Orthodontic Treatment In Patients Research Articles

Orthodontic Treatment of Patients With Clefts: Satisfaction and Psychological Aspects.

To assess parents’ satisfaction with cleft child's facial appearance and function; compare these findings with orthodontist (expert) satisfaction and evaluate influence of various factors on satisfaction. Cross-sectional study. Sixty-three parents of non-syndromic patients with clefts (ages 7-20 years), and an orthodontist, completed the Cleft Hearing, Appearance and Speech Questionnaire. Two scores were produced: cleft-associated, and non-cleft-associated features. Additional open questions were presented to the parents. Both parents and orthodontist gave high satisfaction scores (mean: 8.4 & 8.2, respectively), significantly correlated, for the cleft-associated features ( P < .001). Parents were least satisfied with appearance of teeth, then nose, then lips. Scores did not vary significantly with age and sex of patients. Higher parents’ satisfaction was found in the unilateral cleft lip + alveolus (UCL + alveolus) group, compared with the unilateral cleft lip and palate (UCLP), regarding cleft-associated features, and compared with cleft palate (CP), regarding non-cleft-associated features ( P < .05). Greater parents and orthodontist satisfaction were found when parents’ education was >12 years. Parents of Jewish ethnicity showed higher satisfaction, compared with parents of non-Jewish ethnicity. Patients requiring future surgery received lower scores. Parents satisfaction was directly correlated to socioeconomic status. The following factors appear to lower parents’ satisfaction: [1] cleft severity, [2] hearing or speech of CP/BCLP patients, [3] requirement for further surgery, and [4] low socioeconomic status. Severe cases may require additional explanation to parents in order to lower expectations. A more thorough explanation may be required in patients of lower socioeconomic status.

Camouflage orthodontic treatment combined with genioplasty distraction osteogenesis for skeletal class II relationship secondary to osteosarcoma excision surgery

The treatment of orthodontic patients who survive head and neck tumors is challenging because of dentoskeletal deformities and other unexpected dental and facial complications. This case report describes the case of a 26-year-old woman who presented with mandibular retrognathia after survival from osteosarcoma. Camouflage orthodontic treatment was chosen instead of combined orthodontic-orthognathic surgery after primary reconstructive surgery with an iliac bone graft. Genioplasty distraction osteogenesis (DO) was performed to achieve an optimal facial profile. Although unexpected condyle dislocation and epithelial hyperplasia occurred during treatment, a favorable facial profile and optimal skeletal and dental relationships were accomplished after 32 months of treatment. The patient underwent genioplasty DO and experienced unexpected left condyle dislocation. However, the treatment achieved esthetic goals after intermaxillary elastics were applied.

Long-term stability of Class III malocclusion treatment with maxillary transversal deficiency, short roots, gingival recession, and alveolar bone loss

• The SARPE in a patient with short root, gingival recession, and alveolar bone loss. • SAPE in the absence of atresic morphology of the palate for a skeletal transverse discrepancy. • Long-term periodontal stability is achieved in the case of reduced periodontal support tissues. • Special care in orthodontic treatment of shortened roots and alveolar bone loss. Orthodontic treatment in patients with Class III malocclusion can be complex, particularly when associated with other problems. This case report describes the retreatment of a 32-year-old woman with Class III malocclusion, transverse maxillary deficiency, short roots, and gingival recession. The patient was retreated with fixed appliances combined with surgically assisted rapid palatal expansion. The results of the debonding were excellent esthetics, good intercuspation, gingival health with adequate overjet, and overbite. After 22 months of treatment, the proposed goals (dental Class III relationship correction and transverse maxillary deficiency) were obtained. After the 5-year follow-up, the sagittal and transverse relationship remained stable.

