless orthodontics treatment)

Anterior open bite is a type of malocclusion in which there is the presence of a negative vertical overlap between the incisal edges of the upper and lower anterior teeth. It is considered a complex anomaly with distinct characteristics and difficult to treat with prevalence of 25% to 38% of patients orthodontically treated. The aim of this article is to report a clinical case of Class III right subdivision and open bite using 3DBOT technique, a fixed, comfortable, predictable, imperceptible technique with 3D technology and with extreme clinically proven satisfaction. Case report: Patient V.B.V.S., 23 years and 1 month old, leukoderma, male, mild dholico, straight profile, symmetrical, Class ¼ of Class III of molar and canine right subdivision, anterior open bite, inverted smile, mild upper and anterior dental crowding. Treatment plan: The use of 3DBOT was planned along with the use of intermaxillary elastics and refinement with the aid of MyAligner® aligners. Conclusion: The 3DBOT technique showed to be a viable option for treating anterior open bite

The Relationship Between Maxillary and Mandibular Base Lengths and Dental Crowding in Patients with True Class II Malocclusions

INTRODUCTION: Orthodontists, for a long time have considered that occlusion and facial beauty are so interdependent that they must be equal goals of treatment.AIM: To validate the relationship between maxillary and mandibular effective lengths and dental crowding in patients with Class II malocclusions. MATERIALS AND METHOD: A sample of 40 orthodontic patients with complete bilateral Class II malocclusions in the permanent dentition (25 males, 15 females) who were divided into two groups based on severity of pre-treatment mandibular anterior dental crowding. The maxillary and mandibular effective lengths and tooth-arch size discrepancies were measured on the pre-treatment Lateral cephalograms and initial casts, respectively. Intergroup comparisons of apical base lengths were assessed with independent t-tests. Correlation between effective length and dental crowding was assessed by Pearson's correlation coefficient (P &lt;.05).RESULTS: Subjects with Class II malocclusion and moderate to severe crowding had significantly smaller maxillary and mandibular effective lengths compared with subjects without crowding and with minimal dental crowding. A weak inverse correlation was also found between maxillary and mandibular effective lengths and the severity of dental crowding. CONCLUSION: In patients with complete Class II malocclusion, decreased maxillary and mandibular effective lengths constitute a significant factor associated with dental crowding.

Mesial Rotation of the Upper First Molar: Association with Anterior Dental Crowding in Mixed and Permanent Dentition

The position of the upper first molar (UFM) is currently considered the “key of occlusion”. The purpose of this study was to evaluate the prevalence of the mesiorotated UFM, and its relationship with anterior dental crowding in mixed and permanent dentition. Intra-oral scans of upper dental arches of 180 subjects with mixed dentition and 169 subjects with permanent dentition were retrospectively analyzed to investigate the presence of UFM mesiopalatal rotation and presence of anterior crowding. The occlusal relationship and the presence of caries were also recorded. In subjects with permanent dentition, there was a statistically significant correlation between anterior crowding and UFM mesiopalatal rotation (Pearson’s chi-square = 9.03; p = 0.06). Among cases with permanent dentition, subjects with UFM mesiopalatal rotation showed an OR = 3.28 (95% CI = 0.99–10.93; p = 0.042) of moderate/severe anterior dental crowding, respect to subjects without UFM rotation. In subjects with mixed dentition, there was a statistically significant correlation between molar occlusal relationship and UFM mesiopalatal rotation (Pearson’s chi-square = 14.98; p = 0.002), and subjects with molar class II showed a OR = 10.2 (95% CI = 2.16–48.22; p = 0.0005) to present UFM mesiopalatal rotation, with respect to subjects with molar class I. UFM mesiopalatal rotation is associated to anterior dental crowding in permanent dentition, and to class II malocclusion in mixed dentition.

Masticatory Adaptation to Occlusal Changes.

This review deals with the frequent wide variability of masticatory capacity/incapacity. Neither researchers nor clinicians have taken sufficient account of this variability despite its implications for nutrition. Mastication in normal healthy oral conditions is first described, followed by a short presentation of the mechanisms of masticatory adaptation in the nervous system. Capacity, incapacity, and successful compensatory adaptation of mastication are then defined, along with the different methods used for their evaluation. Examples of adaptation needs are given, such as those concomitant with dental wear or occlusal changes. Finally, given its vital importance for deeply impaired mastication/deglutition function, the impact of masticatory adaptation processes on nutrition is examined.

