Incisor Inclination Research Articles

Correlation between Cleft Width and Adjacent Teeth Inclination in Patients with Unilateral Cleft Lip and Palate Using CBCT: A Retrospective Study.

To evaluate buccolingual and mesiodistal inclination of cleft-adjacent maxillary permanent central incisors (U1) and canines (U3) in patients with unilateral cleft lip and palate (UCLP) in the late mixed dentition and to investigate the correlation between the alveolar cleft width and cleft-adjacent teeth inclination using cone beam computed tomography (CBCT). Observational cross-sectional retrospective study. Department of Orthodontics, Hama University Dental School. 32 patients with UCLP (22 boys, 10 girls; mean age = 10.53 ± 1.51 years). Buccolingual and mesiodistal inclination of maxillary central incisors and canines were measured on both sides. Then, the cleft and non-cleft sides were compared using the Wilcoxon signed-rank test. Pearson's correlation was used to explore the association between the alveolar cleft width and cleft-adjacent U1 and U3 buccolingual and mesiodistal inclination. The cleft-adjacent central incisors were significantly inclined lingually and distally compared with their non-cleft antimeres (P = .003, P < .001, respectively). The cleft-adjacent canines were significantly inclined buccally and mesially compared with their non-cleft antimeres (P < .001, for both). A positive correlation was found between the buccolingual inclination of cleft-adjacent U1 and the alveolar cleft width (r = 0.49, P = .004). Patients with UCLP demonstrated a significant lingual and distal inclination of cleft-adjacent U1 and a significant buccal and mesial inclination of cleft-adjacent U3. The buccolingual inclination of cleft-adjacent U1 tends to increase with increasing the alveolar cleft width; however, the correlation was weak.

Buccal corridor and gummy smile treatment with MARPE and gingivoplasty: A 2-year follow-up case report

The advent of Mini-screws assisted rapid palatal expansion (MARPE) has introduced a simpler in-office procedure that enables the translation of the alveolar process in adults. This case report showed the combination of MARPE, orthodontic treatment, and gingivoplasty to correct malocclusion and enhance smile aesthetics. A 20-year-old woman expressed concerns about excessive buccal corridors and a gummy smile. She exhibited skeletal class I malocclusion, with buccal corridors exceeding 4 mm, a gummy smile, and lingual tipping of the lower posterior segments. The treatment plan involved utilizing the MARPE appliance, a Nitinol wire, gingivoplasty to address the gummy smile. Retention evaluations demonstrated the stability of MARPE in transversal skeletal discrepancies. There was notable improvement in incisor inclination and soft tissue profile, particularly evident in the E-line and nasolabial angle. Cephalometric analysis confirmed these changes, showing a decrease of 5.9 degrees in the inclination of the maxillary incisors. After a 2-year follow-up, the results remain stable, and the patient expresses satisfaction with the outcome. MARPE can be considered as an effective tool for managing buccal corridors, complemented by fixed orthodontic treatment employing labial appliances and gingivoplasty to correct malocclusion and enhance smile aesthetics. The treatment showed positive long-term outcomes.

Reconsidering the role of nasolabial angle in premolar extraction decision-making: A case-series study.

To evaluate the impact of changes in upper incisor inclination and position on the alteration of the nasolabial angle (NLA) in a series of cases involving the extraction of four first premolars. The study included 41 patients who underwent orthodontic treatment with premolar extractions. The patients were divided into two groups based on their pretreatment NLA values: Group 1 (NLA ≤ 100°) and Group 2 (NLA > 100°). Measurements of NLA, U1.NA and U1-NA were obtained before and after treatment and U1-Ls pretreatment measure was registered. Statistical analyses were performed to compare the differences in NLA, U1.NA and U1-NA between the two groups and to evaluate the influence of these variables added to U1-Ls (T1) on NLA changes. The results showed that Group 1 exhibited significant changes in NLA, while Group 2 did not. However, both groups showed significant changes in U1.NA and U1-NA. In Group 1, 80% of the individuals presented an increase in NLA and 20% no changes. In Group 2, 10% presented a decrease, 57% no changes and 33% an increase in NLA values. Multiple linear regression analysis indicated that the group factor had a statistically significant influence on NLA variation. Additionally, in Group 2, a negative correlation was observed between changes in U1.NA and NLA. The findings suggest that individuals with higher pretreatment NLA values tend to maintain their NLA values even after the correction of upper incisor inclination.

