Lip Bumper Research Articles

Effectiveness of lip bumper appliances as a reducer of lip sucking habit in children: A case report

Effectiveness of lip bumper appliances as a reducer of lip sucking habit in children: A case report

Simplified Appliance for Lip Biting Habit—A Case Report

Lip biting habit can cause severe malocclusions and should be intercepted early in age. The lip bumper device is a helpful treatment as it can stop the habit and prevent the resulting malocclusion. Lip biting habit is intercepted by removable or fixed lip bumper. A simplified appliance for lip biting habit that is easy to fabricate and is more accepted and comfortable for the patient was designed. It consists of a thermoplastic sheet with a labial acrylic pad as in a conventional lip bumper appliance. Improved patient compliance was noted with added advantage of ability to maintain better oral hygiene.

Short-term dentoalveolar effects of aesthetic lip bumper appliance: A longitudinal cases-series and pilot study

BackgroundTo investigate the short-term dentoalveolar effects on the mandibular arch of a modified, aesthetic lip bumper (ALBAa). The study sample comprised 23 patients (13 boys and 10 girls, with a mean age of 9.5 ± 1.8 years) in mixed dentition, with no previous orthodontic treatment. For each patient, a scan of the mandibular arch was digitally acquired pre-treatment (T0), and at 3 months (T1), 6 months (T2) and 9 months (T3) post-treatment. Linear intra-arch measurements, Little’s irregularity index of the amount of mandibular anterior crowding, and the crown tipping values on all mandibular teeth were measured and compared statistically between time points. ANOVA and subsequent post-hoc tests were performed, considering a p-value of < 0.05 as significant. ResultsLinear intra-arch distances and crown tipping values on the mandibular teeth increased between the following time points: T0vsT1, T1vsT2, T0vsT2 and T0vsT3 (p < 0.05), although in the last three months of observation (T2vsT3) they only reached statistical significance at the lower incisors and lower left premolar concerning crown tipping values. There was a statistically significant decrease in anterior crowding throughout the observational period (p < 0.05), and this effect was equally distributed across the different time points investigated. ConclusionsALBAa therapy led to an increase in both linear intra-arch distances and crown tipping values, with a reduction in Little's index. The distribution of the effects reported across the observational period depended on the mechanism of action (mechanical vs. functional).

SCHWARTZ APPLIANCE AND LIP BUMPER AS TREATMENT MODALITIES FOR MANDIBULAR CROWDING IN MIXED DENTITIONS

Dental crowding is the most common form of malocclusion. It is more pronounced in the mandible than in the maxilla and tends to increase with age. Depending on the degree of space deficiency and the age of the children the prevalence of dental crowding can be as high as 50%. Schwartz appliance and lip bumper have been widely used as an early treatment for increasing lower dental arch dimensions. The aim of this review is to evaluate the scientific research about the efficacy of Schwartz appliance and lip bumper and compare the changes caused by the two appliances in addressing mandibular crowding in the mixed dentition. A comprehensive literature search on the electronic databases: PubMed, Cochrane Library and Google Scholar was performed. Also, a search of the reference lists of included studies was conducted, to ensure comprehensive coverage of the literature. Search terms included "Schwartz appliance" OR "removable appliance" AND "lip bumper" OR "fixed appliance" AND "mandibular crowding" AND "mixed dentition" OR "early dentition". The search resulted in identifying several studies that met the inclusion criteria.Results show that both Schwartz appliance and lip bumper can effectively improve mandibular crowding in mixed dentition, although the extent and type of changes produced by these appliances may vary. Schwartz appliance is more effective in increasing inter canine width, while the lip bumper has more effect on increasing the arch length. Patient compliance as well as treatment duration are important factors that can have an effect on the success of orthodontic treatment. Schwartz appliance and lip bumper are effective in alleviating mandibular crowding, thus providing cost-effective and simple treatment in mixed dentition. The choice of the appliance should be based on the individual patient’s needs and treatment goals. Further research is needed to evaluate and compare the stability and long-term effects of these two appliances as well as the need for further fixed orthodontic treatment. Key words: Schwartz appliance, lip bumper, mandibular crowding, mixed dentition &nbsp

Management of Lip Sucking Habit Using Combination Therapy: A Case Report

Oral habits are those that are repeatedly performed thereby causing deleterious effects on the teeth and the adjoining oral tissues. In addition to or as a substitute for thumb sucking, lip sucking or biting is often observed. An orthodontic lip bumper, designed to intercept dental and occlusal problems, is a fixed or removable functional appliance. In this case report, the habit was treated using fixed lip bumper, lip exercises and habitual therapy conducted by both parents and the child. Parental encouragement and constant reminders combined with the child’s co-operation in wearing the appliance and performing the advised lip exercises regularly are significant factors in the success of this treatment.

