Initial Orthodontic Treatment Research Articles

Evaluation of the Effects of TENS Therapy and Acetaminophen on Pain Alleviation in Initial Orthodontic Treatment.

This prospective study aimed to evaluate the analgesic effects of acetaminophen and Transcutaneous Electric Nerve Stimulation (TENS) therapy for pain control. Forty orthodontic patients who underwent fixed orthodontic treatment were randomly assigned to one of 3 groups: (1) acetaminophen, (2) TENS therapy, or (3) control. Pain was evaluated at 12, 24, 36, and 48 hours after the placement of both 0.014" NiTi and 0.016" NiTi archwires using a 10 cm visual analogue scale (VAS). Because the data were found to be non-normal, Kruskal-Wallis test was employed for both stage I and stage II intra-group comparisons. For both stage I and stage II, evaluation of the VAS scores for all 3 groups at different time intervals showed that the difference between groups A and B was statistically insignificant (p>0.05). The scores of Group A compared to Group C were significant, and Group B compared to Group C showed significant values. Both TENS and acetaminophen reduced the pain experienced by patients compared with the placebo group. The acetaminophen group showed VAS results similar to those of the TENS group.

Influence of malocclusion on OHRQoL in adolescents in initial orthodontic treatment phase.

Besides correcting malocclusions, another main objective of orthodontic treatment is to improve patients' oral health-related quality of life (OHRQoL). This study aimed to assess changes in OHRQoL of children within the first six months of orthodontic therapy with fixed orthodontic appliances. 85 patients aged 11 to 14 years requiring fixed orthodontic appliance therapy were included. The children completed the German version of the Child Perceptions Questionnaire (CPQ-G-11-14) before (T0), 1 month (T1) and 6 months (T2) after the start of orthodontic treatment. The type of malocclusion was categorized according to the Index of Orthodontic Treatment Need (IOTN). The initial type of malocclusion affected the children's OHRQoL, whereas gender and age did not. The IOTN dental health component (DHC) had a significant impact on the CPQ score (median CPQ of 15.00 for the group DHC 4 vs. 22.50 for DHC 5, p = 0.032). The onset of orthodontic treatment initially affected the CPQ domains "Oral symptoms" and "Functional limitations, with a change versus baseline of 2.00 (p = 0.001), but improved again after 6 months. Regression analysis demonstrated that children with an IOTN DHC 5 malocclusion experienced a greater impact on their ORHQoL, as indicated by a CPQ score 7.35 points higher than that of children with an IOTN DHC 4 malocclusion (p = 0.015). At the beginning of orthodontic treatment, the OHRQoL slightly worsens, probably due to the discomfort and appearance of the appliances. However, 6 months after the start of orthodontic treatment, OHRQoL improved again in patients with severe malocclusion (IOTN 4 and 5), and approached baseline values. The results help the clinician to better understand specific aspects of oral health that may be affected by different malocclusions, thereby improving the child's satisfaction and overall quality of life.

Development of the Orthodontic Treatment Impact Questionnaire: Cross-sectional validation

The need to involve patients in developing and evaluating health care interventions is now well-recognized. This study assesses and refines the Orthodontic Treatment Impact Questionnaire for use as a patient-reported outcome in an interventional clinical trial to evaluate and compare any orthodontic interventions. The face and content validity of a previously developed questionnaire were tested in 2 focus groups involving adolescents aged 11-17 years. They were wearing a range of orthodontic appliances and at different treatment stages. A similar cross-sectional convenience sample completed the questionnaire during routine appliance adjustment appointments. A Rasch model, using item response theory, was used for item reduction, assessment of the response format, and differential item functioning. Spearman's rank correlation was used to assess construct validity, Cronbach α for internal consistency and reliability, and intraclass correlation coefficient for test-retest reliability. Seven adolescents (4 females, 3 males) were involved in the initial testing; 181 (117 females, 64 males; mean age, 14.7 ± 1.5 years) completed the questionnaire once and 41 twice. The initial measure demonstrated a misfit to the Rasch model. Ten of the original 31 items had disordered thresholds and were removed. The 5-point scale was changed to a 3-point scale. None of the participants demonstrated a misfit to the model. Construct validity (P= 0.480), internal consistency (Cronbach α= 0.827) and test-retest reliability (intraclass correlation coefficient= 0.85; 95% confidence interval, 0.73-0.92) were good. The initial Orthodontic Treatment Impact Questionnaire was tested and modified using item response theory. The modified questionnaire demonstrated good construct validity, reliability, and internal consistency. Further testing to assess generalizability and longitudinal responsiveness is required.

