Buccal Shields Research Articles

Stepwise Advancement Simplified - A Modified Frankel II

Frankel II appliance has been one of the most commonly used appliances in treating class II malocclusions with retrognathic mandible. For step wise advancement, clinicians usually follow the conventional method suggested by Rolf Frankel by splitting the buccal shields and advancing the lower labial pads and lingual pads as a unit, followed by re-acrylisation or by fabrication of a new appliance. The modified Frankel II appliance is constructed by incorporating two orthodontic expansion screws on either side of the buccal shields of Frankel II during the fabrication of the appliance. Activation of the expansion screws will help in advancing the lower lingual pad and the labial pads as a unit therefore offering several significant advantages over the previously used technique. Keywords: Modified FR II, Stepwise advancement in FR II, Hybrid appliance

Functional Generating Bite Therapy in Children During Growth and Development Period

Introduction: Function generating bite is an individualized functional appliance made from acrylic resincomprised of several components namely: SS bite blocks, buccal shields, expansion coil and palatal button.This appliance enables teeth reposition entirely based on the temoporomandibular joint physiologicalcondition and avoiding cups-to-cusp misalignment. This is due to the fact that the SS bite block allows opencontact in the posterior region to open the mandible and regulate/reposition the mandible in three differentplanes during orthodontic movement. One of the vital mechanisms of bite block is occlusal plane levelingand dental arch parallelism to prevent the occurrence of dental trauma. Method: In this systematic review,article search was performed using Google Search and Pubmed. Articles published from 2000 and 2020were included. Seven articles were found which include: 7 articles from electronic search and 0 articles frommanual search, 7 articles were screened, 1 article was excluded and 6 articles were included for feasibilitytest and 6 complete articles were included. Results: There were 6 articles on functional generating bite thatcan correct malocclusion whilst increasing the masticatory function. Conclusion: Function generating biteis not only able to correct malocclusion but can also have an effect on mastication, hence this appliance canbe used as a therapeutic tool for masticatory function in children during growth and development.

Pink esthetic and radiological scores around immediate implants placed in the esthetic zone - Socket-Shield Technique versus Immediate Conventional Technique: A Pilot Study.

Objective:It is irrefutable that the extraction of teeth inextricably results in definitive changes in the surrounding hard and soft tissues. Recently, Socket-Shield Technique (SST) has been used to keep the buccal two-third of the root intact in the socket. This buccal shield further preserves the periodontium-bundle bone complex and hence preserves the buccal hard and soft tissue. The purpose of the study was to do a statistical comparative analysis of two different types of flapless and graftless techniques using the esthetic (Pink Esthetic Index) and radiological parameters.Materials and Methods:A total of thirty nonrestorable tooth/root stumps (vital or nonvital) were selected and randomly allocated to two different groups: control group with immediate conventional implant placement (without SST) (Group C, n = 15) and test group with immediate implant placement using SST (Group S, n = 15). All of the sites received immediate chairside temporaries. All implants were restored either with screw- or cement-retained prostheses 4 months postoperative. Each control and test group was analyzed at two different durations: 15 days after placement of provisional and 15 days after placement of definitive prosthesis. Five parameters of Pink Esthetic Score (PES) were used for esthetic analysis, and digital periapical radiographs were used for radiographic analysis.Results:Within the time frame of the study (15 days postplacement of definitive prosthesis), a statistically significant difference (p < 0.05) was observed between PES of the two techniques. Test group S (mean = 9.07) showed better scores than control group C (mean = 6.87). It was observed that buccal bone was maintained in all the cases of test group S while there was loss of buccal bone in almost all the cases of control group C.Conclusion:Within the limitations of this short-term pilot study, better soft-tissue parameters were observed with SST as compared to a conventional graftless technique whenever a restoration on immediate implant placement is considered.

A Novel Buccal Shield to Prevent Cheek Biting in Post-surgical OSMF Patients.

A Novel Buccal Shield to Prevent Cheek Biting in Post-surgical OSMF Patients.

Author's Response.

Author's Response.

