Orthodontic Research Articles

Clinical outcomes of surgery-first approach correcting adult skeletal class III malocclusion

Objective To explore the clinical effect of surgery-first approach (SFA) for correcting adult skeletal class Ⅲ malocclusion deformity patients. Methods A total of 28 adult patients diagnosed with skeletal class Ⅲ malocclusion were treated. Bilateral sagittal split ramus osteotomy (BSSRO) and geniplasty were performed without presurgical orthodontics treatment; postoperative orthodontics treatment was carried out after a healing period of 2-4 weeks. Lateral cephalometric radiographs were taken preoperatively (T1), within a week posoperatively (T2) and six months posoperatively (T3); cephalometric measurements were carried out by the software. Results All the patients were satisfied with the effect, no complications occured. The mean postoperative orthodontics treatment duration was 13.2 months. The mean setback of mandible at Po and B point was (7.74±3.93) mm (P<0.01) and (8.13±3.84) mm (P<0.01), and superior movement lengths were (2.73±1.83) mm and (2.76±1.67) mm, respectively. Compared to T2, Po and B point moved forwardly with (2.36±1.23) mm and (2.66±1.65) mm, and inferior movment were (2.16±1.37) mm and (1.21±0.87) mm, respectively. The mean decrease of SNB and GA was (3.74± 1.61)° (P<0.01), (3.41± 1.87)° (P<0.01), respectively. During postoperative period, both of them increased, although these were no statistical differences. Conclusions SFA combined postoperative orthodontics therapy is feasible for the correction of adult skeletal class Ⅲ malocclusion, which has shorter treatment duration than traditional joint orthognathic-orthodontic. With the advantages of earlier improvements in patient's facial aesthetics and dental function, the reduction in difficulty and treatment duration of orthodontic management, and increasing patient acceptance. Key words: Surgery-first approach; Orthognathic surgery; Malocclusion deformity

Essential Orthodontics

Essential Orthodontics

Comparison of Using Self etch Adhesive System in Orthodontic Bracket Bonding Procedures

Amac: Bu in vitro calismanin amaci kendinden puruzlendirmeli (self-etch) adeziv sistemlerin baglanma dayanimlarinin karsilastirilmasidir. Gerec ve Yontemler: Bu arastirmada cekilmis 100 tane insan ucuncu molar disi kullanildi. Bu disler rastgele 5 farkli gruba ayrildi (n=20). Her dise, mezio-bukkal ve disto-bukkal yuzeylerinde olacak sekilde ust birinci premolar braketleri yapistirildi (kontrol ve deney grubu). Tum gruplarda, rastgele secilen kontrol yuzeyleri total etch sistem ile bondlandi. Bonding ajani olarak grup I’de Transbond Plus SEP (3M Unitek, Monrovia, Calif); grup II’de kuraray self plus; grup III’de kuraray self; Grup IV’de ormco self etch; Grup V’de AdheSE (Ivoclar Vivadent AG, Schaan, Liechtenstein) kullanildi. Braketleme sonrasi disler 24 saat 37 C° distile suda bekletilip, termocycling cihazinda yapilan 5000 tur sonrasinda, hizi 1mm/dk olan universal test cihazinda shear testi yapildi. Istatistiksel degerlendirme tek yonlu varyans analizi ve tukey testleri ile yapildi. Bulgular: Istatistiksel analizler self etch sistemlerin total etch sisteme gore azalan baglanma dayanimlari arasinda anlamli bir fark oldugunu gosterdi (P<0.05). Grup II (%30,1) en az baglanma dayanimi kaybina sahip olmakla beraber grup I (%31,95) ile arasinda anlamli bir farklilik gozlenmedi. Grup III’un (%36,65) baglanma dayanimi kaybi Grup V’e (%40,3) gore daha dusuk bulundu. Grup IV (%49,5) ise diger gruplara gore en fazla baglanma dayanimi kaybi gosterdi. Sonuclar: Total etch sistem ile yapistirilan braketlerin baglanma dayanikliliklari self etch sistemlerinkine gore daha iyidir. Ancak bazi firmalarin urettigi self etch sistemler klinik olarak anlamli derecede yuksek baglanma dayanimi gostermektedir. Anahtar Kelimeler: Baglanma, kendinden puruzlendirmeli adeziv sistem, makaslama baglanma dayanimi

