Lower Anterior Crowding Research Articles

Assessment of Factors Associated with Mandibular Anterior Crowding in Mixed Dentition

ABSTRACT Introduction: Dental crowding can be defined as a disparity in the relationship between the tooth size and arch length, which results in imbrication and rotation of teeth. Crowding of permanent teeth, especially in the anterior part of the mandible, is believed to be the most frequent form of malocclusion in children. The appropriate age for treatment of crowding is the late mixed dentition period. Aim: To assess and compare the dental and skeletal factors associated with early crowding and non-crowding in children with mixed dentition. Methodology: This experimental cross-sectional study was conducted in Mangalore within 24 months. A total of sixty subjects between the age group of 7–10 years of both sexes were included in the study, in which the experimental group includes 30 subjects with mandibular crowding and the control group includes 30 subjects without lower anterior crowding. A comparison of model analysis parameters between the crowding group and the non-crowding group was done using Student’s t-test. Any P-value of ≤0.05 is considered statistically significant. Results: The result showed that dental parameters like total incisor width were greater and intercanine width was found to be reduced in the crowding group, whereas arch diameter was found to be increased in non-crowding group, which was statically significant (P-value). Skeletal parameters like SNA and SNB were found to be significantly decreased in crowding individuals (P-values of 0.011 and 0.04, respectively). Conclusion: The total incisor width was found to be greater in the crowding group when compared to the non-crowding group, and this could be one of the reasons for the cause of crowding in the early mixed dentition period. The intercanine width and arch diameter were reduced in the crowding group when compared to the non-crowding group. Crowding in the permanent dentition may either be eliminated or at least severity can be reduced if interceptive orthodontics is initiated at an early stage in such children.

Pattern of malocclusion in patients with noma sequelae: The need for orthodontic and orthognathic therapy

Abstract Introduction: Noma is a gangrenous infection that destroys the orofacial structures and leaves the survivors with severe functional, psychosocial, and esthetic impairments. Malocclusion is one of the central sequelae that current Noma care often neglects. Aims: This study aimed to present the pattern of malocclusion in Noma survivors and highlight the role of orthodontic and orthognathic therapy in the management. Materials and Methods: This was a cross-sectional study conducted over 6 months. After obtaining institutional ethical approval, all noma survivors with permanent teeth, including complete upper and lower molars at least on one side, who presented for review were included in the study. Patients’ demographics, Angle class of malocclusion, and various malocclusions were recorded. Data obtained were analyzed using the statistical package for the social sciences (IBM SPSS) version 25. Results: There were 35 (54.7%) males and 29 (45.3%) females in the age range of 12–36 years and a mean ± standard deviation of 22.52 ± 6.01 years. Most patients, 52 (81.3%), have Angle class 1 molar relation. Protrusion of anterior teeth was present in 34 (53.1%), posterior crossbite in 8 (12.5%), upper and lower teeth crowding in 11 (17.2%), isolated upper anterior crowding in 9 (16.7%), isolated lower anterior crowding in 4 (6.3%), and open bite in 5 (7.8%). Other dental malalignments, such as rotations and tooth displacement, were invariably present in 34 (53.1%). Conclusion: Malocclusion in noma survivors constitutes one of the most observable problems of noma sequelae. Orthodontic and orthognathic therapy could promote these patients’ surgical, esthetic, and psychosocial rehabilitation.

Ankyloglossia-Related Speech Articulation Correction in Orthodontics: A Case Report

The ability of the tongue to protrude and elevate is the most crucial characteristic for activities like eating, speaking, nursing, and the development of dental arches. When the lingual frenum is short and tight, it can hinder the movement of the tongue, leading to malalignment of anterior teeth and Speech Articulation. This article discusses a case report of a 20-year-old male patient with a chief complaint of speech difficulty, maxillary anterior teeth spacing, and mandibular anterior teeth crowding. There was lingual frenum attachment suggestive of mild ankyloglossia. Patient underwent a lingual frenectomy pro- cedure under local anaesthesia which resulted in speech correction and relief of lower anterior crowding. Maxillary anterior spacing and midline diastema was corrected with orthodontic mechanotherapy and labial frenectomy, re- spectively. In cases where the frenulum anomaly is severe enough to result in both mechanical and functional limitations, surgery to reduce the frenulum (frenulectomy) is recommended. In consequence, it is fair to state that the chief complaint of inappropriate speech of the patient need to be resolved by an interdisciplinary approach.