Quantitative measurement of the palatal mucosa in cleft lip and palate using elastography

ABSTRACT Purpose Cleft lip and palate (CLP) are the most common congenital abnormalities in the craniofacial region. Patients with CLP usually have palatoplasty in early childhood, which causes scar tissue on the palatal mucosa. Scar tissue prevents growth of the maxilla. However, no studies have quantitatively evaluated the characteristics of the palatal mucosa. This study aimed to quantitatively evaluate the physical characteristics of the palatal mucosa after palatoplasty in patients with CLP using elastography. We also aimed to investigate the association between the physical characteristics of the palatal mucosa and the use of maxillary protraction therapy (MPA). Materials and methods We enrolled 57 patients with CLP (mean age, 20.82 ± 3.50 years) and 30 control subjects without CLP (mean age, 26.97 ± 2.09 years) and measured the stiffness of the palatal mucosa using elastography. Among the patients with CLP, we investigated the association between the use of MPA and the stiffness of the palatal mucosa. Results The palatal mucosa in patients with CLP was significantly stiffer than that in control subjects. Moreover, the palatal mucosa in the MPA group was significantly stiffer when adjusted for cleft type compared with the group with no MPA. Conclusions Our findings suggest that there are characteristic differences in the palatal mucosa between patients with CLP and subjects without CLP and between those with and without MPA use. Elastography could be a new and effective diagnostic tool in orthodontic treatment for patients with CLP.

Late alveolar bone grafting in complete unilateral cleft lip and palate (UCLP): Biomechanical considerations for the success of orthodontic finishing.

Orthodontic treatment in patients with cleft lip and palate (CLP) is challenging. Alignment of the maxillary segments and orthodontic levelling of the teeth adjacent to the cleft area are important before alveolar bone grafting (ABG), in the permanent dentition. In this clinical report, orthodontic procedures, before and after late ABG, are described as an alternative that can optimise the orthodontic and periodontal results. The gingival margins of the teeth adjacent to the cleft area were levelled. Root divergence was corrected. Interdental papilla and improvement of the periodontal condition were obtained.

Rare Disorders: Diagnosis and Therapeutic Planning for Patients Seeking Orthodontic Treatment.

The available literature on the orthodontic treatment of patients with rare disorders is extremely scarce. The aim of this study was to analyze the diagnosis and orthodontic treatment of a group of 94 individuals with rare diseases, referred for orthodontic evaluation to a university special care dentistry center (University of Santiago de Compostela, Spain). We created a control group of 94 systemically healthy individuals, paired by sex and age range. For all participants, we recorded their dental and skeletal abnormalities, oromotor dysfunctions and the characteristics of their orthodontic treatment. Some of the morphological and functional abnormalities were more prevalent in the rare disorders group than in the control group, including dental agenesis, microdontia, enamel defects, maxillary hypoplasia, overbite, cleft lip/palate, mouth breathing, atypical swallowing, lingual/labial interposition, labial incompetence, modified consistency diet, bruxism, and muscle tone abnormalities. Compared with the control group, the 56 patients with rare disorders who underwent orthodontic treatment required more desensitization sessions, used mixed appliances (fixed and removable) more often and for longer periods and had more frequent complications, such as gingivitis, caries, mucosal ulcers and recurrent debonding of the device. In conclusion, for selected patients with rare disorders, it is feasible to perform orthodontic treatment, whose planning will be determined by the dental-skeletal abnormalities and oromotor dysfunctions. Although complications are more frequent, they can typically be solved without having to stop treatment.

Bacteremia after Orthodontic Miniscrew Insertion.

Objectives: Use of miniscrews has become very common in orthodontic treatment of patients. Following tissue manipulation during miniscrew placement, bacteremia may occur, which is important in patients susceptible to infective endocarditis. This study aimed to investigate the possibility of bacteremia following orthodontic miniscrew placement. Materials and Methods: The present quasi-experimental study was conducted on 30 orthodontic patients, including 11 males (36.7%) and 19 females (63.3%) with a mean age of 23.67±4.87 years, who required miniscrew placement in their treatment plan. Two blood samples were taken from the patients for aerobic and anaerobic cultures right before and 30-60 seconds after miniscrew placement. To investigate the presence of bacteremia, the blood samples were incubated in an automated blood culture machine for five days. The standard biological methods were used for the positive sample(s) to identify the type of bacteria. Data analysis was performed using the McNemar test. Results: The blood samples of 29 patients were negative for the bacteria before and after miniscrew placement. Blood sample of one patient was positive for aerobic and anaerobic bacteria after miniscrew placement. However, bacteremia was negative in the initial (preplacement) blood samples for both aerobes and anaerobes. Conclusion: Miniscrew placement in orthodontic patients was not associated with bacteremia.

