Orthodontic Techniques Research Articles

Addressing mucosal ulcers during orthodontic treatment: An urgent call for preventive strategies.

Mucosal ulcers are a common yet often overlooked complication during orthodontic treatment, significantly impacting patient comfort and compliance. This letter aims to highlight the prevalence, potential causes, and management strategies for mucosal ulcers in orthodontic patients. By reviewing recent literature and clinical observations, we underscore the necessity for proactive measures and tailored interventions to mitigate the incidence and severity of these lesions. Emphasizing the role of patient education and the use of protective devices, we call for a multidisciplinary approach to enhance patient care and treatment outcomes. This discussion is particularly relevant in the context of evolving orthodontic techniques and materials, which necessitate continuous adaptation of clinical practices to ensure patient safety and well-being.

Improvement of the Facial and Dental Esthetics With Surgery-Only Approach.

With the development and introduction of orthodontic techniques and surgical protocols, modern patient prototypes are emerging. This paves the way for new approaches to the treatment of dentomaxillofacial deformities. The aim of the authors' study is to determine the appropriate timing and procedure for orthognathic surgery and to obtain the best patient and physician-oriented results. It is stated that surgery first and surgery only approaches are protocols that increase the motivation for treatment, with esthetic improvement being the priority. In this case report, the treatment of the authors' patient, who complained of asymmetry and planned to have a prosthetic restoration after correction of the skeletal deformity, with only a surgical protocol, is described. Treatment of dentomaxillofacial deformities involves a comprehensive analysis of patient, orthodontist, and surgeon-specific variables. Within appropriate indications, only a surgical approach can be an ideal approach for patients and specialist physicians in a short time.

Utilizing the Open Space Approach in Interdisciplinary Management of Bilateral Congenital Lateral Incisor Agenesis: A Case Report

Tooth agenesis, particularly the bilateral absence of maxillary lateral incisors, is a prevalent condition with notable aesthetic and functional implications. This anomaly, impacting approximately 62% of individuals with genetic predisposition, poses significant challenges in both orthodontics and prosthetic rehabilitation. The treatment of bilateral congenital lateral incisor agenesis is a multidisciplinary approach that requires a thorough clinical examination. Implant-based solutions face challenges due to narrow alveolar dimensions and adjacent root orientations. Successful implant placement often requires pre-treatment orthodontic space creation, ridge augmentation, and careful timing to accommodate continued alveolar growth. Advanced orthodontic techniques and precise implant placement protocols are critical for achieving optimal outcomes. This case report illustrates a time-sequenced interdisciplinary approach combining mesialization of canines with space opening and implant-supported rehabilitation. An interdisciplinary approach, leveraging advancements in orthodontics, implantology, and digital prosthetics, is essential for successful outcomes.

Pierre Fauchard (1678-1761): Pioneering Dental Surgeon of the Enlightenment Age.

Pierre Fauchard, widely referred to as the "Father of Modern Dentistry," fundamentally transformed the field with his seminal 1728 publication, Le Chirurgien Dentiste, ou Traité des Dents.Born circa 1677 in Brittany, France, Fauchard's early exposure to severe dental conditions during his naval service catalyzed his pursuit of advancements in dental science. Upon transitioning from naval service to establish a practice in Angers, and subsequently gaining acclaim in Paris, Fauchard systematically documented and organized dental practices, encompassing oral surgery, orthodontics, periodontics, and prosthodontics, thereby laying the foundational framework for contemporary dental practices. Fauchard's innovations included the use of materials such as lead, tin, and gold for dental fillingsand the introduction of early orthodontic techniques, notably the Bandeau.His treatise also emphasized the importance of preventive care and oral hygiene, which provided a basis for modern dental hygiene protocols. Additionally, Fauchard's critical evaluation of fraudulent practices and his inclusion of numerous clinical case studies in his treatise bridged theoretical knowledge with practical application, significantly impacting dental education and professional standards. Fauchard's influence extends beyond national boundaries, profoundly shaping global dental practices and educational frameworks. The Pierre Fauchard Academy, established in 1936, continues to uphold his principles, underscoring the enduring relevance of his contributions. Fauchard's work remains a cornerstone of modern dentistry, reflecting his profound and lasting impact on the discipline.