Autotransplanted premolars for substituting traumatic maxillary central incisors in a Class II growing patient

A 10-year-old young Hispanic male patient was referred to the Endodontics Department with the chief complaint of color change of maxillary central incisors. The parents reported trauma one year before and as a result root canal treatment; maxillary central incisors extractions were necessary due to poor prognosis, so he was referred to the Orthodontics Department to evaluate if the patient could be the candidate for orthodontic treatment, as he showed severe crowding. The patient had no medical conditions, and the pretreatment records showed a Class II skeletal relation and vertical pattern. Dental findings were mixed dentition, an Angle Class II molar relationship, moderate upper and lower anterior crowding, 4 mm of overbite, and 7 mm of overjet. The patient underwent autotransplantation of maxillary second premolars into the place of maxillary central incisors that needed to be extracted as stated by the endodontist (premolar extractions were needed to solve the orthodontic problems). The suggested position for the autotransplant teeth was not accomplished by the surgeon, so orthodontic forces were applied to the autotransplant teeth to the ideal position. At the end of orthodontic treatment, the autotransplanted teeth were restored by the prosthodontist. Therefore, the facial balance improved, and the final occlusal relationships were good. COVID-19 global lockdown was a challenging obstacle to overcome during treatment. This case report intends to highlight the potential benefits of tooth autotransplantation and to increase awareness of this treatment protocol.

Convalescing Mandibular Anterior Crowding through Piezocision and the Micro-Osteoperforation Surgical Procedure-A Clinical Comparative Study.

Minimally invasive periodontic (perio) surgical procedures, piezocision, and micro-osteoperforation are useful techniques for accelerating tooth movement. These techniques also offer advantages in the orthodontic (ortho) and aesthetic domains. This study aimed to evaluate and compare the rates of lower anterior decrowding with piezocision and micro-osteoperforation. This clinical study included 24 patients requiring fixed orthodontic treatments. Two periodontic techniques (piezocision (PZ) and micro-osteoperforation (MOP)) were considered for the orthodontic treatments. Each patient was randomly allocated to either the piezocision (PZ) group or the micro-osteoperforation (MOP) group. The piezocision group received five radiographically guided incisions on the labial surface of the alveolar bone, whereas the micro-osteoperforation group received one to three MOPs each using a mini-implant drill between the six lower anterior teeth, and later, an initial arch wire was ligated to each bracket. Little's irregularity index (LII) was calculated using a digital vernier caliper on study models every four weeks until decrowding was achieved. The difference in the rates of lower anterior crowding between the piezocision and micro-osteoperforation groups was analyzed to determine the statistical significance. The rates of irregularity index change during decrowding were 4.38 ± 0.61 in the piezocision group and 3.82 ± 0.47 in the micro-osteoperforation group. Piezocision was found to be 1.2 times faster than micro-osteoperforation in terms of the rate of decrowding. The advanced perio-ortho combination technique was advantageous in accelerated decrowding. In comparison to MOP, there was an increase in the rate of decrowding with PZ. Decrowding can be completed quickly with PZ, and it can thus be used to treat crowding effectively in a limited time frame.