The Effect of Probiotics Use on Salivary Cariogenic Bacteria in Orthodontic Patients with Various Caries Risk Status.

Background: The purpose of this study was to evaluate the change in intraoral cariogenic bacteria density after probiotic use in patients with orthodontic treatment, and to compare the impact of probiotics in patients with various caries risk status. Methods: Patients that planned to receive orthodontic treatment were recruited according to this study’s inclusion/exclusion criteria. A probiotic prescription (Lactobacteria 3 mg, Glycobacteria 2 mg) was started one month after the initial orthodontic treatment. Saliva sampling and cultures using a CRT kit (caries risk test) were performed at three time points (T0, T1, T2). Mutans streptococci (MS) and Lactobacilli (LB) density were evaluated and scored using the interpretation chart in the CRT kit to evaluate the change in bacteria density at three time points, to define the high and low caries risk prior to orthodontic treatment, and to evaluate if there were differences in probiotics between the high and low caries risk groups. Results: Thirty-three orthodontic patients were enrolled, twenty-two classified as high caries risk and eleven as low caries risk. After undergoing treatment for one month, the densities of MS and LB increased significantly (p = 0.011, p = 0.001); probiotics for one month decreased the density of MS and LB, but the differences were statistically nonsignificant (p = 0.109, p = 0.109). Patients classified as low risk of caries demonstrated an increase in MS and LB density one month after orthodontic treatment (p = 0.024, p = 0.001), probiotic use did not result in a significant reduction in bacteria density (p = 1000, p = 0.933). In patients with high caries risk, there were no statistically significant changes in MS count between the three time points (p = 0.127); a significant change in LB density occurred at T0–T1 (p = 0.011) only. Conclusions: Supplemental use of probiotic oral tablets during orthodontic treatment aimed at reducing cariogenic bacteria count in saliva did not achieve significant differences, regardless of patients’ risk status for caries.

The Correction of Multiple Diastemas in Adult Patients with Bad Tongue Habit (A Case Report)

There are various options in multiple diastemas correction due to the multifactorial malocclusion aetiology. The treatment of this malocclusion is a challenging task for clinicians not only for aesthetic achievement but also for the stability of orthodontic treatment. The multidisciplinary approaches depend on the aetiology of malocclusion and patient compliance. This reported case aims to describe the correction of multiple diastemas in adult patients with bad tongue habits. A 27-year-old male patient came to dental hospital Universitas Sumatera seekingrthodontics treatment with multiple spacing as the chief complaint. The comprehensive lateral cephalometry analysis showed class III skeletal malocclusion, concave profile skeletal trend, and abnormal dental inclination. There was also tongue thrusting in speech and swallowing based on functional examination. The initial orthodontic treatment was started by controlling the patient’s bad tongue habit along with orthodontic treatment. After seven-month of orthodontic treatment, this malocclusion was corrected and good interdigitation was achieved. Albeit there were no skeletal significant changes in this orthodontic treatment, the dental inclination showed a significant change based on cephalometry evaluation analysis. The success of the orthodontic treatment in the adult patient is not only dependent on proper mechanotherapy but also relied on the patient’s compliance with tongue habit control. Therefore, early bad oral habit detection as one of the etiologic factors in treating this malocclusion can support the success of orthodontic achievement.