Mandibular transverse dentoalveolar and skeletal changes associated with lip bumper and rapid maxillary expander: A cone-beam computed tomography study

Currently, there is little consensus regarding the spontaneous uprighting of the mandibular dentoalveolar complex in response to maxillary expansion, which poses the question about the necessity of combining mandibular treatment with rapid maxillary expansion to coordinate the maxilla and mandible transversely. This study aimed to evaluate the effects of the bonded rapid maxillary expander (RME) alone compared with RME with lip bumper (LB) treatment on the mandibular transverse changes. This retrospective study analyzed 3 groups: the control group with no orthodontic or orthopedic treatment (23 patients [14 females, 9 males]; mean age 9.13 years at T1 and 11.24 years at T2); the RME group with no mandibular treatment (22 patients [9 females, 13 males]; mean age 8.73 years at T1 and 12.04 years at T2); and RME+ LB group (23 patients [16 females, 7 males]; mean age 9.45 years at T1 and 12.18 years at T2). Three-dimensional superimposition of the mandibular images was performed with cone-beam computed tomography taken at prephase and postphase I treatment (growth and development check records for the control group) to conduct the angular and linear measurements at the dental, alveolar, and skeletal levels. The intergroup comparisons were performed using the Mann-Whitney U-test. Accompanying slight molar self-uprighting during the normal mandibular growth period observed in the control group, transverse growth was also observed in both alveolar and basal bone levels of the mandible, but no significant changes in the alveolar bone inclination occurred. The bonded RME slightly increased the mandibular first molar uprighting but not the mandibular widths at the tooth or alveolar levels. Adding a LB significantly increased the intermolar width and molar uprighting while decreasing the alveolar bone inclination but did not increase the amount of mandibular transverse growth at the bone level. RME alone did not significantly increase the transverse dimension of the mandible. RME+ LB significantly increased mandibular intermolar width, uprighted the mandibular molars, and reduced the alveolar bone inclination.

Lip Bumper Therapy Does Not Influence the Sagittal Mandibular Incisor Position in a Retrospective CBCT Study.

Lip bumper (LB) therapy is used as a treatment approach for mild to moderate crowding without extraction of teeth. Previous studies demonstrated that LB increases arch length through molar uprighting and lateral expansion. However, the effects of LB on mandibular incisors are inconclusive. The controversial results from different studies may be due to limitations including absence of a control group and/or use of 2D radiography. To address this issue, the current retrospective longitudinal CBCT study compared a rapid maxillary expansion (RME) group with no lower treatment [16 patients (9 females, 7 males); median age 8.86 years at T1 and 11.82 years at T2] and an RME + LB group [18 patients (13 females, 5 males); median age 9.46 years at T1 and 12.10 years at T2]. The CBCTs taken before and after phase 1 treatment were 3D superimposed based on the mandibular structure and were measured to determine the angular and linear changes of the mandibular incisors over the course of LB treatment. For comparisons between different timepoints within a group, a Wilcoxon matched-pairs signed rank test was used. For intergroup comparisons, a Mann–Whitney U test was used. Both groups showed eruption and protrusion of the mandibular incisors during the observation period, while there was no significant change in proclination of the lower incisors. When comparing the discrepancy of change between groups, there was no statistically significant difference detected. In summary, by utilizing a longitudinal 3D database, the current study demonstrated that the effect of LB on the position of the mandibular incisors is limited.

Does Early Treatment Improve Clinical Outcome of Class II Patients? A Retrospective Study.