Assessment of the effect of orthodontic treatment on the stability of pre-orthodontic recession coverage by connective tissue graft: a randomized controlled clinical trial.

To compare the changes in periodontal parameters after orthodontic treatment in patients having isolated gingival recession treated with and without pre-orthodontic gingival recession coverage. Thirty-six patients requiring orthodontic treatment with a facially positioned mandibular anterior tooth with labial recession were randomly allocated to either test group: root coverage by subepithelial connective tissue graft (SCTG) followed by orthodontic treatment, or control group (orthodontic treatment only). Primary clinical parameters included recession depth, keratinized tissue width, root coverage, root esthetic score, and gingival phenotype. The patients were followed up for at least 1 year. Level of gingival margin attained in test group teeth after SCTG were maintained at end of orthodontic treatment (P = .727). Root coverage achieved was 69.33 ± 30.74% versus 22.36 ± 27.70% in test and control group, respectively (P = .000), and gain in keratinized tissue width was 1.59 ± 0.73 mm in test versus 0.41 ± 0.49 mm in control group (P = .000). The number of teeth with improved gingival phenotype and decreased hypersensitivity was also observed to be statistically significant in the test group (P = .049, P = .002). Root coverage procedure may be performed before the planned orthodontic treatment as graft stability is preserved throughout the course of orthodontic treatment.

Biometric Assessment of Temporomandibular Disorders in Orthodontics: A Multi-arm Randomized Controlled Trial.

This randomized controlled trial aimed to evaluate the role of fixed orthodontic treatment in the aggravation, precipitation, or alleviation of temporomandibular disorders in young adults. Sixty patients were randomly assigned to 4 groups of 15 patients each (group I, orthodontic treatment in temporomandibular disorder-free orthodontic patients; group II, orthodontic treatment in patients with mild symptoms of temporomandibular disorders; group III, splint therapy accompanied by orthodontic treatment in patients with moderate symptoms; and group IV, control with no treatment). The biometric equipment used were the T-scan, to analyze the occlusal component; the BioEMG for muscular analysis; BioJVA for temporomandibular joint acoustic analysis; and JT3D for mandibular kinematic analysis. The paired t-test and ANOVA were used for intragroup and intergroup comparisons, respectively. The difference between groups was assessed using post hoc Tukey's test. Groups I and III showed significant difference in the occlusal, muscular, temporomandibular joint vibration, and kinematic mandibular assessment variables. Group II showed significant improvement in occlusal variables only. Group IV did not show improvement in any of the variables except for certain muscular components. Successful practical utilization of biometric equipment revealed that fixed orthodontic treatment does not aggravate temporomandibular disorders. It was also found that temporomandibular disorders due to malocclusion can be treated successfully with orthodontic treatment, whereas temporomandibular disorders due to multifactorial temporomandibular joint and muscular components might require splint therapy before orthodontic intervention.

Application of biofeedback orthodontic treatment in patients with increased generalized tooth abrasion

Application of biofeedback orthodontic treatment in patients with increased generalized tooth abrasion

Changes in Dietary Stress during Surgical Orthodontic Treatment for Patients with Dentofacial Deformities

Changes in Dietary Stress during Surgical Orthodontic Treatment for Patients with Dentofacial Deformities

Effectiveness Of Using Fermented Herbal Preparation In Complex Therapy Of Periodontitis Developed As An Orthodontic Treatment Complication