To Evaluate and Compare the Aligning Efficiency of Clear Aligners and Nickel Titanium Arch Wires In Unraveling Lower Anterior Crowding - A Prospective Study

To Evaluate and Compare the Aligning Efficiency of Clear Aligners and Nickel Titanium Arch Wires In Unraveling Lower Anterior Crowding - A Prospective Study

Treatment Plan and Discussions of Class I with Smilestream: A Case Report

The aim of the study was to present a Class I case and the treatment plan related to orthodontic diagnosis. The chief complaint of a patient and his parents are crowded teeth upper and lower and anterior crossbite. “@I’m looking like a crocodile” were the first words of the boy sitting on the dental chair. The main task was functional but also esthetics because it was from the first important to him. The treated malocclusion is characterized with a narrow maxillary width and prominence of the mandible. The maxilla was deficient in anteroposterior and transverse dimensions, causing a slightly concave and unpleasant profile, a crossbite relationship of lateral incisors and upper and lower anterior crowding. The use of mechanics was preferred and accepted as a better solution for the patient according to the idea to generate well directed growth. The patient was 12 year-old boy with Class I malocclusion and anterior crossbite. A molar and canine class 1 and correction of the malocclusion were obtained. The improvement of facial aesthetics and smile enlarging were also ensured.

Severity of mandibular arch crowding in different sagittal malocclusions.

Mandibular anterior crowding is caused by a variety of factors. Mandibular incisor crowding can be caused by a number of causes including incisor and molar inclination, early loss of deciduous molars, mandibular growth, and oral musculature. The study was aimed to perform an association of the lower anterior crowding severity with gender and type of malocclusion. The current study was performed in a hospital setup and data about mandibular arch crowding patients were collected from the Records management system of a Private Dental Hospital in Chennai city. All the patient data on Mandibular arch crowding were sourced and tabulated after which statistical analysis with SPSS-IBM was done. Data collection was done over a period from June 2019 to February 2021. The entire study sample size was 634 case records. The result obtained from the statistical analysis was found that nearly 46% of the patients were found to have Mandibular arch crowding with female predilection (50%). The most commonly associated age groups were children than adults (63.2%) associated with mild type of crowding (65.1%). The most commonly involved malocclusion was found to be Class 1 (88.4%) Mild imbrications of the lower arch were common and were seen mainly in subjects with Class I malocclusion. Female subjects presented with more prevalence of mandibular arch crowding when compared to male subjects. Children were more affected by crowding than adults.

Stripping versus extracción del incisivo inferior

Dental crowding is present in a large percentage of the population. The amount of crowding increases with age and is one of the most common problems in dental practice, especially in the field of orthodontics. Two principal ways to resolve the lower anterior crowding are dental extractions and enamel interproximal reduction. The objective of the present study was to perform a literature review on the effects of applying the enamel interproximal reduction technique in comparison with the lower incisor extraction method for correcting the lower anterior crowding. This literature review involved the analysis of 34 articles published (either in Spanish or English) between 2004 and 2020 from SciELO, PubMed and Google Scholar databases. The most relevant results were the following: the interproximal reduction and the lower incisor extractions are effective in the treatment of class I malocclusions with permanent dentition that present moderate lower anterior crowding. However, more evidence supporting that this is the best treatment option is needed. In conclusion, clinical intervention is an individual-based decision that must consider crowding, dental and oral health, dental characteristics, patient expectations, and the use of articulated models.

Driftodontics – A case series

In spite of the tremendous improvements in technology that allow for fewer patients to require extractions, there are always patients who have significant enough crowding that ultimately necessitate the removal of premolars. Alleviating the lower anterior crowding prior to placement of the fixed appliances shortens the time in braces, and allows self correction by natural drift. One such treatment strategy which allows all this is Driftodontics.This paper is intended to bring forth the clinical advantages of driftodontics by showing some of our cases which achieved efficient results.

SEVERITY OF LOWER ANTERIOR ARCH CROWDING AND ANGULATIONS OF IMPACTED THIRD MOLAR

Objective: To find out the association of lower anterior arch crowding with the angulations of impacted mandibular third molar. Materials and Methods: Data for this cross-sectional study was collected from the Panoramic radiographs and dental casts of the patients meeting the inclusion criteria. The mandibular impacted third molars were classified based on Winter’s classification and lower anterior arch crowding was classified using the little’s irregularity index. A statistical analysis was performed using both descriptive and inferential statistics. Mean ± standard deviation was used for numerical data. Chi square test was used to observe any association between the variables. Results: A significant association was found between severity of lower anterior crowding and angulation of mandibular third molar impaction (p value 0.01). Out of total 83 cases, 40 (48.2%) were vertical impactions in which mild crowding of incisors was more prevalent (56.0%), also in 28 (33.7%) cases which were of mesioangular impaction type, also showed increased prevalence of mild crowding (40%). Conclusion:There was a significant association of mandibular incisor crowding with angulations of impacted third molars.