Reliability and safety of miniscrew insertion planning with the use of lateral cephalograms assessed on corresponding cone-beam computer tomography images.

Recently, lateral cephalograms have been proposed for guided miniscrew insertion planning. Therefore, the aim was to assess the reliability and safety of such planning on corresponding cone-beam computer tomography (CBCT) images. Intraoral scans, lateral cephalograms, and CBCT images of 52 subjects (even sexes distribution), aged 15.1 ± 2.5 years, were included. Miniscrew (n = 104) insertion planning was performed using lateral cephalograms superimposed on the maxillary intraoral scans, while the assessment of their bicortical placement, length in bone, contact with adjacent teeth, incisive canal, and nasal floor perforation was done on corresponding superimposed CBCT images. Moreover, maxillary incisor inclination, crowding, and the maxillary intercanine width were measured. The overall miniscrew length in bone was 7.2 ± 1.3mm. Bicortical placement was seen in 58.7% of the sample (38.5% of subjects). Incisive canal and nasal floor perforation was seen in 25% and 21.2% of subjects, respectively. No contact of the miniscrew with adjacent teeth was recorded. A negative significant interaction was seen between the miniscrew length in bone, the percentage of total miniscrew length and maxillary anterior teeth crowding (β, -0.10, P = .047 and β, -0.90, P = .006, respectively). Moreover, a positive significant interaction was seen between the incisive canal perforation and maxillary anterior teeth crowding (OR = 1.32, P = .021). Exclusion of subjects with impacted teeth. Miniscrew insertion planning using lateral cephalograms, despite being safe in preventing contact with adjacent teeth, is limited in achieving bicortical placement and insufficient in completely avoiding incisive canal and nasal floor perforation.

The effect of micro-osteoperforations on the rate of maxillary incisors' retraction in orthodontic space closure: a randomized controlled clinical trial

BackgroundThis single-centered randomized controlled clinical trial aimed to evaluate the effectiveness of micro-osteoperforations (MOPs) in accelerating the orthodontic retraction of maxillary incisors.MethodsForty-two patients aged 16–40 were recruited and randomly assigned into two groups, one which underwent MOPs (MOPG) in the buccal and palatal region of all maxillary incisors immediately before the start of retraction and one which did not (CG). Eligibility criteria included the orthodontic need for maxillary first premolars extraction and space closure in two phases. The primary outcome of the study consisted of measuring the rate of space closure and, consequently, the rate of incisors’ retraction using digital model superimposition 14 days later and monthly thereafter for the next 4 months. The secondary outcomes included measuring anchorage loss, central incisors’ inclination, and root length shortening, analyzed using cone beam computed tomography scans acquired before retraction and 4 months after retraction. Randomization was performed using QuickCalcs software. While clinical blinding was not possible, the image’s examinator was blinded.ResultsTwenty-one patients were randomly assigned to each group. However, due to various reasons, a total of 37 patients (17 male and 20 female) were analyzed (mean age: 24.3 ± 8.1 years in the MOPG; 22.2 ± 4.2 years in the CG) during the trial. No statistically significant difference was found between the MOPG and the CG regarding the incisors’ retraction measured at different time points at the incisal border (14 days, 0.4 mm vs. 0.5 mm; 1 month, 0.79 mm vs. 0.77 mm; 2 months, 1.47 mm vs. 1.41 mm; 3 months, 2.09 mm vs. 1.88 mm; 4 months, 2.62 mm vs. 2.29 mm) and at the cervical level (14 days, 0.28 mm vs. 0.30 mm; 1 month, 0.41 mm vs. 0.32 mm; 2 months, 0.89 mm vs. 0.61 mm; 3 months, 1.36 mm vs. 1.10 mm; 4 months, 1.73 mm vs. 1.39 mm). Similarly, no statistically significant differences were detected in the space closure, anchorage loss, central incisors’ inclination, and radicular length between groups. No adverse effect was observed during the trial.ConclusionsMOPs did not accelerate the retraction of the maxillary incisors, nor were they associated with greater incisor inclination or root resorption.Trial registration ClinicalTrials.gov NCT03089996. Registered 24 March 2017—https://clinicaltrials.gov/ct2/show/NCT03089996.