Objective — to study the effectiveness of topical application of standardized fermented papaya gel (SFPG) in the complex therapy of moderate chronic periodontitis developed as an orthodontic treatment complication. Material and Methods — Our study involved 50 patients with periodontitis of a moderate severity developed against the background of a treatment with a fixed orthodontic appliance. Periodontitis has developed as a long-term consequence of the fixed orthodontic appliance. Orthodontic treatment of patients was carried out with metal ligature braces. The patients were divided into two groups: Group 1 with conventional periodontitis treatment supplemented by SFPG applications on the gums for 15 minutes daily during 14 days; Group 2 with conventional treatment alone. The concentration of proinflammatory and anti-inflammatory cytokines in periodontal pockets was determined using solid-phase type of enzyme immunoassay (Vector-Best test system, Russia). The nitrite/nitrate content in the periodontal pocket fluid was determined spectrophotometrically using the Griess reagent kit, following the manufacturer’s instructions (Sigma-Aldrich, USA). Results — Patients receiving SFGP exhibited a reduction in inflammation, manifested in decreased gum bleeding, swelling, hyperemia, and exudate from periodontal pockets. We observed the restoration of the balance of proinflammatory cytokines (IL-1β, IL-6) and anti-inflammatory interleukin (IL-10), and reduction in the nitrite/nitrate content. Conclusion — Clinical effectiveness of the therapy with natural fermented herbal preparations may be associated with its antioxidant and antimicrobial properties.

Prevalence of Caries Secondary to the Orthodontic Treatment in Patients Visiting a Private Dental Hospital-A Retrospective Study

Introduction: Orthodontic treatment involving fixed appliance is a long term process. This treatment has a maximum risk of development of caries as proper oral hygiene maintenance would not be noticed. This increases the number of streptococcus mutans and lactobacillus which would form a biofilm. The armamentarium used in this treatment like molar band, brackets etc. are plaque stagnant areas, which over a period of time leads to caries, gingivitis etc. Thus, proper oral hygiene should be maintained by patients.
 Aim: The main objective of the study is to assess the prevalence of caries secondary to the orthodontic treatment in patients visiting a private dental hospital.
 Materials and Methods: A descriptive study which was performed under a university setting where all the patients reported to Private Dental college and hospital, Chennai. The data was collected by reviewing patients records and analysed the data of 140 patients who underwent orthodontic appliance treatment between May 2019- December 2020. The population size of the study was found to be n=80. Data was collected, tabulated, statistical analysis was done using SPSS- IBM.
 Results and Discussion: From the statistical analysis, it is observed that the total number of caries that could be seen after the orthodontic appliance treatment was more in males (58.23% ) when compared to females and the most commonly affected age is between 18-25 years with 49.37%. Moreover, the common tooth that affected were molars with 49.37%.
 Conclusion: Within the limitations of the current study, it is found that molars are the most commonly affected teeth and the age group which is affected the most is between 18-25 years. Thus, it is the imperative for dentists to provide preventive resin restorations, fluoride varnish and also proper instructions for maintenance of oral hygiene during the orthodontic treatment.

Comparative Evaluation of Preventive and Interceptive Orthodontic Treatment Need in Children of 6-9 Years and 9.1- 12 Years

Introduction: Preventive and interceptive orthodontics, emphasizes on reduction of later need for complex orthodontic treatment. This thus increases the comprehensiveness of healthcare and help in strengthening the primary care. In literature, there is no comparison between the preventive and interceptive treatment needs in patients belonging to growing age (6-9 years) and those belonging to non-growing age (9.1-12 years). There is a need to compare these finding according to the age group.
 The present study aims to utilize the IPION to quantify the proportion of central Indian children who would gain from the preventive and interceptive orthodontics.
 Materials and Methods: The study will be conducted in the Department of Orthodontics, SPDC, Wardha in collaboration with Department of Public Health Dentistry, SPDC, Wardha. Total 383 patient in age group of 6 to 12 years, will be selected. All the features of the IPION-6 and IPION-9 will be recorded, and the variables will be multiplied by weighting factors according to the instructions of the original study by Coetzee. All the features of IPION-12 will be recorded, and the variables will be multiplied by weighting factors.
 Expected Results: There will be a decrease in the need of orthodontic treatment in patients who have completed the age of 9 years.