Correlation of Lower Third Molar Angulation and Posterior Space Discrepancy with Mandibular Anterior Crowding using 3d Intra Oral Scanner


 
 
 
 OBJECTIVES:
 To objectively determine the correlation of lower third molar angulation and posterior space discrepancy with mandibular anterior crowding digitally using intraoral scanner.
 METHODOLOGY:
 Cross sectional analytical study conducted at Rehman College of Dentistry (RCD) Peshawar from15th November 2020 till 15th December 2020. Lower third molar angulation and posterior space discrepancy were measured by IC 3.1 measure software, using digital Orthopantomograms (OPG). Digitally scanned models by (CS 3600 intraoral scanner) were analyzed using (CS 3600 3D software). Sample was divided into Control (N=30; perfect alignment), Experimental (N=30; crowding >1mm) groups, based on Little’s Irregularity Index. Both lower third molar angulation and posterior space discrepancy (Ganss Ratio) were correlated with lower anterior crowding using Pearson’s Correlation. To determine any difference between two groups independent t-test was used.
 RESULTS:
 Statistically insignificant difference and a weak correlation were found for Ganss ratio and third molar angulation in both control and experimental groups.
 CONCLUSION:
 Third molar angulation and the retro molar space has no direct effect on the lower anterior crowding.
 
 
 

ISW for the Treatment of Adult Skeletal Class II Case with Temporary Anchorage Device

Patients with a Class II malocclusion, proclination, severe crowding of the maxillary and mandibular anterior teeth, and high mandibular plane angles are a treatment-planning challenge. This case report describes an orthodontic treatment and maxillary premolar extraction without orthognathic surgery for a 18-year old man. Maximum anchorage is needed for upper anterior retraction by using Temporary Anchorage Device (TAD’s). The use of IME and ISW unilateral MEAW was important to relieve upper and lower anterior crowding. After treatment, the patient had a better profile, adequate overjet and overbite. This case report demonstrates that a minimally invasive treatment can successfully correct a severe skeletal Class II malocclusion with large overjet.

Alleviation of Lower Anterior Crowding with Super- Elastic and Heat-Activated NiTi Wires: A Prospective Clinical Trial.

To compare the amount of alleviation of lower anterior crowding and changes in intercanine width (ICW), intermolar width (IMW), and arch depth (AD) dimensions using 2 different types of nickel-titanium (NiTi) archwires. Thirty participants were randomly allocated to 2 treatment groups, using heat-activated NiTi (HANT) or super-elastic (SE-NiTi) round (0.014") archwires. The inclusion criteria were a Little's Irregularity Index (LII) greater than 4, malocclusion requiring non-extraction therapy, all teeth erupted to the second molars in the lower arch, and Angle's Class I malocclusion. The primary aim was to measure alleviation in mandibular crowding over 12 weeks; the secondary aim was to measure changes in ICW, IMW, and AD during those 12 weeks. Simple randomization was performed. The measurements were made on dental stone casts using a coordinate measuring machine at 4-week intervals. LII at 0, 4, 8, and 12 weeks was 8.59 ± 1.44, 6.17 ± 1.65, 4.65 ± 1.63, and 3.28 ± 1.57 mm in the HANT; 8.87 ± 1.29, 6.92 ± 1.49, 5.25 ± 1.32, and 3.63 ± 1.32 mm in the SE-NiTi group, respectively. ICW increased from 25.43 ± 1.39 to 27.41 ± 1.29 mm in the HANT and from 25.81 ± 1.78 to 27.27 ± 1.83 mm in the SE-NiTi groups over a period of 12 weeks, at P < .05. There was a statistically significant increase in IMW, CAD (canine arch depth), and MAD (molar arch depth), favoring the HANT group (P < .05). No significant differences in LII between the 2 groups were noted (P > .05). The amount of alleviation of lower anterior crowding was similar with both archwires. ICW, IMW, and AD increased with HANT archwires.