Orthodontic treatment for malocclusions in mixed dentition

Early orthodontic treatment is an important means of preventing and treating dentofacial deformities during the period of growth and development. In this stage, children have great potential in growth and development, high adaptability of muscles and temporomandibular joint, and good responsiveness to orthodontic force. Therefore, orthodontic intervention and treatment in this stage can prevent and guide the normal growth and development of dentition, occlusion and maxillofacial complex. This article summarizes the commonly used orthodontic techniques and appliances in the mixed dentition, including interceptive treatment of oral habits, application of functional appliances, fixed appliances, clear aligners, as well as management of severe crowding and space maintenance. This article comprehensively explains the application and indications of different orthodontic techniques in design and appliance selection in the treatment of malocclusions in the mixed dentition.

Accelerated Orthodontics: A Descriptive Bibliometric Analysis of the Top 50 Cited Articles from 2012 to 2023.

Accelerated orthodontics represents a significant shift in dental practice aimed at reducing treatment times while maintaining optimal patient outcomes. This bibliometric analysis evaluated the research landscape of accelerated orthodontics from 2012 to 2023, focusing on publication trends, citation patterns, influential journals, leading institutions, and key contributors. A comprehensive search in Scopus identified 600 relevant articles, with the top 50 most-cited papers encompassing systematic reviews, randomized controlled trials, and experimental studies. Key techniques, such as corticotomy and piezocision, have been frequently highlighted for their effectiveness in expediting tooth movement. The analysis revealed fluctuating annual scientific outputs, with notable peaks driven by technological advancements and increased patient demand for quicker orthodontic solutions. However, the production of high-impact papers was hindered by delays in citation accumulation and disruptions caused by the COVID-19 pandemic. Keyword analysis identified critical themes, such as orthodontic tooth movement, malocclusion, and demographic factors, while a global collaboration map underscored extensive international research partnerships. Leading journals included the American Journal of Orthodontics and Dentofacial Orthopedics, and prominent institutions such as the University of California at Los Angeles played significant roles in advancing the field. This study provides a comprehensive overview of the current state of accelerated orthodontics, emphasizing the need for continued research, particularly RCTs, to further refine and validate accelerated orthodontic techniques and improve clinical outcomes.

The Role of Orthodontics in the Management of Maxillofacial Fractures in Children: A Review on Contemporary Approaches.

Maxillofacial fractures present complex challenges requiring effective orthodontic management to restore function and aesthetics. This review explores various orthodontic techniques, including fixed braces, maxillomandibular fixation (MMF), functional orthodontic therapy (FOT), and acrylic splints, emphasizing their roles in stabilizing fractures and promoting healing. The management of condylar fractures is discussed, highlighting the benefits of early intervention with functional appliances to facilitate condylar remodeling in children and adolescents. Additionally, the review covers splinting methods for dental and dentoalveolar fractures and the use of open reduction internal fixation (ORIF) for maxillary fractures. It addresses the complications and challenges of fracture management, the need for a multidisciplinary approach, and the limitations of current studies. Future directions include the use of advanced technologies such as virtual surgical planning (VSP) and 3D printing to enhance treatment precision and outcomes. This review provides a comprehensive overview of orthodontic strategies for maxillofacial fractures, offering insights into clinical applications and future advancements.

Gender-Based Variation in Alveolar Bone Thickness of Maxillary Incisor Teeth: A CBCT Retrospective Study.