Biomechanical Simulation of Orthodontic En-Bloc Retraction Comparing Compound Technique and Sliding Mechanics Using a HOSEA Robotic Device.

En-bloc retraction is a common procedure in orthodontic therapy. The application of palatal root torque moments is required to control incisor inclination during retraction, yet studies comparing forces and moments with respect to different mechanics are lacking. This study aimed to investigate the forces and moments during orthodontic en-bloc retraction using a robotic biomechanical simulation system, comparing two distinct approaches: (I) compound technique [stainless steel (SS) combined with nickel-titanium (NiTi)] using industrially pretorqued retraction-torque-archwires (RTA) in combination with NiTi closed coil springs; (II) conventional sliding mechanics using SS archwires with manually applied anterior twist bends in combination with elastic chains. Two dimensions (0.017" × 0.025" and 0.018" × 0.025") and ten archwires per group were investigated using 0.022" slot self-ligating brackets. Kruskal-Wallis tests with a significance level of α = 0.05 were conducted. The biomechanical simulation showed that en-bloc retraction was characterized by a series of tipping and uprighting movements, differing significantly regarding the examined mechanics. Collateral forces and moments occurred in all groups. Notably, RTA exhibited fewer extrusive forces. The most bodily movement was achieved with the compound technique and the 0.018" × 0.025" RTA. Sliding mechanics exhibited maximum palatal root torque moments of more than 20 Nmm, exceeding recommended values.

Comparing Four Cephalometric Methods Used to Evaluate the Change in the Lower Incisor Inclination

Aim: The assessment of change in the lower incisor inclination using cephalometry during any orthodontic treatment is used to determine the treatment outcome. The inclination change is measured using the lower border of the mandible even though it is subjected to remodeling in growing children. We have used Bjork’s superimposition technique using “stable structures” to eliminate these growth changes. In this study, we have evaluated if there is any major difference between three routinely used methods to estimate the lower incisor inclination change influenced by orthodontic treatment (gonion-gnathion, gonion-menton, and tangent drawn to the lower border of the mandible) in contrast to Bjork’s superimposition technique. Materials and Methods: This study was performed using the lateral cephalograms of total of 39 subjects undergoing orthodontic treatment using fixed appliances, aged 12–16 years at the beginning of the treatment. The pretreatment and mid-treatment cephalograms of these subjects were evaluated with a gap of at least 1 year between the two radiographs. Patients who had undergone lower incisor extractions were excluded from this study. Results: The ICC was calculated using Bjork’s superimposition technique as references and subsequently the other techniques were compared. The linear regression model showed good ICC between all methods, with ICC being 0.92 for Go-Me, 0.94 for Go tangent, and 0.88 for Go-Gn. All the three methods showed a significant correlation with Bjork’s method. Conclusion: The data in the current study showed that there was no significant difference in the findings obtained by Bjork’s superimposition method when compared to other techniques. Furthermore, remodeling of the lower border of the mandible showed no significant changes in the investigated time frame.

Influence of differences in mandibular incisor inclination on skeletal stability after orthognathic surgery in patients with skeletal class III malocclusion

Objective: The preoperative inclination angle of mandibular incisors was crucial for surgical and postoperative stability while the effect of proclined mandibular incisors on skeletal stability has not been investigated. This study aimed to evaluate the effects of differences in presurgical mandibular incisor inclination on skeletal stability after orthognathic surgery in patients with skeletal Class III malocclusion.Methods: A retrospective cohort study of 80 consecutive patients with skeletal Class III malocclusion who underwent bimaxillary orthognathic surgery was conducted. According to incisor mandibular plane angle (IMPA), patients were divided into 3 groups: retroclined inclination (IMPA < 87°), normal inclination (87° ≤ IMPA < 93°) and proclined inclination (IMPA ≥ 93°). Preoperative characteristics, surgical changes and postoperative stability were compared based on lateral cephalograms obtained 1 week before surgery (T0), 1 week after surgery (T1), and at 6 to 12 months postoperatively (T2).Results: The mandible demonstrated a forward and upward relapse in all three groups. No significant differences in skeletal relapse were observed in the 3 groups of patients. However, the proclined inclination group showed a negative overbite tendency postoperatively compared with the other two groups and a clinically significant mandibular relapse pattern. Proclined IMPA both pre- and postoperatively was correlated with mandibular relapse.Conclusion: Sufficient presurgical mandibular incisor decompensation was of crucial importance for the maintenance of skeletal stability in patients with skeletal Class III malocclusion who subsequently underwent orthognathic surgery.