The present study was carried out to evaluate the benefits from one-phase Class II Early Treatment (ET) using extraoral forces and functional appliances but without intermaxillary forces and eventual lower leeway space preservation compared to two-phase Class II Late Treatment (LT) with the need for extractions and full fixed appliances as well as lower incisor proclination. The ET group (n = 239, 115 M, 124 F, mean age 10.6 ± 1.2 years), with first premolars not in contact and the second deciduous lower molars preserved, was compared to the LT group (n = 288, 137 M, 151 F, mean age 12.4 ± 1.5 years). The ET group was first treated with headgears, growth guide appliances, or Teuscher activators and, in borderline crowding cases, with lower space maintenance by a lingual arch, lip bumper, or fixed utility arch. The LT group and the second phase of ET were treated with full fixed appliances including intermaxillary forces such as Class II elastics or noncompliance devices; headgear and a growth guide appliance were also used. Cephalograms and plaster models were taken before (T1) and after treatment (T2) to calculate cephalometric changes and space balance discrepancies. The differences between T1 and T2 were analyzed by a t-test for normally distributed data and by the Mann–Whitney Test for nonnormally distributed data at a level of p < 0.05. The groups were defined as statistically homogeneous at T1. A statistical analysis showed that the ET group (mean treatment time 35.3 ± 13.3 months) was significantly associated with a 22.2% lower extraction rate, 15.9% less need for a full fixed appliance, and more than 5° less incisor proclination in the nonextraction cases compared to the LT group (mean treatment time 25.9 ± 8.1 months); treatment time significantly increased in the ET group compared to the LT group. Early Class II treatment resulted in a significant treatment effort reduction in more than one third of the patients and less lower incisor proclination, even if it clinically increased treatment time.

Orthodontic treatment for crowded teeth in children.

Orthodontic treatment for crowded teeth in children.

Arch Measurements, Bigonial Width, Dental Caries, and Their Effect on Occurrence of Mandibular Incisors Crowding in Early Mixed Dentition Period.

Aim and objectiveTo assess the effect of various arch parameters, bigonial angle, and caries occurrence on mandibular incisors crowding during the early mixed dentition period.Materials and methodsSixty children (mean age of 7.5 years) with mandibular anterior incisors crowding and class I molar relationship in early mixed dentition were selected. Bigonial width (BW) and caries occurrence were recorded during patient examination. The study casts were prepared divided into a normal group (NG) and crowded group (CG). Different vertical and transverse arch perimeters along with space available for the permanent mandibular incisors were measured manually. Statistical analysis was done to establish the association of all these variables with two crowding groups.ResultsThe total incisor width or the tooth material was significantly more, and all arch parameters were less in measurements in CG than NG. The available space, BW, and caries occurrence did not differ significantly between NG and CG.ConclusionThe amount of tooth material and individual variations in arch parameters significantly contribute to mandibular anterior crowding in the early mixed dentition period irrespective of the age and gender of the child.Clinical significanceAll cases of early mixed dentition mandibular incisors crowding should be individually assessed for arch length discrepancy, and transverse discrepancy results of this study help in the prediction of crowding before an establishment of a customized treatment plan with the use of lingual arch or lip bumper appliances in patients with anterior mandibular crowding may be valuable.How to cite this articlePaul S, Garg S, Saraf BG, et al. Arch Measurements, Bigonial Width, Dental Caries, and Their Effect on Occurrence of Mandibular Incisors Crowding in Early Mixed Dentition Period. Int J Clin Pediatr Dent 2021;14(S-1):S57–S62.

The Brodie bite: Addressing a confounding orthodontic problem

• Interceptive treatment of buccal crossbites (Brodie bite). • Lip bumper and Fränkel regulator for correction of Brodie bites. • Considerations on tongue position as a possible etiologic factor. The demands of correcting severe buccal crossbites warrant the need for early intervention—as soon as the malocclusion is identified. The severity of buccal crossbites warrants the need for early interventions as soon as the malocclusion is detected. The main characteristic of a buccal crossbite malocclusion is the complete deepbite, with a total absence of occlusal and incisal contacts in centric relation. This article aimed to offer interceptive orthopedic and orthodontic treatment modalities to correct this type of malocclusion. Successful treatment of 3 very severe buccal crossbite malocclusions is presented. Appropriate application of physiology and biomechanics led to favorable results. Orthopedic and orthodontic treatments using lip bumpers, Fränkel regulators, and eventually crossbite elastics proved to be efficient means to minimize and correct buccal crossbites with long-term stability.