BACKGROUND This retrospective study from a single center in Cyprus aimed to assess labial (buccal) and palatal bone thickness in 6 anterior maxillary teeth of 120 adults using cone-beam computed tomography (CBCT). MATERIAL AND METHODS The CBCT scans of 120 patients (720 teeth) were examined, with scanning parameters of 90 kvP, 24 s, 4 mA, voxel size 0.3 mm, and field of view of 10×6 cm. All maxillary incisors were categorized into 3 distinct points in terms of buccal (B) and palatal (P) points, with points B1 (buccal) and P1 (palatal) 4 mm below the cementoenamel junction; points B2 and P2 at the midpoint between the labial and palatal alveolar crest plane extending to the root apex; and points B3 and P3 at the root apex. Evaluation was done by measuring the distance from these points to the labial and palatal alveolar bone. RESULTS When the thicknesses were measured between all 6 points and labial and palatal bone, the thickness of point B3 of tooth 13 in men was significantly higher than that in women. At points P1, P2, and P3 for teeth 11 and 13, the palatal bone thickness of men was significantly higher than that of women. At points P2 and P3 of tooth 12, the palatal bone thickness of men was significantly higher than that of women. CONCLUSIONS The study found a correlation between alveolar bone thickness and patient sex in the North Cyprus population. Alveolar bone thickness in the anterior maxillary should be considered in implant treatment and orthodontic techniques.

Treatment strategies for vertical maxillary excess: Cases with and without anterior open bite

This comprehensive review investigates the treatment of vertical maxillary excess (VME) with and without anterior open bite (AOB) in seven unique case studies. These cases illustrate the implementation of advanced orthodontic techniques, such as miniscrew-assisted intrusion of the maxillary and mandibular arches. The multifaceted nature of AOB must be considered, highlighting the need for clear diagnostic criteria and an understanding of the long-term impacts of treatment strategies. The main goal of treatment is to reduce the vertical dimension of the maxillomandibular complex. A single miniscrew in the midpalatal region for the maxillary arch and two miniscrews in the buccal areas of the mandibular arch can be applied for the effective intrusion of the posterior teeth. The review then delves into the specific challenges and treatment modalities for managing VME without AOB, stressing the critical role of individualized intervention plans. Each case study demonstrates a different aspect of the treatment approach: from differential intrusion of molars to address esthetic concerns and functional issues to comprehensive strategies involving the intrusion of entire dental arches to correct severe malocclusions. The outcomes emphasize the importance of controlled orthodontic mechanics in achieving and maintaining optimal posttreatment stability. This review underscores the effectiveness of these treatment strategies in significantly improving facial profiles and dental function while highlighting the adjunctive use of myofunctional therapy and other retention techniques to prevent relapse. Collectively, these cases provide valuable insights into the tailored treatment of complex orthodontic conditions, offering guidance on achieving long-term success in clinical practice.

Transforming Adolescent Smiles: Correcting Skeletal Mandibular Retrusion and Bimaxillary Protrusion with Clear Aligners.

Maxillary protrusion combined with mandibular retraction is a highly prevalent but extremely complex maxillofacial deformity that can have a serious negative impact on patients' facial aesthetics and mental health. The traditional orthodontic treatment strategy often involves extracting 4 first premolars and conventional fixed techniques, combined with mini-implant screws, to retract the anterior teeth and improve facial protrusion. In recent years, an invisible orthodontic technique, without brackets, has become increasingly popular. However, while an invisible aligner has been used in some cases with reasonable results, there remain significant challenges in achieving a perfect outcome. This case report presents an adolescent patient with bimaxillary protrusion and mandibular retrognathia. Based on the characteristics of the invisible aligners and the growth characteristics of the adolescent's teeth and jawbone, we designed precise three-dimensional tooth movement and corresponding resistance/over-correction for each tooth, while utilizing the patient's jawbone growth potential to promote rapid development of the mandible, accurately and efficiently correcting bimaxillary protrusion and skeletal mandibular retrognathia. The patient's facial aesthetics, especially the lateral morphology, have been greatly improved, and various aesthetic indicators have also shown significant changes, and to the patient's great benefit, invasive mini-implant screws were not used during the treatment. This case highlights the advantages of using invisible aligners in adolescent maxillary protrusion combined with mandibular retraction patients. Furthermore, comprehensive and accurate design combined with good application of growth potential can also enable invisible orthodontic technology to achieve perfect treatment effects in tooth extractions, providing clinical guidance for orthodontists.