Extraction of four premolars in hyperdivergent individuals, does it help? -A case report

Treatment of any malocclusion requires careful diagnosis and treatment planning to resolve aesthetic, occlusal, and functional problems. Premolar extractions in orthodontics, over the years has been carried out to relieve dental crowding and affect incisor inclination. Clinicians’ decisions on premolar extractions and the extraction patterns have been influenced by desired anchorage control or changes to the vertical dimension. The introduction of mini-screw skeletal anchorage systems has broadened our horizons by giving us complete control over the anchorage as well as good vertical control. However, this case report shows the vertical control and the anchorage achieved using the low-lying transpalatal arch. The use of basic armamentarium along with avoiding an invasive procedure, provides an equally efficacious treatment outcome.

Long-Term Assessment of Treatment Timing for Rapid Maxillary Expansion and Facemask Therapy Followed by Fixed Appliances: A Multicenter Retro-Prospective Study

Background: to determine the role of treatment timing in the long-term effects produced by rapid maxillary expansion and facemask therapy (RME/FM) in Class III patients. Methods: This study compared two sample groups treated with RME/FM followed by fixed appliances: the early prepubertal group (EPG) (17 patients; mean age before treatment (T0), 5.8 ± 0.7 years; range, 4.3–6.9 years) and the late prepubertal group (LPG) (17 patients; mean age at T0, 10.1 ± 0.8 years; range, 9.0–11.1 years). Lateral cephalograms for the two groups were examined before treatment (T0) and at a long-term observation (T1) (EPG, 19.8 ± 1.0 years; LPG, 21.0 ± 2.1 years). Independent sample t-tests were performed to compare the two groups at T0 and T1. Results: No statistically significant differences were found for any of the cephalometric variables at T0, except for the total mandibular length, overjet, and inclination of the maxillary incisors to the palatal plane, which were greater in the LPG. At T1, no statistically significant differences were detected for any of the cephalometric variables. Conclusions: There were no significant long-term differences when treating Class III patients with RME/FM, either during an early prepubertal phase (≤7 years of age) or during a late prepubertal phase (≥9 years of age).

Morphological Evaluation of the Incisive Canal in the Aspect of the Diagnosis and Planning of Orthodontic Treatment—CBCT Study

Background: Understanding the anatomy of the incisive canal is crucial for effective diagnosis and treatment planning in clinical orthodontics. This is because, during orthodontic tooth movement, there is a risk of contact between the roots of the upper central incisors and the incisive canal. Objective: The aim of this study was to assess the anatomical variability of the incisive canal using cone beam computed tomography (CBCT), as well as to evaluate its correlation with age, sex, and the position of the maxillary central incisors. There are only a few studies on this topic. Materials and methods: We analysed CBCT data from 67 patients aged from 13 to 49 years. This study was conducted at the Wroclaw Medical University. Measurements were performed twice by two independent researchers, and intra-observer error and correlation were calculated. The mean difference between the first and second observations and between observers was also assessed. We examined the dimensions of the incisive canal and its relationship to the roots of the upper central incisors in relation to age and gender. Results: Our study results revealed a significant correlation between the width and length of the incisive canal. Males exhibited a significantly greater canal length at the lowest point of the incisive canal on the palatal wall. Additionally, males had wider canals compared to females. The analysis of canal width and distance between the most mesial point of the root and the line passing through the most anterior point of the incisive canal showed a negative correlation in all age groups of men. The analysis of incisal inclination and incisal canal inclination showed a very strong relationship, especially in the age group of 13 to 20 years. Several potential risk groups of contact between the roots of central incisors and the incisive canal have been identified based on their structure and the planned incisors’ orthodontic movement. Conclusions and implications: Knowledge of the anatomy of the incisive canal and the use of 3D imaging in high-risk patients can prevent resorption of the incisor root by considering the individual anatomical conditions of the patient when planning orthodontic tooth movement. We recommend performing a CBCT scan before starting orthodontic treatment in the case of moderate and significant retraction of the incisors, or a significant change in their inclination due to the wide anatomical diversity of the incisive canal, especially in adult patients.