Skeletal Class II Malocclusion Treatment with Combined Twin Block and Lip Bumper Appliances: A Case Report

Functional appliances have been used over a century in clinical orthodontic treatments for skeletal Class II malocclusion patients. Its popularity is attributed to its high patient adaptability and ability to produce rapid treatment changes. The twin block and lip bumper can be combined depending on the patient’s cases. The purpose of therapy with twin block is effective in mandibular growth deficiencies to induce supplementary lengthening of mandibular by stimulating increased growth at the condylar cartilage. The patient was a ten-year-old male patient with skeletal Class II malocclusion. He had a convex facial profile, SNA (sella, nasion, A point) angle of 77.5°, SNB (sella, nasion, B point) angle of 73.0°, ANB (A point, nasion, B point) angle of 4.5°, overjet of 6.5 mm, overbite of 11/41 = 5.0 mm, 21/31 = 4.5 mm, abnormal upper labial frenulum, crossbite in the second left premolar of maxilla, crowded anterior teeth of mandibular, deficiency of mandibular growth, lower lip sucking habit, anterior teeth of maxilla with diastema and proclination. Orthodontic treatment for patient is a combination of twin block and lip bumper appliances. After seven months, frenectomy is used to eliminate and correct the spacing in the frenulum. After 10 months, the patient’s skeletal and profile had improved to skeletal Class I malocclusion, SNA angle of 78.0°, SNB angle of 75.0°, ANB angle of 3.0°, overbite and overjet of 4.0 mm, and the lower lip sucking habit had stopped. Twin block and lip bumper appliances are particularly good alternative treatment in managing selected cases of skeletal Class II malocclusion.

Mini-implant Supported Lip Bumper

Patients with a skeletal class II malocclusion are usually associated with a prognathic maxilla with orthognathic mandible or a retrognathic mandible with orthognathic maxilla or a combination of both. Patients with severe prognathic maxilla are usually associated with increased overjet which results in a lower lip trap. The lip trap should be managed the earliest as it will lead to further proclination of the upper anterior teeth and also hinder the normal growth of the mandible. To overcome the limitations of a conventional lip bumper, we arrived at an idea of fixed lip bumper supported using mini-implants.

Perioral muscle activity changes after Lip Bumper treatment.

This prospective non-randomised case-control study analysed lip muscle activity after Lip Bumper (LB) treatment thought surface electromyography. The study group was composed of 40 young patients with a mean age of 10 years and 1 month, treated with LB in the lower arch, while 40 children who did not undergo any treatment, matched for sex and age with the previous sample, constituted the control group. Measurements were performed at the beginning and after 1 year for both groups. Electromyographic recordings were obtained in rest position and during the swallowing of 50 ml of water. In the study group, after 1 year of LB treatment, a statistically significant decrease in values was found; specifically, in upper lip muscle activities at rest position with the appliance in situ (p <0.002) and both with (p <0.001) and without (p <0.001) the appliance for the lower lip. One year of LB treatment significantly reduced lip muscle activities at both rest position and during swallowing compared with the untreated sample. These results indicated a potential short-term of upper and lower lip muscle adaptation to the new balance induced by LB treatment.

New orthopedic and orthodontic treatment modality for adult patients with skeletal Class III malocclusion with insufficient maxillary incisor exposure

This paper aims to offer a new orthopedic and orthodontic treatment modality for treating adult patients with mild-to-moderate skeletal Class III discrepancy and insufficient maxillary incisor exposure who reject orthognathic surgery. For Phase I treatment, a rapid palatal expansion or miniscrew-assisted rapid palatal expansion is activated on the maxilla, and a modified lip bumper is installed on the mandibular dentition. At night, a facemask with a forward and downward orthopedic force is applied, whereas during the day, modified lip bumper and intraoral heavy Class III elastics are used. During Phase II treatment, intraoral elastics from the miniscrews between the mandibular premolars to the hooks between the maxillary lateral incisors and canines are activated to increase the maxillary incisor showing. In addition, activating elastomeric chains between the mandibular miniscrews and hooks between the mandibular lateral incisors and canines, the whole mandibular dentition is distally moved, and the mandibular incisors are intruded. Orthopedic and orthodontic treatment using a facemask, modified lip bumper, and mandibular miniscrews is an efficient way to improve adult skeletal Class III malocclusion and deficient maxillary incisor exposure.

The Biomechanics of Lip-Bumper Appliances. A Finite Elements Analysis Approach

The lower Lip Bumper (LB) is a widely employed appliance in the non-extraction treatment...

Modified Arnold expander: an alternative for mandibular arch expansion.