Clear aligner in orthodontic retreatment

Improper diagnosis and design, misusing orthodontic technique, relapse after orthodontic treatment, and poor patient compliance may lead to treatment failure, requiring orthodontic retreatment. While in such cases, patients usually have already had their teeth extracted, or are with periodontal, joint, and other dental problems, which often require multidisciplinary treatment. The retreatment of orthodontic patients is difficult, and the treatment options are limited. The characteristics of clear aligner treatment, such as comfortable and beautiful appearance, high degree of digital precision, and personalized tooth arrangement to simulate the final outcome, make it popular in the orthodontic retreatment. This article discusses and summarizes the details of orthodontic design, case monitoring, and the application of clear aligner in orthodontic retreatment of failed cases. Before starting treatment, the difficulty assessment tool (clear aligner treatment complexity assessment tool) can be used to evaluate the difficulty of clear aligner treatment. Orthodontists are recommended to treat orthodontic patients with clear aligners within their ability to avoid treatment failure. The key to the success of the extraction case treatment with clear aligner is to make the correct diagnosis and select the right cases. In the treatment planning, attention should be paid to the restoration of anterior tooth torque, making good use of molar distalization to obtain the space, vertical control, and improving posterior tooth relationship. Proper selection of cases and reasonable design in clear aligner treatment are expected to obtain tooth alignment, good intercuspation, normal overbite and overjet, periodontal health, parallel roots, and to achieve the goal of aesthetic, functional, stable, and healthy orthodontic treatment.

An Update on 3D-printed Orthodontic Aligners

Clear Aligner Treatment (CAT) is an orthodontic technique used to align teeth with removable and scarcely visible appliances. Conventionally, these are produced through the process of thermoforming. The inherent disadvantages of thermoforming include increased surface roughness leading to plaque accumulation, compromised biomechanics due to a reduction in force delivered and flexure of the aligner, and altered mechanical properties, such as increased opacity, water sorption, and hardness. Direct Three-dimensional (3D)-printed aligners, or Direct Printed Aligners (DPA), introduce a new frontier to aligner technology and are a recent addition to the ever-improving field of orthodontics. Through 3D printing, the various disadvantages of thermoformed aligners like surface roughness, extent and definition of aligner borders, undercuts, and differential thickness of the aligner can be controlled to enhance the accuracy of aligner fit with lesser reliance on attachments. 3D printing of aligners is more environmentally friendly since there is no subtractive process for thermoforming or post-processing of the TA. Various methods of 3D printing, such as selective laser melting, selective laser sintering, Stereolithography (SLA), and Digital Light Processing (DLP), can be applied to the printing of clear aligners. Challenges in printing primarily involve maintaining transparency and designing support during the printing process. The present review aimed to include a detailed description of all aspects of direct 3D-printed aligners.

Methods of treatment of patients with skeletal forms of distal occlusion using dental alveolar compensation. The role of digital technologies and the approach to treatment

Improving the effectiveness of complex treatment in patients with distal occlusion of the dentition during the period of active skeletal growth. 202 patients with skeletal distal occlusion were examined and treated. Patients are divided into three subgroups depending on the position/size of the jaw bones and the main link of pathogenesis. The parameters of TRG and CBCT sections were measured before and after treatment. Various parameters were used for the analysis: skeletal (SNA, SNB, ANB, etc.), dental (II/SN, II/ii, APog-I, APog-i, etc.), skeletal profile and soft tissue parameters. Various orthodontic techniques have been applied, including FNTA, the Damon bracket system, the Biederman apparatus and others. In the retention period, non-removable retainers in the frontal section and removable night retention devices of various structures were used. Patients were monitored for up to 15 years after the completion of the active orthodontic treatment stage. The analysis of the X-ray examination data indicates the normalization of the mutual position of the jaw bones in relation to the base of the skull, optimization of the ratios of the bone elements of the TMJ. An algorithm has been developed for the treatment of patients with dental anomalies in the sagittal plane, with narrowing of the upper jaw during the bite of permanent teeth. Comprehensive treatment of patients with distal occlusion during the period of active skeletal growth makes it possible to achieve significant improvements in dentition, position and closure of teeth, as well as skeletal parameters of X-ray examinations. The results indicate the importance of early intervention using modern orthodontic techniques. Long-term follow-up in the retention period shows the stability of the results and the effectiveness of the treatment.