Morphology of Prochaetoderma iberogallicum Salvini-Plawen, 1999 and Its Validity vs Prochaetoderma boucheti Scheltema &amp; Ivanov, 2000

Prochaetoderma Thiele, 1902 is a genus of the class Caudofoveata under constant review, with several classifications and synonymizations of species. This genus is represented off the Iberian Peninsula by seven species, among which Prochaetoderma iberogallicum Salvini-Plawen (Iberus 17(2):77–84, 1999) and Prochaetoderma boucheti Scheltema and Ivanov (J Molluscan Stud 66(3):313-362, 2000) can be found. Both species are anatomically very similar and difficult to differentiate. Thanks to the study of new specimens collected in several oceanographic expeditions carried out off Galicia (NW Iberian Peninsula) and their comparison with the type series of both species, their taxonomical status is clarified and their anatomical study is also completed in terms of body morphology, buccal shield and typology of sclerites.

The habitus of Scutopus robustus Salvini-Plawen, 1970 (Caudofoveata, Limifossoridae), a rare mollusc from the NW Iberian Peninsula

Caudofoveata are vermiform, aplacophoran molluscs with reduced foot and a mantle covered with calcareous sclerites. Most Caudofoveata live at great depths mainly burrowing in muddy bottoms. They are usually damaged during their collection, thus the iconography available is incomplete, except for the patterns of the sclerites. A sample of Scutopus robustus was collected during the oceanographic expedition MASPROGAL 2013, carried out by the EBMG-USC, on the bottoms of polymetallic nodules and corals of the NW Iberian Peninsula at a depth of 600–700 m (43°48,000’N, 8°51,760’W). S. robustus is a rare species recorded for the first time in this geographic area, which confirms the suspicions of Salvini-Plawen and Garcia-Alvarez (2014) about its presence off the Iberian Peninsula; so far, it has only been found off Norway, Iceland, northern England, southwest Ireland and the western Mediterranean Sea (Salvini-Plawen 1970; Ivanov and Scheltema 2001, Salvini-Plawen and Garcia-Alvarez 2014). Specimen: 5 mm long × 0.25–0.5 mm wide. White in 70% ethanol. Postoral buccal shield slightly flanking the mouth. Three body regions (Fig. 1a): anterium, trunk and tassel, covered in sclerites lying longitudinally on the mantle. Anterium (Fig. 1b), with flat, smooth, lanceolate sclerites (40–70 μm long × 15–30 μm wide) and truncated base (Fig. 1e, f). Trunk narrowing in its medial region (Fig. 1c), with two types of sclerites: first type lanceolate (80–130 × 25–45 μm) with smooth waist, truncated base with slight notch and reinforced apical end of the blade (Fig. 1g–j) on the first part of the trunk; second type (100–150 × 20–50 μm) like the first but with a round base (Fig. 1k, l) at the end of the trunk. Tassel bell-shaped (Fig. 1d) with two types of sclerites: first type lanceolate (150–200 × 30–40 μm) with slight waist and round base longer than the blade (Fig. 1m); second type acicular (180–220 × 10–15 μm) and smooth (Fig. 1n). The iconography of S. robustus is scarce, and only two low-quality photographs of the habitus and some drawings of the sclerites are known (Salvini-Plawen 1970, 1972, 1975). The detailed photographs of the habitus and sclerites under and optical microscope and SEM presented in this paper are the first for this species. The studied specimen differs from those already described (Salvini-Plawen 1970, 1972, 1975), as the small, triangular sclerites described from the anterior part were not observed, probably due to the strong contraction of the anterior part, and the acicular sclerites of the tassel are longer than those of previous descriptions. The fact that the trunk Communicated by P. Martinez Arbizu