ABSTRACTIntroduction: Due to the anatomical constraints of the mandible, mandibular dental arch usually serves as a guideline to determine the required changes in the maxillary transverse dimension. The Schwarz appliance and the Lip Bumper are the traditional orthodontic appliances for mandibular arch expansion in patients with borderline amounts of crowding, and/or transverse discrepancy. However, they often require patient cooperation, which may be a concern for orthodontists in daily practice. Objectives: This article illustrates a simple fixed orthodontic device as an alternative to achieve mandibular arch expansion in patients with moderate tooth-size/arch-length discrepancy. The four reported cases refer to 8 to 10-year-old patients in the mixed dentition, with an Angle Class I or Class II malocclusion, transverse deficiency in both arches, moderate crowding and/or posterior crossbite, combined with compromised smile aesthetics. The patients were treated with rapid maxillary expansion (RME) using Hass expander appliance and the modified Arnold expander (MAE). Conclusion: This low-cost compliance-free orthodontic appliance provided dentoalveolar decompensation by means of uprighting the posterior teeth, with minimal or no adjustments during treatment. The final results were achieved in only three to four months, and fulfilled all treatment objectives, such as an increase in the arch perimeter and width, and a better teeth alignment.

Tratamento ortodôntico em paciente com queimadura facial – relato de caso

Numerous variables are considered in a normal occlusion, one of those is the homeostasis of the facial musculature and its harmony with bones and teeth. Several factors can lead to change in muscle functionality. An example is the facial burn injury in which it is common formation of hypertrophic scars that cause muscle structures dysfunction and impact on facial growth and dentition development. Patient K.R.S, 15-years-old, female, sought treatment at the Center for Attention and Research of Craniofacial Anomalies (CEAPAC) complaining of “crooked teeth”. She reported during anamnesis that when she was a child, she suffered a domestic accident which caused facial, and body burn injury. The patient had Angle Class I malocclusion and upper and lower incisor lingualization. Dental arch atresia and moderate crowding were observed. Rapid maxillary expansion and lower dental expansion were performed with the lip bumper, followed by teeth alignment and leveling with a fixed appliance. n the retainment phase, Hawley plates (upper and lower) were used in addition to a fixed lower retainer. The treatment of arch expansion and alignment proved to be viable and predictable, however, the stability has a dubious prognosis, which led the authors to indicate the use of retainers indefinitely.

Spontaneous Transversal Changes of Lower Arch Following Palatal Skeletal Expansion

Objective: To evaluate how the lower arch spontaneously change after upper rapid palatal expansion in a group of patients with transversal skeletal deficit . Material and Methods: Twenty-four patients treated by the same orthodontist with a rapid palatal expander (RPE) bounded on a deciduous molar have been selected. The sample was divided into two groups: no treatment was provided for group one, while group two was treated using a lip bumper or Schwarz appliance. For each patient, dental casts were collected when the RPE was bounded (T0) and at the end of treatment, 9 months ± 3 months later (T1). Each outcome was analyzed, providing descriptive statistics, main effects significance tests and post-hoc analyses with the objective to evaluate the variations between pre-treatment (TO) and post-treatment (T1) of each of them. Results: If the linear measurements are considered, a significant beneficial effect on both arches is observed. However, the upper arch always shows a major increase of all values at T1 with respect to the lower arch. Even though the post-hoc tables indicate that time differences are all statistically significant across considered partitions, the lower arch's increase is more pronounced in group two, where patients were treated in both arches. If the angular measurements are concerned, the increase of lingual crown inclination was found in all patients, independently from the type of treatment in lower arch . Conclusion: All patients show normalization of upper diameters, regardless of whether the lower arch was treated or not.

The management of mesially inclined/impacted mandibular permanent second molars

Mesially impacted mandibular second molars are a common occurrence in orthodontic practices, especially those using the lingual arch or lip bumper for alleviating anterior crowding. Horizontally impacted second molars, on the other hand, occur so infrequently that most practitioners have limited experience in treating such a patient. Because of this there is little consensus on the management of these cases. As opposed to vertically impacted molars that may be associated with ankylosis or other factors preventing eruption, the mesially angulated, horizontally impacted mandibular second molar usually has eruption potential, because its impaction is more commonly due to lack of space and/or abnormal eruption path. Hence, orthodontic uprighting shows the most promise and can commonly be done without extracting the third molar or surgically exposing the impacted second molar. Modern clinicians have at their disposal a myriad of biomechanical choices that can be used to successfully reposition these teeth and enable finishing with an optimal occlusion.