Months Of Orthodontic Treatment Research Articles

Possibilità e limiti del camouflage ortodontico. Un caso di asimmetria mandibolare con follow-up a 2 anni

Objectives The purpose of this study was to evaluate the possibilities and limitations of orthodontic camouflage treatment for mandibular asymmetry. Materials and methods The patient was a 26-old woman with right mandibular asymmetry who refused surgical orthodontic treatment, which is a gold standard for treatment of her condition. The decision was therefore made to use an orthodontic camouflage approach to improve/correct only the alveolo-dental positions of the two arches. The patient was treated with a palate expander attached to teeth (1.6-1.4-2.6-2.4) and banding of both arches with a standard edgewise technique. Refinement was achieved with interarch elastics. Results After 24 months of orthodontic treatment, the patient presented good compensation but the midline deviation remained. Conclusions Orthodontic surgery is the gold standard for correcting mandibular asymmetry. If the patient refuses this kind of therapy, an orthodontic camouflage approach can be a valid alternative if the appropriate selection criteria are met.

Root resorption diagnosed with cone beam computed tomography after 6 months of orthodontic treatment with fixed appliance and the relation to risk factors

To investigate root resorption after 6 months of active orthodontic treatment and its relation to possible risk factors. Ninety-seven patients (10-18 years) with a Class I malocclusion and crowding treated with fixed appliance and premolar extractions were examined with cone beam computed tomography before and after 6 months of active treatment. The exposure covered all teeth from first molar to first molar in both jaws. The Malmgren index was used to evaluate the degree of root resorption. Irregular root contour (score 1) was seen in most teeth already before active treatment, and therefore resorptions were registered only as score 2 (<2 mm, minor resorption) or higher. Minor root resorption was noted in 10% of the patients and severe root resorption, >2 mm (score 3) was found in four patients. Root resorption was more frequently seen in the upper jaw, especially the incisors. There was no statistically significant correlation of root resorption with any of the selected risk factors. After 6 months of treatment, clinically significant resorption was diagnosed in 4% of the patients, ie, in 96% of the patients the radiographic examination did not reveal any significant information. The selected risk factors did not have any impact on the amount of resorption after 6 months of active treatment.

An Interdisciplinary Treatment Approach Combining Orthodontic Forced Eruption with Immediate Implant Placement to Achieve a Satisfactory Treatment Outcome: A Case Report

Periodontal disease often results in severely bony defects around the teeth and leads to eventual extraction. Remaining bone morphology often compromises ideally restoration-driven positions and deteriorates the success rates for dental implants. The present investigation illustrates the clinical outcome of immediately installing an implant following orthodontic forced eruption and atraumatic extraction. The subject of this study is a 40-year-old Asian female with a right mandibular first molar that had a deep probing depth on the mesial side and mobility. Via the aid of radiographic examination, the tooth that had an angular bony defect and apical lesion was diagnosed as having deep caries and chronic periodontitis with a poor prognosis. After consultation with the patient, we developed a treatment plan incorporating a forced eruption with immediate implantation, intended to augment the alveolar bone volume and increase the width of keratinized gingivae, in a nonsurgical manner. Following 12 months of orthodontic treatment, the tooth was successfully moved occlusally in conjunction with an 8 mm vertical interdental bone augmentation. Because of sufficient volume of bone and satisfactory gingival dimensions, the implant showed adequate initial stability in the correct position to facilitate physiological and aesthetic prerequisites. After 6 months of osteointegration, a customized impression coping was utilized to transfer the established emergence profile to a definitive cast for the fabrication of a customized abutment. The final prosthesis was made using a customized metal abutment and ceramometal crown. In the face of difficult clinical challenges, meticulous inspection and a comprehensive treatment plan were crucial. Interdisciplinary treatment through the careful integration of multiple specialists suggests the possibility of optimal results with high predictability.