Association between maxillary and mandibular apical base lengths and severity of dental crowding or spacing in Class II malocclusion subjects: An in-vitro study.

BackgroundAnterior crowding/ spacing are one of the major problems that inspire patients to undergo orthodontic treatment. Several factors associated with anterior crowding/ spacing includes arch width and length, mesio-distal tooth diameter and proportions. The aim of the present study was to evaluate the relationship of maxillary and mandibular base lengths to the amount of anterior dental crowding/ spacing in patients with complete class II malocclusions.Material and MethodsA retrospective study was done with 152 patients who were divided into four groups according to the severity of pre-treatment dental crowding/spacing present in the mandibular arch. Measurements were performed on the pre-treatment dental casts and lateral cephalograms. Statistical analysis was done using t-test and chi-square test.ResultsSubjects with complete class II malocclusion and moderate to severe mandibular crowding [≥3mm] have significantly smaller base lengths as compared to the subjects with slight crowding or spacing [<3mm].ConclusionsThere exists an inverse correlation between maxillary and mandibular base lengths and the severity of dental crowding and direct correlation with spacing. Key words:Apical base lengths, Class II malocclusion, Crowding, Incisor inclination, Spacing.

Prediction of the occurrence and severity of mandibular incisor crowding in the early mixed dentition using craniofacial parameters.

With the recent interest in esthetics at an early age, prediction of mandibular incisor crowding is of significant importance. Since dental arch development is related to craniofacial growth, we conducted a cohort study to find a regression model for mandibular incisor crowding based on various craniofacial parameters in children. A total of 250 children, all in the early mixed dentition, were selected randomly by cluster sampling from primary schools. Craniofacial parameters were measured by a caliper bow, and intercanine widths were measured on dental casts. After a 12-month follow-up period, mandibular incisor crowding and intercanine width were assessed on each subject's dental cast. Discriminant and multiple regression analyses were performed separately for boys and girls. Of 250 children, 148 returned for the 1-year follow-up and met the inclusion criteria. Regression analyses of patients with normal occlusion showed a statistically significant correlation between anterior dental crowding and facial height and bigonial width in both sexes. A significant inverse correlation was found between initial intercanine width and incisor crowding in girls. Furthermore, using the aforementioned parameters, the occurrence of mandibular incisor crowding could be predicted with an accuracy of 92.6%. We found that the occurrence and severity of mandibular incisor crowding in the early mixed dentition can be predicted accurately based on certain craniofacial parameters.

The efficacy of orthodontic treatments for anterior crowding with Invisalign compared with fixed appliances using the Peer Assessment Rating Index.

The purpose of this retrospective study was to determine the efficacy of Invisalign in a large sample of patients compared to fixed appliances. The test group consisted of 100 patients treated with Invisalign compared with a control group treated with conventional fixed appliances matched for sex, age, and initial severity of malocclusion based on the amount of anterior dental crowding (Little Index) and the Peer Assessment Rating (PAR Index) scores. The retainer used was a 0.0175-inch multistranded stainless-steel wire bonded from canine-to-canine in the mandibular arch and from lateral inisor-to-lateral incisor in the maxillary arch. A paired t test was used to compare both initial and final PAR scores. There was an overall 80.9% improvement, and 63 subjects did not need any refinement. The mean number of aligners used was 14 (+ 15 for the refinements) in the maxillary arch and 29 (+ 14 for the refinements) in the mandibular arch. The mean duration of treatment was 14 months (+ 7 months for the refinements). Significant statistical differences were found in the posttreatment scores, within both the Invisalign group and the control group. No differences were found in the follow-up scores. Additionally, the duration of treatment was 4 months longer in the control group. More than 90% of the subjects treated with Invisalign achieved a significant improvement, as shown by the PAR scores. A need for additional aligners was reported for 37% of the patients. Fixed bonded retainers seem to be a good option in preventing tooth relapse after Invisalign and fixed conventional treatments.

Three-dimensional evaluation of mandibular anterior dental crowding in digital dental casts.