Photobiomodulation with 940 nm laser diode: effect on the interleukin 6 expression after orthodontic initial archwire activation

To evaluate the effect of photobiomodulation (PBM) during the initial stage of orthodontic treatment, measuring levels of IL-6 in gingival crevicular fluid (GCF), and comparing to a control group of teeth. Forty-four first premolars were orthodontically treated with passive self-ligation Damon Q (Ormco, Orange, CA, USA) brackets and 0.014 CuNiTi archwires. Sides were randomly assigned to a non-irradiated control group and experimental group (n = 22) treated with 940 nm, 0.1 W, and 2 J for 20s/surface. Gingival crevicular fluid was obtained before treatment and 24 h after; a third sample was obtained immediately after a second laser irradiation. IL-6 concentration was measured by enzymatic immunoassay. The basal concentration of IL-6 in the control group (3.194 ± 0.71 pg/μl) was higher than in the experimental group (2.923 ± 0.48 pg/μl) and was reduced 24 h after the initial archwire placement. In the experimental group of teeth, 24 h after and after the first laser application, the levels were lower. However, the values obtained following the second laser application, evaluating immediate effect, presented a mild increment. The difference between control and experimental groups after 24 h was significant. PBM with 940 nm, 0.1 W, 4 J, 21.05 J/cm2, and 40 s per tooth is not able to produce statistically significant changes in the concentration of IL-6 in GCF, immediately or after 24 h of its application, during initial orthodontic treatment with light forces.

Differences in dental arch characteristics between genders in patients with suspected condylar hyperplasia in a North Sumatra subpopulation: a cross-sectional study

Background: Condylar Hyperplasia (CH) is a self-limiting mandibular condyle disorder that shows asymmetry progress in conjunction with associated occlusal changes as long as condylar growth is still active and leads to facial asymmetry. This study aimed to analysis the difference of dental arch characteristics based on genders in orthodontic patients with suspected CH in a North Sumatra subpopulation. Methods: This is a retrospective study of suspected CH patient’s clinical records who sought for the initial orthodontic treatment between January 2015 to March 2019. Patient with facial asymmetry (based on photography, posterior crossbite and midline deviation), the positive temporomandibular joint disorder in functional analysis, and no history of facial trauma were included in the study. Dental arch asymmetry was based on the measurement of dental midline deviation, canine tip in the dental arch, the distance of the upper canines from the palatal suture, and inter canine distance. The evaluation of dental arch was achieved by comparing arch width and length. Results: There was a significant difference (p<0.05) of upper canine distance from the palatal suture in female patients when evaluating upper dental arch asymmetry. There was a moderate correlation (r=0.379) in midline deviation between upper and lower dental arch. The dimension and dental arch form were mid and flat, and there was moderate correlation (r=0.448) between the upper and lower dental arch form in these suspected CH patients. Conclusion: Indeed skeletal asymmetry, the evaluation of the dental arch characteristic symmetry and arch form showed asymmetric occlusal characteristics in orthodontics patient with suspected CH in the North Sumatera subpopulation. In treating these patients, we recommend the plaster cast evaluation as essential and routine procedure in order to understand the complexity of occlusal change due to active growth of condylar and limitation in radiography evaluation.

Differences in dental arch characteristics between genders in patients with suspected condylar hyperplasia in a North Sumatra subpopulation: a cross-sectional study

Background: Condylar Hyperplasia (CH) is a self-limiting mandibular condyle disorder that shows asymmetry progress in conjunction with associated occlusal changes as long as condylar growth is still active and leads to facial asymmetry. This study aimed to analysis the difference of dental arch characteristics based on genders in orthodontic patients with suspected CH in a North Sumatra subpopulation. Methods: This is a retrospective study of suspected CH patient’s clinical records who sought for the initial orthodontic treatment between January 2015 to March 2019. Patient with facial asymmetry (based on photography, posterior crossbite and midline deviation), the positive temporomandibular joint disorder in functional analysis, and no history of facial trauma were included in the study. Dental arch asymmetry was based on the measurement of dental midline deviation, canine tip in the dental arch, the distance of the upper canines from the palatal suture, and inter canine distance. The evaluation of dental arch was achieved by comparing arch width and length. Results: There was a significant difference (p<0.05) of upper canine distance from the palatal suture in female patients when evaluating upper dental arch asymmetry. There was a moderate correlation (r=0.379) in midline deviation between upper and lower dental arch. The dimension and dental arch form were mid and flat, and there was moderate correlation (r=0.448) between the upper and lower dental arch form in these suspected CH patients. Conclusion: Indeed skeletal asymmetry, the evaluation of the dental arch characteristic symmetry and arch form showed asymmetric occlusal characteristics in orthodontics patient with suspected CH in the North Sumatera subpopulation. In treating these patients, we recommend the plaster cast evaluation as essential and routine procedure in order to understand the complexity of occlusal change due to active growth of condylar and limitation in radiography evaluation.