Effect of power arm length combined with additional anterior torque on the axial orientation of the maxillary incisors during en-masse retraction: A finite element analysis

This study aimed to clarify the effect of power arm length combined with additional torque incorporated into the archwire on the controlled movement of the anterior teeth using the finite element method. An adult patient requiring medium anchorage after extraction of the maxillary first premolars was selected for this study. The power arms were placed between the lateral incisor and the canine at 3 levels: 3 mm, 6 mm, and 9 mm. A 150 g of retraction force was applied from each height of the anterior hook to the first molar tube, with 0°, 5°, and 10° of applied lingual root torque on the incisors. A 3-mm hook with 10° of applied torque, a 6-mm hook with 5° of applied torque, or a 9-mm hook with no extra torque constituted the best combinations targeted at controlling the inclination of incisors during retraction. Extrusion and distal tipping of the canine were observed. Moreover, mesial tipping and mesiopalatal rotation of the molar were unavoidable. Finally, intercanine and intermolar widths were decreased. Adding extra torque on the incisors or using high torque brackets is recommended for patients with maxillary first premolar extraction.

Association between the Obstructive Sleep Apnea and Cephalometric Parameters in Teenagers.

OSA is a common problem in children and adolescents. Angle class II malocclusion, a tendency toward the vertical type of growth, causes a decrease in the volume of the oral air space, increasing the risk of OSAS. The aim of this study was to evaluate the relationship between cephalometric and OSA parameters, to develop collaborative approaches between orthodontists and somnologists in the treatment of adolescents with OSA. We analyzed data from 41 adolescents with OSA. Their mean age was 15.8 ± 1.08 years. Orthodontic and polysomnographic examinations of patients were conducted. Statistical analysis was performed in SPSS 19.0.0. Most often in patients with distal occlusion, a violation of the harmony in the development of the dental system was observed. The sagittal incisive fissure, characteristic of a distal occlusion, was absent due to the palatal inclination of the upper incisors in 25 (60.98%) patients. The SNB was 79.4 ± 3.1°, indicating a distal position of the mandible relative to the anterior cranial base. The SNA exceeded the normal value, which is one of the prerequisites for mandibular retrognathia. The ANB angle was 4.3 ± 1.9°. Tonsillar hypertrophy affected 6 patients, 21 had adenoid hypertrophy, and 3 had both of them. Movements of the masticatory muscles during sleep were recorded in 22.0% of patients. To improve the quality of diagnosis and treatment of OSA, a multidisciplinary approach is needed that will correct the processes of child growth and development.

A comparison of skeletal and dental changes in patients with a Class II relationship treated with clear aligner mandibular advancement and Herbst appliance followed by comprehensive orthodontic treatment

The objective of this study was to compare the skeletal and dental changes of patients with a Class II relationship treated with clear aligner mandibular advancement (MA) and Herbst appliances followed by comprehensive orthodontic treatment. The participants included 20 patients treated with MA and 20 with the Herbst appliance. Orthodontic records were taken before treatment, after the functional appliance, and completion of phase II treatment. The skeletal and dental changes across the 3-time periods were evaluated using a matched paired t test for each treatment. A 2-sample t test was used to examine the changes across periods between 2 treatment groups (P<0.05). Significant reduction in overjet, overbite, and change in molar relationship were obtained by both appliances with similar skeletal and dental contributions. This was contributed by a forward movement of the mandible and mandibular molars, backward movement of the maxillary molars, and retraction of the maxillary incisors. After phase II treatment, both appliances could maintain the skeletal and dental changes achieved during the advancement phase. Greater change in overbite (2.4 mm vs 1.4 mm), an eruption of maxillary incisors (0.9 mm vs 0.1 mm), and proclination of mandibular incisors were found with the Herbst group (3.9° vs -2.1°). The average total treatment time was similar with the 2 appliances. Both functional appliances were equally effective in reducing the overjet and overbite and achieving a Class I molar relationship with a similar length of treatment time. The Herbst design lacked control of the mandibular incisor proclination, and clear aligners offered better vertical control and management of the mandibular incisor inclination.