기능성 반대교합을 가진 초기 혼합치열기 어린이에서 FR III를 단기간 장착했을 때의 효과

기능성 전치부 반대교합을 가진 성장기 환자의 경우, 조기에 원인을 제거함으로써 골격성으로 이행하는 것을 방지하고 성장 조절로 악골 관계를 개선함으로써 정상적인 기능과 안모를 유도할 수 있다. 1966년 R<TEX>$\ddot{o}$</TEX>lf Fr<TEX>$\ddot{a}$</TEX>nkel에 의해 소개된 Functional regulator(FR)의 한 종류인 FR III는 기능성 전치부 반대교합 및 상악의 열성장을 동반한 반대교합을 치료하기 위해 유치열기, 혼합치열기 초기, 및 영구치열기에 사용되고 있다. 이 장치는 비정상적인 근육력을 차단하여 구강 내 치열 및 악골에 대한 힘의 불균형 상태를 개선하여 정상적인 성장 발육을 할 수 있게 하는 악정형 장치이다. 이번 증례에서는 초기 혼합치열기에서 기능성 반대교합을 가진 환자의 임상 케이스를 선별하여 FR III 장치를 사용하여 다음과 같은 양호한 결과를 얻었다. 1. 초기 혼합치열기 환아에서 FR III 장치를 5~6개월 정도 단기간 장착하여 전치부 반대교합을 치료하였으며, 협측 차폐판에 의해 발생할 수 있는 상악의 횡적인 악골 변화는 나타나지 않았다. 2. 상, 하악 전치의 치성 변화와 하악의 후하방 회전의 효과를 통해 정상적인 치열관계의 회복과 심미적인 안모를 얻을 수 있었다. In case of treating the functional type of anterior cross bite, removing the cause in early stage prevents from turning to skeletal type, leads to perform normal function, and has improved facial appearance. Functional Regulator III (FR III), one kind of the Functional regulator(FR)s suggested by R<TEX>$\ddot{o}$</TEX>lf Fr<TEX>$\ddot{a}$</TEX>nkel in 1966, applied to patients with the functional and skeletal anterior crossbite in early mixed, and permanent dentition. This appliance improves unbalanced power condition by blocking abnormal muscle-power effect, so that normal growth can be expected. In this case report, favorable results were obtained by selecting clinical cases of children in their early mixed dentition with functional cross bite. 1. FR IIIs were applied to patients with anterior crossbite for 5~6 months. Anterior crossbite patients were corrected favorably, nevertheless they didn't show any horizontal skeletal-changes by buccal shields. 2. Normal occlusion and esthetic facial contour were achieved from dental movement of maxillary and mandibular anterior teeth while the mandible rotates to posterior and inferior direction.

Effects of the functional regulator III on transversal changes: a postero-anterior cephalometric and model study

Studies assessing the transversal treatment changes caused by the functional regulator III (FR-3) are limited in number. This clinical study was planned to analyse the transversal effects of the FR-3 appliance therapy. The treatment group consisted of 17 patients (8 males and 9 females) with Class III malocclusion, who were treated with the FR-3 appliance. The control group consisted of 17 subjects (7 males and 10 females) with a normal occlusion. Mean ages of the subjects were 10.73 and 10.66 years in the treatment and control groups, respectively. Postero-anterior radiographs and stone casts were obtained before (T1) and after (T2) treatment/observation. The results of the Student's t-test comparing initial values showed that maxillary dentoalveolar and skeletal widths are significantly larger in the control group than those in the treatment group. At the end of the treatment, significant transverse increments occurred only at the dentoalveolar level of the maxilla. The transversal changes in the mandible were not statistically significant. Buccal shields of FR-3 did not stimulate the growth of maxillary apical base but caused an enhanced and supplementary widening of maxillary dental and alveolar structures.

Efficacy of tin-containing solutions on erosive mineral loss in enamel and dentine in situ

The addition of tin to mouth rinses is, at least in vitro, a promising strategy for symptomatic therapy of dental erosion. The aim of this study was to evaluate the in situ efficacy of an experimental tin-containing fluoride solution on erosive tissue loss in human enamel and dentine. The study was a three-cell (7days each) crossover design involving eight healthy participants. Samples were mounted on buccal shields of mandibular mouth appliances, which were worn for 24h except during meals and drinks. Specimens were demineralised extraorally with 0.05M citric acid (pH 2.3) for 6 × 5min daily and were treated with test solutions intraorally once per day for 30s after the first demineralisation. Three solutions were used: placebo (negative control), a commercially available tin- and fluoride-containing (SnF(2)) mouth rinse (positive control, 409ppm Sn(2+), 250ppm F(-), pH 4.2) and an experimental solution (pH 4.5) containing 1,900ppm Sn(2+) (SnCl(2)) and 1,000ppm F(-) (AmF/NaF). Tissue loss (micrometre) was determined profilometrically. In enamel, tissue loss was 54.8 ± 8.6 in the placebo, 24.5 ± 14.4 in the positive control and 9.7 ± 4.1 in the experimental solution group. The respective values for dentine were 48.5 ± 13.0 in the placebo, 32.8 ± 9.6 in the positive control and 26.2 ± 6.7 in the experimental solution group. The experimental solution was notably effective for enamel but was less effective for dentine. The positive control solution was less effective than the experimental solution; its effects for enamel and dentine were similar.