Evaluation of dental arches in orthodontic patients with condylar hyperplasia in a North Sumatra subpopulation: a cross-sectional study

Background: Condylar Hyperplasia (CH) is a self-limiting mandibular condyle disorder that shows asymmetry progress conjunction with associated occlusal changes as long as condylar growth is still active and leads to facial asymmetry. This study aimed to evaluate dental arches by analyzing dental arch asymmetry and form in orthodontic patients with CH in a North Sumatra subpopulation. Methods: This is a retrospective study of suspected CH patient’s clinical records who sought for the initial orthodontic treatment between January 2015 to March 2019. Patient with facial asymmetry (based on photography, posterior cross bite and midline deviation), positive temporomandibular joint disorder in functional analysis, and no history of facial trauma were included in the study. Dental arch asymmetry was based on the measurement of dental midline deviation, canine tip in the dental arch, distance of the upper canines from the palatal suture, and inter canine distance. The evaluation of dental arch was achieved by comparing arch width and length. Results: There was a significant difference (p&lt;0.05) of upper canine distance from the palatal suture in female patients when evaluating upper dental arch asymmetry. There was a moderate correlation (r=0.379) in midline deviation between upper and lower dental arch. The dimension and dental arch form was mid and flat, and there was moderate correlation (r=0.448) between the upper and lower dental arch form in these CH patients. Conclusion: The evaluation of dental arch symmetry and arch form showed asymmetric occlusal characteristics in orthodontics patient with CH in North Sumatera subpopulation. In treating these patients, we recommend the plaster cast evaluation as essential and routine procedure in order to understand the complexity of occlusal change due to active growth of condylar and limitation in radiography evaluation.

Evaluation of dental arches in orthodontic patients with condylar hyperplasia in a North Sumatra subpopulation: a cross-sectional study.

Background: Condylar Hyperplasia (CH) is a self-limiting mandibular condyle disorder that shows asymmetry progress conjunction with associated occlusal changes as long as condylar growth is still active and leads to facial asymmetry. This study aimed to evaluate dental arches by analyzing dental arch asymmetry and form in orthodontic patients with CH in a North Sumatra subpopulation. Methods: This is a retrospective study of suspected CH patient's clinical records who sought for the initial orthodontic treatment between January 2015 to March 2019. Patient with facial asymmetry (based on photography, posterior cross bite and midline deviation), positive temporomandibular joint disorder in functional analysis, and no history of facial trauma were included in the study. Dental arch asymmetry was based on the measurement of dental midline deviation, canine tip in the dental arch, distance of the upper canines from the palatal suture, and inter canine distance. The evaluation of dental arch was achieved by comparing arch width and length. Results: There was a significant difference (p<0.05) of upper canine distance from the palatal suture in female patients when evaluating upper dental arch asymmetry. There was a moderate correlation (r=0.379) in midline deviation between upper and lower dental arch. The dimension and dental arch form was mid and flat, and there was moderate correlation (r=0.448) between the upper and lower dental arch form in these CH patients. Conclusion: The evaluation of dental arch symmetry and arch form showed asymmetric occlusal characteristics in orthodontics patient with CH in North Sumatera subpopulation. In treating these patients, we recommend the plaster cast evaluation as essential and routine procedure in order to understand the complexity of occlusal change due to active growth of condylar and limitation in radiography evaluation.

Assessment of salivary interleukin-1β (IL-1β), prostaglandin E2 (PGE2) levels and pain intensity in children and adults during initial orthodontic treatment.