METHOD OF HEALTHY TEETH EXTRACTION IN ORTHODONTIC TREATMENT

In the treatment of orthodontic patients, the most difficult and controversial is the question of removing healthy teeth. The aim was to evaluate the 30-year orthodontic clinical experience of the staff of the Postgraduate Education Department of Orthodontists for the use of medical methods of removal of individual healthy teeth in the treatment of dental anomalies.
 The aim of our study is to evaluate 30 years of orthodontic clinical practice of the staff of the Postgradu- ate Education Department of Orthodontists for the use of medical removal of individual healthy teeth in the treatment of dental anomalies.
 1340 dental outpatient cards of orthodontic patients who underwent orthodontic treatment and completed it with a positive result were reviewed at two clinical bases of the Postgraduate Education Department of Orthodontists.
 The analysis of selected outpatient cards was performed taking into account the age and sex of patients, as well as depending on the type of pathological occlusion (according to Angle) and the type of teeth removed. Cards of patients with Angle's class I and II pathology were selected for scientific analysis.
 241 patient underwent tooth extraction at both bases in total in terms of treatment, which is 17.99%. The number of patients with removed temporary teeth was 59.39% (143/241), patients with removed permanent teeth - 40.7% (98/241).
 Permanent teeth were removed 1.45 times more often at the clinic "Orthodontist", which is explained by the higher frequency of requests for orthodontic care from adults and adolescents.
 On the basis of the Postgraduate Education Department of Orthodontists, patients with deciduous teeth predominate - 69% (51/74) against 45% (75/167) in the clinic "Orthodontist". This is due to the fact that the main contingent of patients who seek help from the department are patients in the age of variable occlusion, which means that the Hotz method and the author's method of corrective removal of temporary molars are used more often.
 A detailed analysis of the documentation of patients was performed at the base of the Postgraduate Edu- cation Department of Orthodontists who were treated with the use of individual teeth extraction by periods of occlusion. Children in the period of the first half of the variable occlusion accounted for 39.19% (29/74), chil- dren in the second half of the variable occlusion - 25.67% (19/74), and patients older than 13 years - 35.14% (26/74).
 In female patients, regardless of age, tooth extraction is performed 13% -15% of cases more often than in men, which is due to a more attentive attitude to the appearance of girls by their parents.
 Among patients with various types of pathological occlusions treated with the method of removal of individual healthy teeth, children, adolescents and adults with Angle class I occlusion pathology accounted for 53.94% (130/241). Assessing the frequency of application of the method of extraction of healthy teeth by age, we can say that in pathology of class II according to Angle most often the method is used in patients with permanent occlusion in 38.73% (43/111).
 In the treatment of pathology of class I according to Angle, the removal of healthy teeth is twice as often performed in alternating occlusion than in permanent. In the treatment of pathology of class II according to Angle, the method of removing individual teeth is more often used in patients with permanent occlusion.
 Research on the consequences of removing individual healthy teeth in orthodontic treatment is relevant and timely. Both in the private sector of orthodontic care and on the clinical basis of the Postgraduate Education Department of Orthodontists, about a fifth of patients of any age and any orthodontic pathology are treated orthodontically using the clinical method of removing individual healthy teeth.

Enhancement of orthodontic tooth movement and root resorption in ovariectomized mice

Background/purposeAs the number of patients with osteoporosis requiring orthodontic treatment is increasing with the aging of society, it is necessary to evaluate the relations between bone metabolism in old age and orthodontic tooth movement (OTM). However, the effects of changes in bone metabolism due to osteoporosis on OTM and root resorption are still unclear. Therefore, we investigated the effects of OTM and root resorption in a mouse ovariectomy (OVX)-induced osteoporosis model. Materials and methodsEight-week-old female wild-type mice underwent OVX or sham surgery (Sham) as controls. One month after treatment, a nickel titanium coil spring was used to apply a mesial force to the maxillary left first molars of OVX or Sham mice for 12 days. The distance between the maxillary first molar and the second molar changed due to OTM and osteoclast formation was evaluated. The odontoclast formation and root resorption along the root surface of the distobuccal root of the first molar was also evaluated by histological analysis and scanning electron microscopy. ResultsDistance of tooth movement and osteoclast formation were significantly increased in OVX mice compared to Sham controls. Furthermore, root resorption in the mesial surface of the distal molars induced by orthodontic force was significantly increased in OVX mice. ConclusionThe amount of OTM was significantly increased, and the accompanying root resorption was also increased in OVX mice. Therefore, attention should be paid to the risk of root resorption associated with orthodontic treatment in patients with osteoporosis.