Various Acceleratory Orthodontic Techniques and their Associated Risks and Benefits- A Review

The primary concern among patients and orthodontists is the prolonged treatment time. In the present scenario where patients desire quicker results, the extended treatment duration is a deterrent for seeking orthodontic treatment. Psychological burnout, poor oral hygiene due to difficulty in performing oral prophylaxis, food lodgment leading to gingival and periodontal diseases, and dental caries are among the many associated problems with orthodontic treatment. Multiple methods have been introduced to improve the rate of tooth movement. This article explains the various mechanisms of action of different acceleratory orthodontic techniques and their associated pros and cons.

Effectiveness of Miniscrew-Supported Molar Intrusion: A Clinical Study.

Mini-screws, also known as temporary anchorage devices (TADs), offer enhanced control and versatility in orthodontic treatment by providing stable anchorage points. This clinical study aims to evaluate the effectiveness of mini-screw-supported molar intrusion in orthodontic practice. For this clinical study, a cohort of 40 orthodontic patients with various malocclusions requiring molar intrusion as part of their treatment plan was recruited. The age range of the participants spanned from 14 to 35 years, representing a diverse patient population. The intervention involved the implementation of mini-screw-supported molar intrusion on one side of the maxillary arch in each patient. To achieve this, temporary mini-screws were strategically placed, and a combination of orthodontic forces and mini-screw anchorage was employed to intrude the molars. The primary outcome measure for this study was the amount of molar intrusion achieved, which was quantified in millimeters from the initial evaluation to the final visit. Additionally, the duration of treatment required to achieve the desired molar intrusion was recorded in months. The results of this clinical study demonstrated that mini-screw-supported molar intrusion was an effective and safe orthodontic technique. On average, a significant mean molar intrusion amount of 4.8 mm (standard deviation [SD] ± 0.6) was achieved with the mini-screw-supported approach. Furthermore, the treatment duration required to attain the desired molar intrusion was relatively short, with a mean of 6.2 months (SD ± 1.1). In conclusion, this clinical study provides evidence that mini-screw-supported molar intrusion is an effective and safe approach in orthodontic practice. It offers orthodontists the advantage of enhanced control and predictability in molar intrusion procedures.

Predictability of Dental Distalization with Clear Aligners: A Systematic Review.

The current review aims to evaluate the scientific evidence relating to the effectiveness of treatment with clear aligners (CAs) in controlling distalization orthodontic tooth movement. "Orthodontics, aligners" and "distalization" were the search terms used on the Scopus, Web of Science and Pubmed databases with the Boolean operator "AND". The results of the last ten years of research were 146 studies; of these, 19 publications were included for this review. The distalization movement is possible with invisible masks alone, but the risk of losing anchorage in the anterior sectors is very probable. The stability of the results and the reduction of unwanted effects can be guaranteed by the use of skeletal anchoring devices and interproximal enamel reduction (IPR), with which compensations are obtained to reduce the initial overjet. Temporary anchorage devices (TADs) can be used to manage posterior anchorage after distalization of maxillary molars with aligners. This hybrid approach has demonstrated the greatest orthodontic success. TADs are useful aids to provide direct and indirect skeletal anchorage. The opposite effect must be considered when planning dental distalization, especially of the molars, in patients with large overjet, and corrective measures or the use of auxiliaries may be necessary to prevent midcourse corrections. This systematic review provides a critical evidence-based assessment of the predictability of dental distalization with CAs, an ever-evolving orthodontic technique.

Orthodontics and Obstructive Sleep Apnea: A Comprehensive Study of Airway Effects and Treatment Approaches

This comprehensive review explores the intricate relationship between orthodontics and obstructive sleep apnea (OSA) over the past decade, with a particular focus on studies conducted in the United Kingdom. The paper synthesizes findings regarding the airway effects of orthodontic interventions, the role of various orthodontic appliances, and their effectiveness in managing OSA symptoms. The literature review encompasses investigations into changes in airway dimensions, soft tissue structures, and breathing patterns resulting from orthodontic treatments. The effectiveness of appliances like mandibular advancement devices and palatal expanders is critically examined. The challenges and limitations in studying this relationship are discussed, addressing issues related to study design, sample sizes, and variability in orthodontic techniques.