Effects of orthodontic tooth movement on alveolar bone density

The object of this study was to evaluate the relationship between changes in the alveolar bone density around the teeth and the direction of tooth movement by using cone-beam computed tomography (CBCT). CBCT was used to measure the bone densities around six maxilla anterior teeth before and after 7 months of orthodontic treatment in eight patients. Each root was divided into three levels (cervical, intermediate, and apical) to determine whether the bone density change varied with the tooth level. Moreover, each level was divided into four regions (palatal, distal, mesial, and buccal sides). Three-dimensional computer models of the maxilla before and after orthodontic treatment were created to detect the direction of tooth movement. The percentage for all 144 samples [8 (patients) × 6 (teeth) × 3 (levels)] in which the side (palatal, distal, mesial, or buccal sides) of maximum bone density reduction (before and after orthodontic treatment) coincided with the direction of tooth movement was calculated; this was referred to as the "coincidence percentage". The bone density around the teeth reduced by 24.3 ± 9.5%. The average coincidence percentage for the eight patients was 59.0%. The coincidence percentages for the eight patients were 62.5%, 62.5%, and 52.1% at the cervical, intermediate, and apical levels, respectively. The obtained results demonstrate that the direction of tooth movement is associated with the side of maximum bone density reduction, and that CBCT is a useful approach for evaluating bone density changes around teeth induced by orthodontic treatment.

External Apical Root Resorption after Six and 12 months of Non-Extraction Orthodontic Treatment

Objectives: The aim of the present study was to test the hypothesis that external apical root resorption (EARR) after six months of orthodontic treatment could be an incidence indicator of EARR after 12 months of treatment in non extraction orthodontic cases. A comparison of EARR between different types of root morphology was also performed. Material and Methods: Periapical radiographs of the upper incisors were obtained prior to treatment (T1) as well as at six months (T2) and 12 months (T3) of non-extraction orthodontic treatment among 47 patients aged 11 years or older. The roots were classified based on anatomic shape. Triangular, pipette-shaped, bent and/or short roots were classified as having a tendency toward EARR, whereas those with a rhomboidal and rectangular shape were classified as having no tendency toward EARR. Results: At 12 months of orthodontic treatment EARR ranged from 0 to 12.1% of total tooth length (mean: 3.5%; SD: 3.03), which meant 0 to 2.7 mm of EARR. There was significant correlation between EARR at six months and EARR at 12 months (r=0.7606; p<0.0001). There was no correlation between root shape and EARR. Conclusions: EARR after the first six months of orthodontic treatment was a good incidence indicator of EARR after 12 months of treatment (r=0.8). Root shape did not show significant influence in root resorption level in non extraction orthodontic cases.

Bone density changes around teeth during orthodontic treatment

The objective of this study was to evaluate bone density changes around the teeth during orthodontic treatment by using cone beam computed tomography (CBCT). CBCT was used to measure the bone densities around six teeth (both maxilla central incisors, lateral incisors, and canines) before and after 7 months of orthodontic treatment in eight patients. In addition, each root was divided into three portions (cervical, intermediate, and apical) to determine whether the bone density change varied with tooth level. The mean reduction in bone density around the measured teeth was 24% after orthodontic treatment. The bone density reduction around teeth was largest for the upper-right and upper-left central incisor (29% and 26%, respectively) and ranged from 20% to 23% for the other four teeth. The mean bone density reduction did not differ significantly between the cervical, portion, and apical portions of the teeth (26%, 22%, and 24%, respectively). CBCT is useful for evaluating bone density changes around teeth during orthodontic treatment. The bone density around the teeth reduced significantly after the application of orthodontic forces for 7 months.

Periodontal pathogen levels in adolescents before, during, and after fixed orthodontic appliance therapy