Efficacy of an Experimental Tin-F-Containing Solution in Erosive Tissue Loss in Enamel and Dentine in situ

The aim of this study was to evaluate the effects of an experimental tin-containing fluoride solution on erosive tissue loss in human enamel and dentine using a cyclic de- and remineralization model in situ. The study was a three-cell (7 days each) crossover design involving 20 healthy volunteers. Samples were mounted on buccal shields of mandibular mouth appliances and worn for 24 h, except during meals and oral hygiene. Samples were demineralized extraorally with 0.05 M citric acid (pH 2.3) for 6 × 5 min per day. Fluoride treatment was performed intraorally once per day for 30 s after the first demineralization. Three solutions were used: placebo (negative control); NaF solution (positive control, 1,000 mg/kg F, pH 4.5), and an experimental solution (1,900 mg/kg Sn as SnCl₂, 500 mg/kg F as NaF, 500 mg/kg F as amine fluoride, pH 4.5). Tissue loss was determined profilometrically. In enamel, tissue loss was 33.6 ± 15.4 μm in the negative control group, 24.2 ± 9.2 μm (p ≤ 0.05) in the positive control group and 9.2 ± 3.4 μm (p ≤ 0.001) in the experimental solution group. The respective values for dentine were 47.8 ± 15.5 μm in the negative control group, 34.1 ± 9.3 μm (p ≤ 0.001) in the positive control group and 23.9 ± 6.4 μm (p ≤ 0.001) in the experimental solution group. The tin-containing solution was very effective in inhibiting erosive mineral in enamel in situ, even under severe conditions and with short application times, but was less effective in dentine.

An Evaluation of Buccal Shield Treatment

To evaluate the short-term effects of the buccal shield modification of the lip-bumper design and on various mandibular dental arch parameters and to determine whether the changes in arch widths are due to the tipping or bodily movements of the teeth involved. This study included 45 consecutively treated patients (29 girls and 16 boys) from a private orthodontic practice. Student's and paired t-tests were used to test the null hypothesis of no change over time for the various measurements. Linear regression analyses were used to determine whether treatment time was a significant predictor of arch width expansion. Significance for all statistical tests was predetermined at P < or = .05. Student's t-test results indicated the presence of a significant (P < .0001) increase in all the arch parameters measured. The greatest mean expansion was observed at the first (5.0 +/- 2.2 mm) and second (3.4 +/- 2.2 mm) premolar width measurements. The changes in arch width parameters were significantly (P < .0001) greater than the normal age-related changes in the corresponding parameters. There was no significant difference between arch width expansion of the occlusal vs gingival levels, indicating a bodily and not tipping movement. Only 30% of the lower incisors demonstrated an increase in their proclination beyond normal values. When using the buccal shield appliance, the mandibular arch width parameters can be expanded in the mixed dentition with bodily movement of teeth. The expanded arch width dimensions are greater than what would be expected as a result of normal growth.

Evaluation of friction during sliding tooth movement in various bracket-arch wire combinations

Frictional forces during simulated sliding tooth movement were measured with a model that was representative of the clinical condition. The model allowed tipping of the tooth until contact was established between the arch wire and diagonally opposite corners of the bracket wings; it also allowed rotation until the wire contacted opposite corners of the ligature tie, or the buccal shield with self-ligating brackets, and the base of the slot. Conventional and self-ligating stainless steel brackets as well as conventional ceramic brackets, and ceramic brackets with a stainless steel slot, all with 0.022 inch bracket slot, were tested with 0.019 × 0.025 inch arch wires of stainless steel, nickel titanium, and beta titanium. Each of the 12 bracket-arch wire combinations was tested 10 times. No significant interaction was detected between brackets and arch wires ( P = .89), but the bracket and arch wire effects were significant ( P < .001). The pairwise differences between conventional and self-ligating stainless steel brackets and ceramic brackets with stainless steel slot were not significant. However, the conventional ceramic brackets generated significantly higher friction than the other brackets tested. Beta titanium arch wires produced higher frictional forces than nickel titanium arch wires, but no significant differences were found between each of the two and stainless steel arch wires. Attempts to identify differences in surface scratches of the arch wires produced by the different brackets were unsuccessful. (Am J Orthod Dentofacial Orthop 1999;116:336-45)