OBJECTIVES:To investigate pain intensity, interleukin-1β and prostaglandin E2 values in saliva during initial orthodontic treatment among varying age groups and their correlation between these mediators.MATERIALS AND METHODS:Twenty healthy patients distributed equally in age and gender groups were chosen. Unstimulated saliva was collected before the placement of orthodontic fixed appliance (T0), 1 hour after the placement of the appliance with 0.014” nickel titanium archwire (T1), 1 month after the first visit (T2), and 1 hour after the placement of 0.016” nickel titanium archwire (T3). The saliva samples were then analyzed for prostaglandin E2 and interleukin-1β using enzyme-linked immunosorbent assay. Pain intensity was measured using a numerical rating scale.RESULTS:Prostaglandin E2 and interleukin-1β levels had increased at T1 followed by a drop at T2 and a subsequent increase at T3. The prostaglandin E2 and interleukin-1β levels were higher in adults than children. There was an insignificant correlation between the interleukin-1β and prostaglandin E2 changes in all the patients. No significant differences were seen in pain scores between adults and children. Insignificant correlation was seen between pain scores and prostaglandin E2 and interleukin-1β.CONCLUSION:Prostaglandin E2 and interleukin-1β can be detected in saliva and are increased in during the initial orthodontic treatment but are higher in adults than children. Pain intensity was not significantly different between adults and children.

Oral health-related quality of life in orthodontic patients during initial therapy with conventional brackets or self-ligating brackets

Background/purposeThe self-ligating brackets (SLB) have been introduced in modern orthodontic treatment in recent years for malocclusion patients. This study was conducted to compare two treatments, conventional brackets (CB) and SLB, in malocclusion to determine which treatment will provide better oral health-related quality of life (OHRQoL) outcomes. Materials and methodsThe research involved a prospective randomized clinical trial, composed of two sets of questionnaires, Short Form-36 (SF-36T) and oral health impact profile-14 (OHIP-14T), concerning HRQoL and OHRQoL. In total, 88 malocclusion patients who were eligible and met the inclusion and exclusion criteria from the Orthodontic Department of Mackay Memorial Hospital from June 2010 to November 2011 participated in the study, and all patients had completed a minimum follow-up of 1 week and 1 month. The quantitative analysis of the questionnaires was conducted through descriptive statistics and repeated measures of analysis of variance to indicate the differences in OHRQoL between the two sets of brackets systems. ResultsFor SF-36T, the physical component score, the mental component score and all of the eight scales yielded no statistically significant differences between the CB and SLB group. For OHIP-14T, the overall score and all of the seven scales yielded no statistically significant difference between the CB and SLB group. Results of this study showed that SLB systems were not shown to be statistically superior to CB systems in improving OHRQoL for malocclusion patients during initial orthodontic treatment. ConclusionThis study may provide the orthodontists with a better understanding how malocclusion patients experience the change of OHRQoL and discomfort for CB systems and SLB systems during the initial fixed orthodontic therapy.

Effect of orthodontic force on expression levels of ten cytokines in gingival crevicular fluid

Various types of inflammatory mediators are involved in the cascade of biological events behind tissue remodeling allowing orthodontic tooth movement. This split-mouth longitudinal study aimed to evaluate the gingival crevicular fluid (GCF) levels of ten cytokines, IL-6, IL-8, IL-10, IL-13, IL-17, IFN-γ, GM-CSF, MCP-1, MIP-1β and TNF-α, during initial orthodontic treatment. The sample comprised 15 healthy patients (9 males and 6 females, 13.9±2.5 years). The lower (test) incisors were moved using fixed appliance carrying a 0.014-inch nickel titanium wire, whereas the upper (control) incisors were bonded without any force. The GCF was collected from the test and control teeth before fixed appliance mounting (baseline) and after 1, 7 and 21days. In 6 sites per tooth, from canine to canine, periodontal conditions were defined as the percentage of sites with visible plaque and bleeding on probing. The total GCF cytokines levels were quantified using multianalysis Luminex technology. Throughout the experimental term, and for both test and control teeth, the mean percentage of sites with visible plaque and bleeding on probing were generally below 25% and 15%, respectively, although variability was also seen. In the test teeth, the GCF levels of all the cytokines remained constant throughout the experimental term. On the contrary, significant reductions were seen in the control teeth for each cytokine. Moreover, significantly greater levels of IL-6, GM-CSF, MCP-1 and TNFα were seen in the test teeth as compared to the control teeth at 7days. The reasons for the differential behavior in the levels of all the investigated cytokines between the test and control teeth may be related to the presence of orthodontic forces and/or subclinical tissue inflammation. Further investigation is needed to elucidate potential roles for these biomarkers in the tissue remodeling incident to orthodontic tooth movement.