This purpose of this study was to document and investigate changes in periodontal pathogen levels before, during, and after orthodontic treatment in adolescents. DNA gene probe analysis was used to quantify the levels of 8 periodontal pathogens before, during, and after treatment with fixed orthodontic appliances in 190 concurrently treated adolescent orthodontic patients. The 8 pathogens examined were Actinobacillus actinomycetemcomitans (AA), Porphyromonas gingivalis (PG), Prevotella intermedia (PI), Tannerella forsythia (TF), Eikenella corrodens (EC), Fusobacterium nucleatum (FN), Treponema denticola (TD), and Campylobacter rectus (CR). Chi-square tests were used to determine whether the percentages of subjects with high counts significantly changed over time. Logistic regression analyses were also performed to derive the relative risk of higher counts of pathogenic bacteria with fixed appliances at the various time intervals studied. For 6 (PI, TF, EC, FN, TD, CR) of the 8 pathogens, the percentages of subjects with high pathogen counts increased significantly after 6 months of fixed appliance treatment, but these returned to pretreatment levels by 12 months of orthodontic treatment. No pathogen level was significantly higher after 12 months of orthodontic treatment, and orthodontic treatment was found to be significantly protective for half of the pathogens (EC, FN, TD, CR) posttreatment. Orthodontic treatment with fixed appliances does not increase the risk of high levels of these periodontal pathogens.

Tooth Autotransplantation in a Free Iliac Crest Graft for Prosthetic Reconstruction

This report documents successful tooth autotransplantation to a free iliac crest graft in an exemplar case. A 14-year-old male patient was operated thrice with increasing amounts of resection for recurrent odontogenic myxoma. When mandibular continuity resection finally was performed, a free iliac crest block autotransplant was used for reconstruction. Upon metal removal 5 months later, 3 wisdom teeth with two-thirds complete root development were transplanted to the free graft and retained by fixed orthodontic appliances including skeletal anchorage with orthodontic microscrews. Tooth graft taking was awaited for 8 weeks with retention. Following undisturbed healing without occlusal forces, 6 months of orthodontic treatment intentionally extruded the autotransplanted teeth to antagonist contact. The third and most dorsal tooth became mobile after 3 months and was lost. The surviving 2 teeth were fitted by a prosthetic bridge as extrusion into the occlusal plane was not completely successful. This exemplar case shows benefit of tooth autotransplants in selected cases of jaw reconstruction with distal bone autotransplants as alternative to dental titanium implants and suprastructures. Orthodontic microscrews can moreover support tooth movement and positioning as anchorage device in altered anatomy.

Clinical Evaluation of Bracket Bonding Using Two Different Polymerization Sources

To comparatively assess clinical failure rate of brackets cured with two different photopolymerization sources after nine months of orthodontic treatment. The sample of this study comprised 30 patients who received comprehensive orthodontic treatment by means of fixed appliances. Using the same adhesive, 600 stainless steel brackets were directly bonded and light cured for 10 seconds with the light-emitting diode (LED) lamp or for 20 seconds with the conventional halogen lamp. A split-mouth design randomly alternated from patient to patient was applied. Failure rates were recorded for nine months and analyzed with Pearson chi2 test, and log-rank test at alpha = .05 level of significance. The overall failure rate recorded with the halogen unit (3.33%) was not significantly different from the failure rate for the LED lamp (5.00%). Significantly more failures were found in boys compared with girls, in the mandibular dental arch compared with the maxillary arch, and in posterior segments compared with anterior segments. However, no significant difference was found between the right and left segments. Both light-curing units showed sufficiently low bond failure rates. LED curing units are an advantageous alternative to conventional halogen sources in orthodontics because they enable a reduced chair-time bonding procedure without significantly affecting bond failure rate.

Does microetching enamel reduce bracket failure when indirect bonding mandibular posterior teeth?

AbstractAimTo determine if microetching the mandibular premolars and first molars prior to acid-etching reduced bracket failures during the first six months of orthodontic treatment.MethodsSixty four patients with 384 mandibular first molar and premolar brackets were used in a split-mouth study design. In each patient the teeth on one side were acid-etched and the contralateral teeth were microetched prior to acid-etching. The microetched side was alternated in successive patients. The brackets were indirect bonded to the teeth on both sides. First time bracket failures were recorded over a 6-month period.ResultsTwo brackets (1 per cent) came loose on the microetched enamel side and four brackets (2.1 per cent) failed on the conventionally acid-etched side. This difference was not clinically or statistically significant (p= 0.41).ConclusionThe addition of microetching prior to acid-etching does not result in fewer bracket failures during the first six months of treatment.