ABSTRACTIntroduction: Digital dental models provide a more accurate and comprehensive assessment of orthodontic cases. Although this technique is quite promising, there are few three-dimensional measurements methods described in the literature. Objective: The aim of this study was to propose a method for assessing the degree of mandibular anterior dental crowding in the three planes of space, using digital dental models. Methods: Thirty dental casts were selected and scanned by Maestro 3D Dental Scanner and imported by Geomagic Qualify 2013 software. The degree of crowding was calculated by two examiners, based on the Little’s Irregularity Index, by means of the definition of axial, coronal and sagittal planes for each model. Intraexaminer analysis was performed with Dahlberg’s Formula (DF) and Intraclass Correlation Coefficients (ICC), and interexaminer analysis was performed with ICC and paired t-test. Results: The ICC showed an excellent agreement (p < 0.05) for all measurements, except for the intraexaminer and interexaminer in the Z-axis, in which it was found a moderate agreement. The DF showed a satisfactory accuracy with all measurements showing less than 1 mm difference. The paired t-test showed statistical difference between the examiners in two measurements, although it was clinical irrelevant. Conclusion: When comparing the three planes of space, the Z-axis showed the greatest variation in landmarks placement; however, overall, the present method seems precise and reproducible.

Correction of transverse maxillary deficiency and anterior open bite in an adult Class III skeletal patient

Transverse maxillary deficiency may be associated with sagittal or vertical problems of the maxilla or mandible. It may contribute to unilateral or bilateral posterior crossbite, anterior dental crowding, and unesthetic black buccal corridors on smiling. An adequate transverse dimension is important for stable and proper functional occlusion. Surgically, assisted rapid palatal expansion has been the treatment of choice to resolve posterior crossbite in skeletally mature patients. The following case report presents an adult Class III skeletal patient with an anterior open bite and bilateral posterior crossbite which was treated by surgically assisted rapid maxillary expansion with satisfactory outcomes.

Controlled canine retraction using orthodontic mini-implants coupled with bondable powerarms.

Many patients present with a substantial amount of anterior dental crowding, necessitating canine retraction prior to incisor alignment. Conventional biomechanics typically requires anchorage reinforcement and risks distal tipping of the canine crown and a delay before incisor alignment. However, it is now possible to produce controlled canine retraction without anchorage loss, even with narrow, flexible archwires in situ. This enables simultaneous alignment of displaced incisors. This technique involves a combination of orthodontic mini-implants (OMIs) and a powerarm bonded directly on either the labial or palatal surface of the target tooth, as described in this paper.

Hybrid Rapid Palatal Expansion With 2 Mini-Screws: A Case Report

ABSTRACT A hybrid expander is a newly designed bone-anchored expander consisting of 2 mini-screws and palatal acrylic; it does not cover any teeth. The aim of this case report is to present the treatment of a patient with transversal maxillary deficiency by hybrid expander. An 11.4-year-old female patient came to our clinic complaining about the appearance of her teeth. She had a narrow maxillary arch, unilateral dental crossbite, anterior dental crowding, and dental Class II canine and molar relationships on both sides. Two self-tapping mini-screws were placed between the first molar and second premolar on the palate under minimal local anesthesia. After 1 week, this appliance was bonded to the mini-screws with Transbond XT (3M Unitek, Monrovia, CA, USA) resin. The expansion screw was activated twice a day for 1 week and then once a day until the expansion was completed. After the expansion period, the brackets were bonded to the teeth without removing the hybrid expander. Sufficient maxillary expansion ...

Orthodontic treatment for a craniomandibular disorder. Case report

Female patient 13 years of age with severe TMJ dysfunction who presented symptoms of pain and generalized muscular hypertonicity, vertigo, difficulty for walking, limitation of mandibular movements, weak chewing and maximum oral opening of 17 mm. She was diagnosed as a skeletal Class II due toretrognathia and micrognathia. She had a convex profile, severe upper and lower anterior dental crowding. Treatment began with neuromuscular reprogramming with a splint for muscular relaxation, thermotherapy with moist heat, muscle relaxants and afterwards, orthodontic treatment. The results of the treatment were satisfactory since the patient experienced improvement in her physical and emotional health. Correct masticatory function was restored giving the patient a better quality of life and allowing her to resume her normal daily activities.Key words: TMJ dysfunction, mandibular retrognathism, muscular hypertonicity.