Measurement of anterior teeth widths in 236 Uygur teenagers

In order to provide reference for orthodontic and esthetic dentistry, we measured anterior teeth widths, and analyzed the ratio between the teeth in 236 Uygur teenagers. Two hundred and thirty-six samples were selected from Uygur population,Vernier calipers was used to measure the widths of the anterior teeth. SPSS21.0 software package was used for independent sample t test, paired t test and REG regression. Except for mandibular lateral incisors, significant difference was observed in anterior teeth widths between males and females, the ratio between the upper and lower central incisors in males was nearly 1.618; the ratio between upper central incisor and lower central incisor, upper central incisor and lower lateral incisor, upper canine and lower lateral incisor in females was not approaching 1.618, i.e. There was no "golden proportion". There was significant correlation between anterior teeth of Ugyur teenagers. No "golden proportion" was found in anterior teeth widths of Ugyur teenagers, but a specific ratio exists.

Awareness of Role of Dentist-Patient Co-operation in Attainment of Ideal Dental Treatment among Dental Interns at DUHS Karachi

Aims: The study aimed to evaluate the Awareness of role of Dentist-Patient Co-operation in attainment of ideal Dental treatment among Dental interns at DUHS Karachi, Pakistan. Background: Safe and effective treatment of all Dental diseases requires mutual understanding and sound cooperation between a Dentist and his/her Patient. Material and Method: A cross-sectional study was conducted in Dental department of DUHS Karachi. Study included Dental interns from different designations i.e. Post-graduates, Graduates, Under-graduates and different sub-departments i.e. Orthodontics, Endodontics, Periodontics, Community Dentistry, Oral medicine, Oral surgery etc. The research tool was a paper based Questionnaire designed by running a pilot study based on 14 Questions evaluating the core aim, with an attached consent form. The sample size was about 250 Dental interns. Descriptive and Association tests were used for statistical analysis using SPSS 16.0. Results: 250 Questionnaires were filled. Gender and Qualification were the variables. Gender vice 32% were Males and 68% were Females Dental interns. Qualification vice 20% were Post-graduates, 40% were Graduates and 40% were Under-graduates. According to 68% Dental interns patients of 26-35 year age group are most cooperative during Dental treatment. 74% Dental interns chosen 2-12 year age group as least cooperative during Dental treatment.90% Dental interns agreed that Patients proper cooperation during chair-side treatment always saves valuable clinic/OPD time. About 60% Dental interns agreed that cooperative Dentist should be flexible enough to mold his/her treatment plans according to Patient’s longing/desire. 70% Dental interns agreed that with follow up appointments patient becomes more cooperative and trustworthy towards his/her Dentist. 66% Dental interns strongly agreed that patient’s phobia of dental treatment and dental instruments can drive him uncooperative during his/her treatment.55% Dental interns strongly agreed that Language barrier between Dentist and Patient can create un-cooperative environment and hence ideal treatment may become un-attainable. 75% Dental interns strongly agreed that Dentists busy schedule, engaged in routine appointments increases Dentist's anxiety level which can leads to uncooperative behavior and affect patient’s treatment.78% Dental interns agreed that if a Dentist is unable to handle patient's un-cooperative behavior or attitude, thus referring the patient to another Dentist for sake of ideal treatment can be a good option. Conclusion: The Dental interns at DUHS were found well aware of role of Dentist-Patient Co-operation in attainment of ideal Dental treatment. A positive relation is found out between Dentist-Patient’s Behavior and Treatment’s Results. A cooperative Dentist-Patient environment is found to be more time and effort saving. With the follow-up appointments the patients are found to be more comfortable and cooperative towards their Dentists. Patients of middle age group i.e. 26-35 year are found to be more cooperative in contrast to patient at extremes of ages specially 2-12 year are found to be least cooperative. Factors like Patients Dental-instrumental phobia and lingo-cultural differences are found to be among driving factors for patients uncooperative behavior. On the other hand Dentist’s hectic scheduling and tiresome work increases Dentist’s stress level and sometime trail them towards uncooperativeness. This study also well affirmed that Ethical Dentistry is of core value in Clinical Dental Practice.