Effects of low-level laser therapy on orthodontics: rate of tooth movement, pain, and release of RANKL and OPG in GCF

The aim of the study was evaluate tooth movement, receptor activator of nuclear factor KB ligand (RANKL), osteoprotegerin (OPG), and RANKL/OPG ratio in gingival crevicular fluid (GCF) in compression side and pain level during initial orthodontic tooth treatment to determine the efficacy of low-level laser therapy (LLLT). Ten volunteers who required fixed appliance positioned from the upper first premolars to upper first molars were selected. For each patient, the upper first premolar of the quadrant 1 was chosen to be irradiated with a laser diode at 670nm, 200mW, and 6.37W/cm(2), applied on the distal, buccal, and lingual sides during 9min on days 0, 1, 2, 3, 4, and 7. The same procedure was applied in the first premolar of the contralateral quadrant inserting the tip but without laser emission. Samples of GCF from the compression side of the upper first premolars to distalize were collected at baseline and after 2, 7, 30, and 45days posttreatment for determination of RANKL and OPG by enzyme-linked immunosorbent assay. In addition, tooth movement was assessed by scanning models and pain intensity was assessed using a visual analog scale. There was improvement in the parameters studied (pain, tooth movement, levels of RANKL in GCF, and RANKL/OPG ratio) in the laser group when compared to the control group, although differences were not statistically significant. The accumulated retraction of the upper premolar at 30days was higher in the laser group, and this difference was statistically significant between groups. LLLT delivered in repeated doses (six times in the initial 2weeks) leads in some extent to a slight orthodontical improvement.

Two Bilateral Transposed and Infraosseus Impacted Maxillary Canines: A Two-Step Combined Periodontal and Orthodontic Approach

An extremely rare case presenting two bilateral transposed and infraosseus impacted maxillary canines was treated with a combined two-step periodontal and orthodontic technique. The canines were transposed mesially and buccally to the lateral incisors, close to the midline and in a horizontal position. Direct orthodontically guided traction of the teeth toward the center of the alveolar ridge was not possible due to the roots of the lateral incisors. The procedure consisted of two distinct treatment phases for each side preceded by an initial orthodontic treatment to achieve the palatal inclination of the roots of the lateral incisors, creating a parallel buccal inclination of the crowns. This approach provided a submucosal buccal space into which the canines could be moved buccally and distally, avoiding any contact with the roots of the lateral incisors. In the first phase, the transposed canines were guided distally. When the canines, still in a submucosal position, were freed from those obstacles, the second phase was begun. The teeth were exposed, permitting the orthodontically guided traction toward the center of the ridge, simulating a proper physiologic eruption alignment pattern in the arch. The combined two-step periodontal and orthodontic approach used to treat two bilateral transposed and infraosseus impacted maxillary canines was extremely successful, resulting in adequate alignment in the arch associated with a physiologic sulcus depth, adequate keratinized tissue width, and absence of marginal recession at the end of the active treatment and 5 years postsurgery.

Class II surgical-orthodontic treatment of a patient with severe coronary disease: 5 years of follow-up

This case study describes the retreatment and long-term follow-up care of a patient with a medical history of 2 heart surgeries and a Class II malocclusion that included a severe anteroposterior skeletal discrepancy characterized by mandibular deficiency. The patient's initial orthodontic camouflage treatment was poorly performed and failed to correct the maxillofacial disorders. In this article, we report the successful retreatment with a surgical-orthodontic protocol and include the 5-year follow-up records showing stable results. Guidelines for the stratification of cardiac risk are included.

Multidisciplinary Approach in the Rehabilitation of Missing Lateral Incisors: A New Trend in Daily Practice

This article reports the case of a patient with bilateral hypodontia of the maxillary lateral incisors who was dissatisfied with the outcome of initial orthodontic treatment, highlighting the importance of a multidisciplinary interaction among Restorative Dentistry, Orthodontics, and Implantology to achieve satisfactory esthetics and functional results.