Expansion With vestibular shields: An experimental test of the periosteal-pull hypothesis

Two mechanisms are said to be responsible for the expansion commonlyproduced by buccal shields: (1) unbalanced tongue pressure and (2) periosteal pull; that is, periosteal traction on the bone overlying the molar roots. The present study used 44 young albino rats to examine these two alternatives. Half the rats wore buccal shields to produce molar expansion, and half had their maxillary molar crowns ground down to the gingiva to eliminate the effect of the tongue. In the resulting 2 x 2 design, four experimental groups were formed: (1) SM, shields and intact molars; (2) Sm, shields and reduced molars; (3) sM, no shields and intact molars; and (4) sm, no shields and reduced molars. It was hypothesized that if vestibular shields produce expansion through periosteal traction, the presence or absence of molar crowns should make no difference. Conversely, if the expansion is caused by unbalanced tongue pressure, shields should have an effect only in conjunction with intact maxillary molars. Palatal amalgam implants and dorsoventral cephalograms were used to measure the maxillary basal and dental expansion that occurred during the 6 weeks of the experiment. Analysis of variance showed the presence of highly significant interaction between shields and molars: the shields produced an increase in posterior dental expansion, but only when molar crowns were present. In contrast, basal expansion was unaffected by any combination of treatments. At least for the rat, it may be concluded that unbalanced tongue pressure, rather than periosteal traction, is probably responsible for the expansion produced by buccal shields.

Effects of buccal shields on the maxillary dentoalveolar structures and the midpalatal suture–histologic and biometric studies in rabbits

The mechanism of the buccal shields with regard to regulating the transversal relationship of the maxillary dental arch is uncertain. The periosteal pull theory, growth at the midpalatal suture and changes in equilibrium have all been proposed as explanatory factors. The aim of the study was to investigate the transversal development of the dental arch and the osseous remodeling at the lateral surfaces of the maxillary alveolar process and in the midpalatal suture after stretching the bucca (cheek) with buccal shields in the vestibulum. Ten New Zealand white male rabbits 12 weeks old were used. The animals were divided into two groups (control and experimental). Initial and final impression had been taken from the two groups and plaster models were made using biometric analysis in all animals of each group. Transversal measurements were taken of the distances between the maxillary right and left teeth. Tetracycline hydrochloride and Alizarin complexone were used to label the mineralizing tissues. After the animals had been killed, the biopsies from the midpalatal suture, the alveolar wall, and the periosteum were studied under a microscope. The results from the biometric analysis showed maxillary dental arch expansion in the two groups that was significantly larger in the experimental group. Microscopically, the growth at the midpalatal suture was also significantly larger in the experimental group, while no significant differences were found at the maxillary alveolar bone in the two groups. The conclusions drawn from this study are that the vestibular buccal shields bring about an increased expansion of the maxillary dental arch and increased growth at the midpalatal suture. No increased bone deposition was found at the buccal dentoalveolar wall, inducing doubts as to the accuracy of the periosteal pull theory for widening of the dental arch. (Am J Orthod Dentofac Orthop 1996;109:521-30.)

Muscle response to the oral-screen activator. An EMG study of the masseter, buccinator, and mentalis muscles.