Dental Travma ve Ortodontik Diş Hareketi Arasındaki İlişkiler

Dental Travma ve Ortodontik Diş Hareketi Arasındaki İlişkiler

Evaluation of profile aesthetics of skeletal Class Ⅱ patients with different treatment methods

To study the aesthetic appearance of skeletal Class Ⅱ patients with maxillary protrusion and mandibular retrusion treated with different methods. The facial profile photographs and lateral cephalometric radiographs of a Chinese woman suffering from skeletal Class Ⅱ with maxillary protrusion and mandibular retrusion was digitized.The digital images were modified to obtain orthodontic compensatory treatment, genioplasty with different advancement ranges and orthognathic treatment comprising 6 profiles by Photoshop software，orthodontic professionals and non-professionals were chosen to score the pictures. Post hoc tests were done with ANONA and the Student Keuls method to analyze the data Using SPSS22.0 software package. The profile with the highest score was the picture treated by orthognathic and orthodontic treatment. The profile with genioplasty (advancement of 4 mm) took the second place. When the advancement distance of genioplasty was 8 mm, the score was under the score of orthodontic compensatory treatment profile. Orthognathic-orthodontic treatment of skeletal Class Ⅱ is still the best treatment option to improve facial aesthetics. Genioplasty, as a adjuvant treatment, improves the appearance based on compensatory orthodontic treatment to some extent, but not comparable to orthognathic-orthodontic treatment.

Obstructive Sleep Apnea Syndrome (OSAS): evaluation and treatment of odontostomatological problems.

The Obstructive Sleep Apnea Syndrome (OSAS) is a breathing disorder characterized by repeated episodes of apnea/hypopnea occurring during sleep and caused by the obstruction of the upper airway. As OSAS can have a significant impact on quality of life, an early diagnosis and a multi-specialized recognition become important. Therapeutic proposals include the Mandibular Advancement Devices (MADs), intraoral devices that induce a mandibular advancement during the night to eliminate snoring and apnea. Italian guidelines on dental aspects of OSAS in adults and children focus primarily on anamnestic and clinical methods by which the dentist, in a role of epidemiological sentinel, can first identify a patient with OSAS and then participate in the therapeutic process using specific orthodontic intraoral devices.

Prosthodontic treatment of an Angle III Class malocclusion: A case report.

Patients with an Angle Class III malocclusion are generally treated by orthodontics with or without orthognathic surgery. A literature search revealed very few articles describing solely the prosthodontic treatment of a Class III malocclusion, as it is rarely used as a treatment modality in these cases. The purpose of this article is to show the effects and benefits of an increase in the vertical dimension of the occlusion (VDO) in patients with a Class III malocclusion. An increase in the VDO causes a clockwise rotation of the mandible, thereby increasing the reverse overjet. This phenomenon allows a prosthodontic treatment of the Class III malocclusion in some patients. Therefore, proper diagnostic procedures, careful planning, and a simulation of the final appearance by wax-up and mock-up are mandatory when choosing the modality of prosthodontic treatment. A case with a Class III malocclusion, treated solely by prosthodontic means, is presented. The implemented prosthodontic treatment included the correction of the crossbite and the occlusal plane, the reestablishment of the anterior and canine guidance as well as the provision of a stable occlusion and enhanced facial and dental esthetics. It is proposed that an increase of the VDO should be taken into consideration whenever a patient with a Class III malocclusion is prosthodontically treated.