Correlation between Nasolabial Angle and Maxillary Incisors Inclination in 18-25-Year-Old Chhattisgarh Population Using Pre- and Post-Treatment Lateral Cephalograms: A Retrospective Study.

One of the primary objectives of orthodontic treatment has been the enhancement of facial aesthetics. To obtain the perfect facial profile with aesthetic balance, knowledge of facial anatomy is essential. The diagnosis and treatment planning of orthodontic patients depend greatly on the examination of the soft tissue profile. Since the nasolabial angle is significantly affected by the inclination of the upper incisors, it is a frequently employed soft tissue parameter in orthodontic diagnosis. The study aimed to find out the correlation between the nasolabial angles with maxillary incisor inclination. In this retrospective study, 120 lateral cephalograms of orthodontic patients including males and females were traced. Their nasolabial angle and maxillary incisor inclination were calculated before and after orthodontic treatment. The mean of pre- and post-treatment nasolabial angle was found to be 91.43° ± 14.008 and 97.93° ± 14.194, respectively. The mean of pre- and post-treatment incisor inclination was found to be 32.59° ± 7.290 and 23.98° ± 6.851, respectively. The gender-wise Pearson's correlation (r) of nasolabial angle with incisor inclination for male and female was found to be -0.464 with a P value of 0.164 and -0.305 with a P value of 0.118, respectively. Overall Pearson's correlation of nasolabial angle with incisor inclination was found to be -0.040 with a P value of 0.384. There is an insignificant negative correlation between nasolabial angle and incisor inclination in the Chhattisgarh population as well as among the two genders.

Comparison of effects of Forsus FRD and miniscrew implant anchorage supported Forsus FRD on lower incisor inclination

Comparison of effects of Forsus FRD and miniscrew implant anchorage supported Forsus FRD on lower incisor inclination

Dentoalveolar and Soft Tissue Changes Following en-Masse Anterior Retraction With Different Force Vectors in Subjects With Bidental Protrusion: A Retrospective Evaluation.

Introduction The aim of the study is to determine the effects of different vertical force vectors acting on dentoalveolar and soft tissues while applying a retraction force using various anchorage sources and their effects on these tissues. Material andmethods Based on the selection criteria, a total of 35 patient case records with Angle's Class I bidental malocclusion and incompetent lips treated with four premolar extractions were included. Retraction was achieved using a NiTi coil spring with two different force vectors. The anchorage in group 1 was enhanced by a transpalatal arch (TPA)and Lower Stabilizing Arch(LSA) in the upper and lower arch, respectively, with a force vector parallel to the occlusal plane,whereas in group 2, the force vector using Temporary Anchorage Devices (TADs) was 15 - 20 degrees to the occlusal plane. The skeletal, dental, and soft tissue were obtained using 40 parameters. Intra-group comparisons between pre- and post-treatment records were conducted using a paired t-test, while inter-group comparisons were conducted using an independent t-test. Result Significant anchor loss was observed in group 1, indicated by mesial movement of molar crowns by (-2.10±0.50) in the maxillary arch and (-1.75±0.38) in the mandibular arch. Distal movement of incisors following premolar extractions with both studied force vectors resulted in an improvement in lip procumbency and incisor inclinations, without any significant skeletal changes.Molar mesial movement was observed in subjects treated with conventional anchorage. Conclusion En masse anterior retraction did lead to anchorage loss when carried out without TADs.Altering the force vector did not produce significant changes in tooth movement along the vertical plane.