Considerations for Orthodontic Treatment in Patients with Endodontically Treated Teeth with Inflammatory Periapical Lesion

Considerations for Orthodontic Treatment in Patients with Endodontically Treated Teeth with Inflammatory Periapical Lesion

Orthodontic Treatment Need at Nishter Institute of Dentistry

Background: The Index of Orthodontic Treatment Need (IOTN) is one of the important index to find out orthodontic need of patients. Aim: To find out the need of orthodontic treatment in patients visiting Nishter Institute of Dentistry, Multan (NID). Method: The index was applied using plaster models and intraoral examination. The measurements of various components of IOTN index was taken with the help of digital vernier calliper. Results: The results of various measurements of IOTN index was taken, recorded and analyzed statistically. Result of the present cross-sectional study showed that 65% patients were in grade 4 and 5 of IOTN. The analysis showed that 13% were in grade 4 of IOTN, 52% were in grade 5, 15% were in grade 3, 16% were in grade 2 and 4% patients was in grade 1 of IOTN index. Conclusion: No significant sex differences were shown for the need of orthodontic therapy in any category of IOTN. The need of orthodontic treatment is very high in patients of Southern Punjab, Pakistan. Keywords: Treatment Need; IOTN; Orthodontics.

Advantages of using toothpaste containing propolis and plant oils for gingivitis prevention and oral cavity hygiene in cleft lip/palate patients

BackgroundThe anti-inflammatory and antibacterial action of preparations used during oral hygiene procedures is particularly important in patients with oral cleft. Few reports have been published assessing the influence of natural products on the state of the oral cavity in patients with oral cleft. The aim of this study was to assess the effect of toothpaste containing Polish propolis and plant oils on oral cavity health in patients with oral cleft treated orthodontically. Materials and methodsA total of 50 patients aged 9–16 years old (20 females, 23 males) were selected and randomly assigned into two groups. Group (A) received toothpaste with Polish propolis, tea tree oil, menthol, and rosemary oil. Group (B) received toothpaste without active ingredients (placebo). A baseline assessment was followed by an oral hygiene index (OHI, debris OHI-D, and calculus OHI-C component) and gingival bleeding index (GBI) after 35 days. The methodology of the oral condition assessment included the presence of cleft malformation as a dysmorphic of the anterior maxilla segment. ResultsIn group A, improvement in oral cavity hygiene assessed for incisors and molars was found (OHI-T p = 0.011). For the gingival condition, a decrease in the gingival bleeding index - total (GBI-T p = 0.002), as well as for the incisors (GBI-I p = 0.007) and molars (GBI-M p = 0.017) was found. ConclusionsThis research confirms the biological effectiveness of toothpaste with Polish propolis and plant oils. These results may be clinically useful for improving preventative oral care and for control of oral infectious diseases during orthodontic treatment in patients with oral cleft.

Using FEM to Assess the Effect of Orthodontic Forces on Affected Periodontium

Orthodontic treatment in patients with no periodontal tissue breakdown vs. horizontal bone loss should be approached with caution even though it can bring significant benefits in terms of periodontal recovery and long-term success. We used the finite element method (FEM) to simulate various clinical scenarios regarding the periodontal involvement: healthy with no horizontal bone loss, moderate periodontal damage (33%) and severe horizontal bone loss (66%). Afterwards, forces of different magnitudes (0.25 N, 1 N, 3 N, and 5 N) were applied in order to observe the behavioral patterns. Through mathematical modeling, we recorded the maximum equivalent stresses (σ ech), the stresses on the direction of force application (σ c) and the displacements produced (f) in the whole tooth–periodontal ligament–alveolar bone complex with various degrees of periodontal damage. The magnitude of lingualization forces in the lower anterior teeth influences primarily the values of equivalent tension, then those of the tensions in the direction in which the force is applied, and lastly those of the displacement of the lower central incisor. However, in the case of the lower lateral incisor, it influences primarily the values of the tensions in the direction in which the force is applied, then those of equivalent tensions, and lastly those of displacement. Anatomical particularities should also be considered since they may contribute to increased periodontal risk in case of lingualization of the LLI compared to that of the LCI, with a potential emergence of the “wedge effect”. To minimize periodontal hazards, the orthodontic force applied on anterior teeth with affected periodontium should not exceed 1 N.