Comparative analysis of periodontal pain and quality of life in patients with fixed multibracket appliances and aligners (Invisalign®): longitudinal clinical study

BackgroundsThe aim of this longitudinal clinical study is to analyse and compare according to location, degree and type, the pain presented by patients during their first year of treatment, as well as the quality of oral life after the placement of two types of orthodontic appliances: conventional brackets and removable Invisalign ® aligners.MethodsThe sample consisted of 140 patients grouped into 2 study groups of 70 patients each. The first group (brackets group- BG), with fixed multibracket appliances, using the MBT technique and a 0.022” slot. The second group (invisaling group- IG), in treatment with removable aligners (IG), using the Invisalign ® system. They were providen with a questionnare where they had to record the degree (mild, moderate or intense), the type and location of the pain monthly during the first year of treatment. The second form was the Spanish version of the OHIP-14, oral quality of life questionnaire, which was provided the twelfth month after the start of treatment.ResultsIn both groups, we found that the most frequent location of pain occurred during the first phase: mandibular for the IG group and maxillary in the BG group. Throughout the whole analysis, the intensity was mild-moderate with lower values in the conventional brackets’ group. The BG group reported acute pain while the IG group reported sensitive pain during the first month; later both reported sensitive pain.ConclusionsThere are differences in terms of periodontal pain in its degree, location, and type according to the different orthodontic techniques used.Trial registrationThe study was approved by the bioethics committee of the University of Salamanca (USAL_20/516).

Evaluation of Challenges Encountered by Dental Students in The Study of Orthodontics

Orthodontic education plays a crucial role in preparing dental students for the specialized field of orthodontics. This study aimed to evaluate the challenges encountered by dental students during their orthodontic studies. A mixed-methods approach was employed, combining quantitative data collection through surveys and qualitative insights through interviews. A total of 321 dental students from various dental schools participated in the research, providing their experiences and perceptions of challenges in orthodontic education. The survey questionnaire comprised 15 close-ended questions, covering academic, clinical, technological, psychological, and motivational challenges. The results revealed diverse perceptions of the difficulty level of orthodontic theoretical concepts, with participants expressing varied opinions on the intensity of coursework. Challenges in applying different orthodontic techniques were frequently reported, highlighting the importance of practical training and clinical support. Participants expressed concerns regarding the sufficiency of academic resources provided by institutions to address challenges, indicating scope for improvements in teaching methodologies and learning materials. Stress levels due to the demands of orthodontic studies were evident, underscoring the need for support systems to promote students' emotional well-being. The study also explored participants' self-confidence and motivation in pursuing orthodontics as a career. While self-confidence in clinical decision-making was reported by a significant proportion, motivation levels varied among participants. Despite these challenges, dental students generally expressed satisfaction with their overall orthodontic education, reflecting the dedication and interest in the specialized field.

Orthodontics and Temporomandibular Disorders: An Overview.

The relationship between orthodontics and temporomandibular disorders (TMDs) constitutes a subject of paramount significance in dental and craniofacial health. This abstract embarks upon an in-depth examination of the intricate connection between orthodontic practices and TMD, primarily focusing on evaluating the impact of orthodontic treatment modalities on the health and functionality of the temporomandibular joint (TMJ). This exploration elucidates the multifaceted interplay between orthodontic interventions and TMD by traversing a landscape of scholarly research and empirical investigations. The review draws from a broad spectrum of studies to analyze the potential influence of orthodontic treatments, which encompass occlusal adjustments and alterations in jaw positioning, on the development and management of TMD symptoms. The inquiry delves into the diverse range of TMD conditions, considering the implications of orthodontic techniques on occlusal stability, condylar alignment, and overall TMJ function. Through a comprehensive synthesis of the available body of knowledge, this abstract aspires to equip dental practitioners, orthodontists, and researchers with a nuanced understanding of the complex dynamics that govern the relationship between orthodontics and TMD. This knowledge, in turn, offers a foundation for informed clinical decision-making and the formulation of effective treatment strategies for patients presenting with TMD symptoms. By shedding light on the intricate interactions between orthodontic procedures and TMJ health, this abstract contributes to the advancement of clinical practices, promoting improved patient outcomes and well-being in the context of both orthodontics and TMDs.