RELATIONSHIP BETWEEN LOWER ANTERIOR CROWDING WITH FACIAL HEIGHT AND DEPTH IN BENGALEE POPULATION - À CEPHALOMETRIC STUDY

INTRODUCTION- A study of head and face presents a multidimensional problem which includes height, depth and width dimension and esthetics. The head and face is not spherical with qual radius in all directions. It is rather an irregular polygon and could not be measured by simple geometrical and mensurational methods. Malocclusion and dentofacial deformity arise through variations in normal developmental process and so must be evaluated against a perspective of normal development of the craniofacial morphology like facial height and depth. AIMS AND OBJECTIVES- The basic aim of this study was to nd the co-relation between lower anterior crowding with facial height and depth in Bengalee population by the lateral cephalometrics. MATERIALS AND METHODS- The present study was conducted on thirty young Bengalee subjects comprising of males and females of fourteen to twenty years of age. Fifteen subjects were selected with noncrowded normal class - 1 cases and fteen with crowded mandibular incisors. The purpose of this study was to evaluate the relationship between facial height, facial depth and lower anterior crowding among the two above mentioned groups. RESULT AND CONCLUSION- Both linear dimensions and angular values were compared between the two sample groups. The measurements were taken from lateral cephalograms. The parameters used were Anterior facial height, Posterior facial height, mandibular length, Facial depth (SN length), 'e' and 'f' values (linear dimensions). The angular values compared were SN-MP angle, SN-Occlusal plane angle and SNEndognathion angle. For each measurement the mean, standard deviation and standard error were established. Correlation were made by comparing the different parameters between the crowded and non-crowded sample group.

Assessment of 2D:4D ratio for the early diagnosis of caries and malocclusion in 7-15-year-old children

Background: The ratio between 2nd and 4th digit length is termed as hormonal fingerprintand is used as an indirect marker in many medical diseases.Dental studies pertaining to theimportance of hormonal fingerprint on oral health are very sparse.&#x0D; Aim and objectives: Tostudy the correlation of dental caries and malocclusion with hormonal fingerprints.&#x0D; Materialsand Methods: A total of 100 children of age group 7-15 years and both genders were randomlyselected and included in the present study. The hormonal fingerprint (2D:4D ratio) wasdone bymeasuring the length ratio of the index and ring finger with the help of digital vernier caliper.Caries assessment wascarried out using standard mouth mirrors and Community PeriodontalIndex probes. WHO assessment form (1997) was followed for assessment of dentitionstatus and treatment need.Occlusal characteristics evaluated were molar relation, anteriorand posterior crossbite, open bite, deep bite and lower anterior crowding. The subjects weredivided into high 2D:4D, equal 2D:4D digit ratio and low 2D:4D. All the measurements weredone by two investigators. The data collected were tabulated and statistically analyzed usingChi-square and ANOVA test.&#x0D; Results: Out of 100 children, 34% were males and 66% werefemales. Most of the participants were 7-8 years old (12 males and 15 females). Majority of theparticipants (87% for the right hand and 80% for left hand) had low 2D:4D ratio, only 6% forright and 11% for the left hand had high 2D:4D ratio and the remaining had equal 2D:4D ratio.Statistically insignificantcorrelation between 2D:4D ratio and deft/DMFT score and occlusalstatus of an individualwere found.&#x0D; Conclusion:The insignificant results of 2D:4D ratio with allthe parameters assessed validates that hormonal fingerprints could not be employed as an earlypredictor of caries and malocclusion in an individual.&#x0D; Bangladesh Journal of Medical Science Vol.20(1) 2021 p.154-158

Assessment of role of mandibular third molar in lower anterior crowding among orthodontic patients of Kathmandu Nepal