Orthodontic and Surgical Management for Osteoma of the Mandibular Condyle causing Facial Asymmetry and Malocclusion

This report is of a 43-year-old woman with osteoma of the mandibular condyle causing facial asymmetry and malocclusion. Preoperative orthodontic treatment was performed after a clinical diagnosis of benign tumour of the left mandibular condyle was made. After 9 months of orthodontic treatment, condylectomy was performed under general anaesthesia. Histopathological examination revealed an osteoma. Postoperative orthodontic treatment was performed for 8 months, and the postoperative course has been favourable. The facial asymmetry and malocclusion have improved.

Effectiveness of an Essential Oil Mouthrinse in Improving Oral Health in Orthodontic Patients

To test the null hypothesis that adding Listerine mouthrinse to the standard oral hygiene regimen has no added benefit for orthodontic patients in maintaining proper oral health. Patients within their first 6 months of orthodontic treatment were assigned either to the brushing + flossing (N = 25) or brushing + flossing + Listerine (N = 25) group. Initially, all of the participants received a prophylaxis and instructions on how to brush and floss. Measurements were recorded for the bleeding, gingival, and plaque indices (BI, MGI, and PI, respectively) that provided baseline values (T1). Subsequent measurements were taken at 3 months (T2) and 6 months (T3). Mean BI, MGI, and PI at T1, T2, and T3 were compared statistically between the groups using repeated measures analysis of variance. The significance level was set at P < or = .05. The response profiles for the BI, MGI, and PI over time were significantly different between the two groups. Patients who had Listerine in their daily oral hygiene regimen exhibited significantly lower scores for all three indices at T2 and T3 than the patients who only brushed and flossed. The hypothesis is rejected. This study shows that use of Listerine mouthrinse can reduce the amount of plaque and gingivitis in patients undergoing orthodontic treatment. Adding Listerine to the standard oral hygiene regimen may be beneficial for orthodontic patients in maintaining proper oral health, thus reducing the likelihood that white spot lesions and gingivitis will develop.

Corticotomie alvéolaire et traitements orthodontiques rapides

When combined with orthodontics, selective periodontal decortication has been shown to be clinically effective in eliminating severe malocclusions three to four times more rapidly than conventional orthodontic treatment. Our technique combines surgical scarring of the cortical bone on both labial and lingual sides of the teeth to be moved, with an augmentation graft to increase alveolar volume. Alveolar spongiosa undergoes rapid transformation as the body attempts to heal the wounds to the cortices resulting in marked tissue turnover. The patient is seen every two weeks and most cases are completed within six months of orthodontic treatment. Moreover, this technique significantly expands the scope of treatment in resolving many skeletal problems such as openbites and severe maxillary constrictions, conditions typically relegated to orthognathic surgery. Clinical outcomes research has shown that the immediate post treatment results settle better during retention and that the long term results become more stable. These facts are likely due to the high tissue turnover induced by decortication as well as the thicker cortical bone resulting from the augmentation grafting.

Typing of Mutans Streptococci by Arbitrarily Primed PCR in Patients Undergoing Orthodontic Treatment

The aim of this study was to clarify the genotypic stability of mutans streptococci (MS) longitudinally during orthodontic treatment. Plaque samples were obtained from the supragingival smooth surface of the upper right teeth at four stages: prior to and after 1, 3 and 6 months of orthodontic treatment. Levels of total viable count, total streptococci and MS in dental plaque of 17 patients were recorded. Streptococci isolated from dental plaque samples were identified as MS on the basis of their morphological and biochemical properties. DNA was prepared from 713 strains of MS and the strains were then identified with polymerase chain reaction (PCR) again. Arbitrarily primed PCR (AP-PCR) fingerprinting was applied in determining the genotypes of MS. The results indicated that levels of total viable count, total streptococci and MS increased significantly after the fixed appliances were bonded. A maximum of 3 different genotypes were found in an individual. All the genotypes were found again after the application of the fixed appliances in 17 patients. A new AP-PCR typing pattern was found after the application of fixed appliances for 1 month in patient 1. That strain was not detected either prior to or after 3, or 6 months of treatment. The result indicated that the MS clones were very stable during orthodontic treatment.