The myofunctional changes that occur during orthodontic treatment with functional appliances constructed with vestibular screen elements, such as buccal shields and lip pads, have not been sufficiently investigated. The aim of this study was to examine electromyographically the response of the masseter, buccinator and mentalis muscles to the oral-screen activator (OSAC), which is a conventional activator constructed with buccal shields and lip pads. The material consisted of 10 children, with Angle Class II, division 1 malocclusion and narrow dental arches (mean age 10.7 years), treated at the Department of Orthodontics, School of Dentistry, Malmö, Sweden. The group had a mean overjet of 8.5 mm, and a mean ANB angle of 6 degrees. Six out of the 10 cases had incompetent lips at relaxed lip position. The construction bite of the OSAC was taken with the anterior teeth in edge-to-edge position. The recording procedure included the following positions: (a) postural position of the mandible with lips relaxed and lips closed; (b) clenching; (c) swallowing saliva; and (d) spatula exercise. EMG recordings were made after 1, 2, and 3 months of appliance treatment. Differences between means were tested with a two-way analysis of variance (ANOVA). The results showed that during postural position with lips closed there was a statistically significant increase in mentalis EMG with the oral-screen activator in place. The buccinator and masseter muscles showed no EMG activity during rest with or without the appliance in the mouth. During clenching we found no statistically significant difference in masseter EMG with or without the appliance in place. During swallowing saliva a statistically significant decrease was recorded in mentalis EMG with the oral-screen activator in the mouth, while buccinator activities remained the same with and without the appliance. The masseter activity, on the other hand, increased significantly with the activator in place. During spatula exercise mentalis and buccinator were highly activated. The conclusions drawn from this study are that the oral screen activator (OSAC) increased masseter activity during swallowing, but it remained unchanged during clenching. Lip pads increase mentalis activity during lip closure, but reduce mentalis hyperactivity during swallowing. The buccinator activity was insignificant and buccal shields did not change that activity. Spatula exercise stimulates both mentalis and buccinator activity.

Myofascial pain as a main symptom of TMJ dysfunction pain syndrome: J. J. SchimekSchweisz. Monatschr. Zahnmed. 94: 801–812, 1984

Buccal shields inserted in the mouths of 30-day-old Sprague-Dawley rats displaced the buccal musculature away from the maxillary molar teeth. Intermolar distances increased significantly (P < 0.02) 15 days following insertion of the appliance, thereafter decreasing with time. Histologically, at the level of the first molars, ossification of the sutural cartilage occurred earlier than in control sutures. While different interpretations are given to explain this result, the adaptive nature of secondary cartilage in the intermaxillary suture of the rat was demonstrated. This adaptation may be limited by the nature of mechanical stress exerted upon, and/or the growth potential, of the suture.

Palatal sutural response to buccal muscular displacement in the rat

Buccal shields inserted in the mouths of 30-day-old Sprague-Dawley rats displaced the buccal musculature away from the maxillary molar teeth. Intermolar distances increased significantly (P < 0.02) 15 days following insertion of the appliance, thereafter decreasing with time. Histologically, at the level of the first molars, ossification of the sutural cartilage occurred earlier than in control sutures. While different interpretations are given to explain this result, the adaptive nature of secondary cartilage in the intermaxillary suture of the rat was demonstrated. This adaptation may be limited by the nature of mechanical stress exerted upon, and/or the growth potential, of the suture.

On the Development of the Plumes in Buds of Cephalodiscus

1. The torsion of the axes of the first and second plumes of the buds of Cephalodiscus described by Masterman does not take place. The grooved faces of the axes of these plumes are in the first instance directed towards the dorsal face of the buccal shield, and they maintain this relation through life. 2. The last two pairs of plumes do not arise between the first two pairs of plumes and the buccal shield, as described by Masterman, but they arise on the dorsal side of those plumes, the side remote from the shield. Their grooves are directed, not towards the shield, but away from it. 3. The evidence derived from a study of the buds of Cephalodiscus bears out the contention of Harrner that the series of plumes and post-oral lamella are continuous. The plume-axes develop in pairs successively, the median pair first, then a pair lateral to these, and so on. When the post-oral lamella appears, usually at the time when the third or fourth pair of plume-axes are beginning to develop, its edge is in contact with the last-developed pair of plume-axes. The fifth plume-axis appears between the fourth plume-axis and the end of the margin of the post-oral lamella, the sixth between the fifth and the end of the post-oral lamella, and, in the case of Cephalodiscus nigrescens, in which there are seven pairs of plumes in the adult, the seventh arises between the sixth and the end of the margin of the postoral lamella. 4. The line of plume-bases in the adult, when viewed from the front, is an ellipse, incomplete on the upper side (text fig.8); and the line of the attached edge of the post-oral lamella is another ellipse, similarly incomplete. The two ellipses join where they are incomplete. 5. Separate accounts are given in this paper of the plume-development in buds of Oephalodiscus hodgsoni, C. dodecalophus, C.nigrescens, and C.gilchristi. 6. The plumes develop relatively later in buds of C.nigrescens and C.gilchristi than those of C.hodgsoni and C.dodecalophus.