Reliability of Software Prediction of Post Orthodontic Treatment Changes

Aim The aim of this study was to assess the accuracy of Dolphin VTO prediction in patients requiring extraction treatment by comparing the VTO-predicted values and post-treatment values. Method Digital pre and post-treatment lateral cephalograms of 52 patients having Class I bimaxillary protrusion were taken and transferred in Dolphin Imaging software for analysis and VTO prediction. A composite analysis was made containing 17 dental and soft tissue parameters (Holdaway, Mc Namara, Rakosi, Steiners, and Tweed analysis). Results A comparison between post-treatment and VTO-predicted values showed that software was able to predict soft tissue changes accurately in regions such as nose, inferior sulcus depth, and chin region ( p &gt; .05). In dental changes, software was able to predict the inclination of upper incisors to Sn and palatal plane correctly ( p &gt; .05). Parameters for other areas such as upper and lower lip, position of upper and lower incisor show significant difference in their VTO and post-treatment values ( p &lt; .05) showing inaccuracy of the software. Conclusion The VTO prediction of dental and soft tissue changes was significantly different from the post-treatment values for parameters such as superior sulcus depth, lower lip to h line, subnasal to h line, upper lip thickness, lip strain, nasolabial angle, interincisal angle, Ui-NA, Li-NB, and IMPA. For nasal prominence, inferior sulcus depth, chin thickness, UI-SN, and UI-PP, there was no significant difference seen. Since, for most of the parameters, a significant difference was found between the post-treatment and the predicted values, so it was inferred that the software-based VTO prediction could not be fully relied for any treatment planning.

Alveolar bone changes around maxillary incisors after intrusion and retraction with controlled tipping versus bodily movement : Aretrospective cone-beam computed tomography study.

To compare the effect of maxillary incisor intrusion and retraction with controlled tipping (CT) versus bodily movement (BM) in extraction cases on alveolar bone height and thickness, using cone-beam computed tomography (CBCT). Correlations between changes in alveolar dimensions and crown or root retraction, incisor inclination, and intrusion were also investigated. In all, 144 incisors of 36 women were retrospectively evaluated. All patients were treated with anterior intrusion and retraction with either controlled tipping (CT) (group1) or bodily movement (BM) (group2). CBCT scans were taken before and after retraction and intrusion and measurements of alveolar bone height and thickness at the level of mid-root and root apex were measured. The prevalence of dehiscence was also calculated. Labial bone thickness (BT) increased at the level of the root apex with increased total BT in the CT group (p < 0.05). The BM group showed decreased palatal BT. Significant vertical bone loss with an increased incidence of dehiscences occurred on the palatal side in both groups. Changes in palatal bone area was negatively correlated with the amount of root apex retraction, while the total BT at the level of root apex was positively correlated with amount of intrusion. Bodily retraction can result in reduced palatal bone dimensions and an increase risk of iatrogenic sequelae following anterior retraction in extraction cases. Vertical bone loss and an increased incidence of dehiscences is to be expected following anterior retraction. Careful attention must be paid to the bone boundary conditions to avoid moving the incisors out of the alveolar housing.

Fixed Functional Appliance Therapy With and Without Skeletal Anchorage in Class II Malocclusion: A Systematic Review of Randomized Controlled Trials

Background: For its synergistic effects in producing skeletal changes as well as to lessen the proclination of the lower incisors, which is a common negative result of mandibular advancement, fixed functional appliances with skeletal anchorage have recently been used. Aim: Objective was to evaluate the skeletal and dentoalveolar effects with fixed functional appliances with and without skeletal anchorage. Methods: Electronic database search and manual search were performed up to 2021, April in four databases namely The Cochrane Library, PubMed, Lilac, and Google Scholar. RCTs that employed the use of fixed functional appliances in Class II malocclusion with and without skeletal anchoring were collected. Two co-authors independently extracted the data, and a pre-designed template was followed during the data extraction process. Data including inclusion and exclusion criteria; study design, the year of publication; age and gender of the patients; type of fixed functional device; stage of skeletal maturation; size and site of mini-implant or miniplate placement, amount of force applied in grams or Newtons; method of study outcome assessment (2D or 3D); and follow up were collected. The skeletal and dentoalveolar parameters were extracted. Results: The risk of bias was evaluated, and the SMD and 95% confidence intervals (CIs) were also calculated. Four RCTs were evaluated for qualitative and quantitative analysis. The review involved data of 179 Class II individuals. The results of a random-effects meta-analysis showed that the SNB differed significantly from the control group (SMD = 0.50 (95% CI –1.55 to –0.10)). No significant differences noted between the two groups in terms of lower incisor inclination and mandibular length changes [SMD = –0.04 (95% CI −2.06 to 1.98) and –1.33 (95% CI −3.28 to 0.62), respectively]. The studies under this were not able to provide enough data to draw any conclusions about the effects of using skeletal anchorage with FFA. Conclusion: According to the evidence that is currently available, using FFA coupled with skeletal anchorage does not appear to have any superior skeletal effects than those without skeletal anchorage.