Advantages of intraoral verticosagittal ramus osteotomy in skeletofacial deformity patients with temporomandibular joint disorders

This preliminary study was performed to clarify the usefulness of intraoral verticosagittal ramus osteotomy (IVSRO) in patients with temporomandibular joint (TMJ) disorders. We examined 34 sides in 19 consecutive patients with dentofacial deformities with TMJ dysfunction undergoing IVSRO. Preoperatively, 15 patients had TMJ sounds bilaterally and 4 had sounds unilaterally. Five sides in 3 patients had pain in the TMJ, and 4 sides in 3 patients had masticatory muscle pain. The TMJ symptoms, including TMJ sounds, pain in the TMJ, and masticatory muscle pain in each patient, were assessed clinically before and approximately 12 months after IVSRO. Magnetic resonance imaging was also performed to determine joint status, including determination of the positions of the condyle and disc. The symptoms of the TMJ after 12 months of orthodontic treatment showed marked improvements, with the disappearance of the TMJ sounds in 94% of the sides examined. Pain in the TMJ improved in 4 of 5 sides, and pain of the masticatory muscle improved in 3 of 4 sides. With regard to the relative positions of the condyle and disc on magnetic resonance imaging, 6 of 8 joints and 5 of 7 joints showed improvement in anterior disc displacement with and without reduction, respectively. The direction and mean amount of movement in the distal segment were 8 mm in setback, 4 mm in advance, and 5 mm counterclockwise. IVSRO is potentially as useful for the treatment of TMJ disorders in orthognathic surgery patients as is intraoral vertical ramus osteotomy, and IVSRO can be used selectively in cases in which intraoral vertical ramus osteotomy is contraindicated.

Latex allergy in an orthognathic patient and implications for clinical management

A 19-year-old girl with mild asthma had had 16 months of orthodontic treatment as part of the joint orthodontic/orthognathic approach to her 9.5 mm overjet. At the time of banding her second molars she developed latex protein allergy as a reaction to the operator’s non-sterile powdered latex gloves. She also gave a history of allergy to other substances as well as of eczema. The patient was confirmed as allergic to latex protein by radioallergosorbent test (RAST) for IgE, requiring precautions be taken during further orthodontic procedures as well as during the subsequent orthognathic surgery for the underlying Class II skeletal pattern.

The combined surgical and orthodontic treatment of mandibular prognathism.

Patients with severe mandibular prognathism are best managed with a combined orthodontic-surgical approach. In our patients, the orthodontic treatment consisted of six to eighteen months of presurgical preparation, which in some patients may accentuate the dental deformity. This is done to provide two well-aligned dental arches that will fit accurately at surgery. The surgical procedure used was an oblique subcondylar osteotomy. This was followed by six to eight months of orthodontic treatment to complete dental alignment. Thirty patients were treated using this combined approach, with excellent results and few complications.

Direct bonding: A clinical study using an ultraviolet-sensitive adhesive system

One hundred twenty-four metal and seventy-three plastic brackets were bonded with an ultraviolet-sensitive adhesive system to all available teeth width the exception of maxillary first molars, which were banded, of ten orthodontic patients. Following approximately 7 months of orthodontic treatment, the relative adhesion of metal and plastic brackets in maxillary and mandibular arches and on anterior and posterior teeth was clinically and statistically evaluated. Metal brackets bonded in both maxillary and mandibular arches maintained a 95 per cent success rate, while plastic brackets bonded in the maxillary arch exhibited an 89 per cent success rate during the 7-month treatment period. The direct bonding system and brackets utilized in this clinical study can be confidently used in conjunction with banded orthodontic appliances to obtain the maximum in benefits from both banding and direct bonding. It is recommended that bands be placed on maxillary and mandibular molars and on any other teeth located posteriorly in the dental arch where isolation during bonding may be difficult. Plastic brackets should be confined to maxillary anterior teeth to minimize wing breakage. Torque requirements with plastic brackets may be effected with torquing auxilliaries off round arch wires.