Changes in the oral health-related quality of life 24 h following insertion of fixed orthodontic appliances

Objectives:The objective of this study was to assess changes in the oral health-related quality of life (OHRQoL) among patients wearing fixed orthodontic appliances 24 h after insertion.Materials and Methods:Sixty patients aged between 14 and 24 years (29 males and 31 females; mean age, 17.8 years; SD 3.1 years) were recruited from the Postgraduate Clinic, Department of Children's Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya. The oral health-related quality of life (OHRQoL) was measured before treatment and 24 h after insertion of the orthodontic appliance. The instrument used to measure OHRQoL was a modified self-administered short version of Malaysian Oral Health Impact Profile (OHIP-16[M]) questionnaire. The higher the score, the poorer is the OHRQoL.Results:Overall score of OHRQoL increased significantly 24 h after insertion (mean 43.5±10.9) as compared to before insertion (mean 34.1±9.2) (P<0.001). Significant changes were found for the following items: Difficulties in chewing, bad breath, difficulties in pronunciation, discomfort in eating, ulcer, pain, avoidances of eating certain foods, difficulties in cleaning, embarrassment, avoid smiling, disturbed sleep, concentration affected, difficulty carrying out daily activities, and lack of self-confidence (P<0.05). Significant changes were also found in the mean difference of OHRQoL for gender (P<0.001).Conclusion:OHRQoL was found to deteriorate 24 h after insertion of fixed orthodontic appliances in almost all domains, with significant changes in gender. This information can be used as “informed consent”, which might increase patient's compliance as they are aware of what to expect from initial orthodontic treatment.

Postsurgical Orthodontic Treatment Planning: a Case Report with 20 Years Follow-up

ABSTRACTBackgroundTraditionally, maxillofacial deformities are corrected surgically after an initial orthodontic treatment phase. However in, this article, the authors emphasize the postsurgical therapeutic protocol which is extremely important for determining the final and permanent retention of the corrected occlusion.MethodsA 55 year old female with severe skeletal Class II malocclusion is presented. Combined surgical and orthodontic correction of the malocclusion was used.Results: The step-by-step procedure the authors followed for the postsurgical therapy is described. The goals of the postoperative therapy were to restore and rehabilitate neuromuscular function, obtain occlusal stabilization, grind teeth selectively, and final occlusion retention. The importance of a surgical occlusal splint for rehabilitating stomatognathic neuromuscular function postoperatively was demonstrated. Furthermore, the orthodontic-prosthodontic treatment ensured occlusion stability after the surgical correction. The long-term results confirmed the efficacy of the treatment protocol presented here from both functional and aesthetical perspectives.ConclusionsPostsurgical orthodontic treatment is an important step in the surgical and orthodontic therapy of maxillofacial deformities.

Sagittal back contour and craniofacial morphology in preadolescents.

The aim of this study was to analyze the correlation ratios between the sagittal back contour (flèche cervicale and lombaire, trunk inclination) and selected parameters of craniofacial morphology in children. The patient sample consisted of 66 healthy children with a mean age of 11.2 years (SD 1.6 years), of which 34 were male (mean age 11.5 years, SD 1.3 years) and 32 were females (mean age 10.9 years, SD 1.9 years). The children were recruited during the preparation of the initial orthodontic treatment records. Craniofacial morphology was analyzed by six angular measurements: facial axis, mandibular plane angle, inner gonial angle, lower facial height, facial depth and maxilla position. Rasterstereography was used for reconstruction of the spinal back sagittal profile. From the profile flèche cervicale, flèche lombaire and trunk inclination were determined and the correlations with the craniofacial morphology were calculated (Pearson and Mann-Whitney U test). Significant correlations were found with respect to the inner gonial angle and the flèche cervicale, the mandibular plane angle and the flèche lombaire, the inner gonial angle and the flèche lombaire, and the angular lower facial height and the flèche lombaire, as well as the inner gonial angle and the trunk inclination. The craniofacial vertical growth pattern, presented by mandibular plane angle, inner gonial angle and the angular lower facial height, and the correlation to flèche cervicale and lombaire as well as trunk inclination reveal correlations between growth pattern and sagittal back contour.