Introduction: Crowding in mandibular arch increases with increasing age and etiology of crowding is multifactorial in nature. Role of mandibular third molar in lower anterior crowding remains a topic of controvery over a period of century. The objective of this study was to assess whether there is any correlation between presence of mandibular third molar position and lower anterior crowding.&#x0D; Materials and Method: On the basis of third molar position one hundred and six sample of pretreatment orthodontic patients aged between 17 to 38 years were divided into erupted, erupting and agenesis group. The study was conducted in Peoples Dental College and Hospital from January 2020 to March 2020 after obtaining ethical approval from the institutional review committee. This cross-sectional study was done on dental casts and orthopantomogram; brass wire was used for measuring arch length and digital vernier caliper for measuring tooth material with modified segmental arch analysis method.&#x0D; Result: Among 106 samples collected 55 (51.88%) were female and 51(48.11%) were male and the mean age was 21.53 ± 3.91 years, Chi square and ANOVA test was used for Statistical analysis. This study showed no statistically significant differences between third molar position and lower anterior crowding on right (P= 0.68) and left side (P = 0.45). The study also showed that association between the third molar position and lower anterior crowding is more on left side compared to right side.&#x0D; Conclusion: Mandibular third molars have not statistically significant difference in lower anterior crowding so, extraction of third molars for relieving the anterior crowding is not justifiable

Occlusal variation among Sharkhan rural population

The purpose of this study was to provide information about the occlusal variations among Sharkhan rural population and explore significant sex and age differences in occlusion. A sample of (194) subjects (117 male and 77 female) aged (12-50) year was examined. Many occlusal features were studied. The results indicate that most of the subjects had class I molar and canine occlusion, approximately (3/4) of the sample had normal overjet and correct midline relation, about (1/2) of the sample had normal overbite The most common malocclusion features was crowding in the lower anterior teeth and spacing in the upper anterior teeth followed by deep bite. While the crossbite and scissors bite were less likely to occur among the total sample. It was found the females had a high percentage of class II canine relation, and missing posterior teeth, while the males had a high percentage of class III canine relation, deep bite and upper posterior teeth rotation. With advancing age the prevalence of lower anterior crowding was decreased while the prevalence of missing posterior teeth were increased.

Cytokine levels in gingival crevicular fluid samples of patients wearing clear aligners

ObjectiveThe aim of this study was to assess & compare the changes in cytokine levels in GCF samples of patients wearing clear aligners. MethodsGCF samples of 10 patients undergoing orthodontic treatment, for correction of lower anterior crowding with clear aligners, were collected on day 0, 1, 3, 7 and 21 using periopaper strips. The upper arch was taken as the control site. The samples collected were further analyzed using commercially available ELISA based kits. ResultsThe mean levels of IL-1β at day 0, 1, 3, 7 and 21 were compared between experimental and control sites using unpaired t-test and it was found that the levels of IL-1β were significantly elevated on experimental site in comparison to control site. ConclusionIt was concluded from the study that elevation in levels of IL-1β as a biomarker of orthodontic tooth movement reaches its peak after 24 h of force application. The clear aligners, as an alternative to conventional fixed orthodontic treatment, were found to be efficient in correcting mild to moderate lower arch crowding.

Comparison of the Periodontal Status of Patients Undergoing Labial and Lingual Orthodontic Therapy.

AimTo compare the periodontal status in relation to the lower anteriors of patients between labial and lingual orthodontic therapy.Materials and methodsThe study includes a total of 20 patients in the age group of 20-30 years. All the included patients were selected with limited lower anterior crowding within 0-8 mm. The subjects were randomly divided into two groups: labial (n=10) and lingual (n=10) fixed orthodontic therapy. The periodontal status was evaluated using three indices, plaque index, calculus index, and gingival index, at two different treatment intervals - the first month and the third month - of orthodontic treatment. ResultsThe values of all the three indices at both time intervals were tabulated. There was no statistical significance when compared to the values in the first month. In the third month, all three indices were statistically significant for both labial and lingual therapy (p<0.001). The lingual appliance had more plaque and calculus accumulation.ConclusionTherefore, the study proves that the lingual surface of patients undergoing lingual orthodontic treatment exhibits more plaque and calculus deposition, thereby the weakening of the periodontal status.