Effect of basic periodontal combined with orthodontic treatment of periodontal disease

Objective To investigate the basic periodontal treatment of periodontal disease treatment effect of orthodontic patients. Methods A retrospective study was performed on 68 cases of periodontal disease who were admitted from July 2008 to July 2016.Patients received periodontal basic treatment combined with orthodontic treatment, the periodontal treatment was observed before(T0 stage), 12 consecutive weeks of periodontal treatment(T1 stage), patients with periodontal disease stable quiescent teeth after treatment combined with orthodontic treatment(T2 stage)and different treatment period of periodontal depth, loose, the bleeding on probing were recorded, attachment loss, application of CBCT measurement of root length, density of alveolar bone and the cemento enamel junction and the alveolar ridge crest spacing and other indicators, assessment of patients before and after treatment were performed. Results During the treatment, patients with root length, cemento enamel junction and the alveolar ridge crest spacing had no statistically significant difference(P>0.05), the tooth periodontal treatment and orthodontic treatment were corrected on the root and alveolar bone resorption which had no obvious effect.T1 and T2 stage alveolar bone density and T0 stages had obvious differences, especially the T2 stage compared with T1 had more significant differences(P<0.05). The masticatory efficiency improvement of periodontal disease in patients with periodontal treatment and orthodontic treatment, the probing depth and mobility of the loss of status and bleeding on probing point proportion were improved significantly, T1 and T2 stages of periodontal indices were significantly higher than those of T0 stage, the difference was statistically significant(P<0.05). After the treatment, the masticatory efficiency was significantly increased(P<0.05). Conclusion Periodontal treatment can take control of periodontal disease development, through oral environmental control to improve the quality of the late periodontal orthodontic corrective maintenance, help to maximize efficacy, improve the patients′ periodontal aesthetic form, and improve the chewing function. Key words: Basic treatment; Periodontal disease; Orthodontic treatment

New evidence supports the role of orthodontics in improving well-being

New evidence supports the role of orthodontics in improving well-being

Socio-economic Factors Affecting Orthodontic Treatment in Korean Children

Socio-economic Factors Affecting Orthodontic Treatment in Korean Children

Wonders to Orthodontics - Drugs and Hormone

Wonders to Orthodontics - Drugs and Hormone

Optimization of standardized training model and evaluation system for residents in the department of orthodontics

Standardized training of residents in the department of orthodontics is an important learning stage for stomatology students before carrying out clinical orthodontic diagnosis and treatment work. At present, there are some deficiencies in the standardized training system of the residents in the Department of Orthodontics, such as the single teaching mode, imperfect training items, and unclear evaluation criteria. The department of orthodontics of Stomatology Hospital of Southern Medical University carried on a preliminary study on the training pattern of resident doctors in the refinement of the training content, optimizing curriculum design, implementation of tutorial teaching mode, the combination of theoretical study and clinical training, regular training evaluation and quantitative assessment indicators. The results showed that the trainees' acceptance and satisfaction were higher, which was beneficial to the improvement of clinical comprehensive ability of orthodontics. Key words: Orthodontics; Resident; Standardized training

The value of bone mineral density and bone resorption markers around the mini-screw implant in the orthodontic treatment

Objective To investigate the value of bone mineral density and bone resorption markers around the mini-screw implant in the orthodontic treatment. Methods 178 orthodontic patients were prospectively collected.According to the organization condition around the mini-screw implant loaded, all patients were assigned into stable group (n=160) and loose group (n=18). The levels of interleukin-1β (IL-1β) and matrix metalloproteinase-9 of the liquid around the mini-screw implant were detected at 1, 2 and 3 months after loading.Moreover, the bone mineral density around the mini-screw implant before and after loading were studied as well. Results Compared with the stable group, the loose groups at 1, 2 and 3 months after loading got significantly higher levels of IL-1β[(35.48±4.39)pg/mL vs. (29.48±3.92)pg/mL, t=3.348, P=0.004; (41.45±5.39)pg/mL vs. (26.29±4.12)pg/mL, t=6.493, P=0.000; (54.39±12.82)pg/mL vs. (23.58±3.62)pg/mL, t=11.589, P=0.000]. Compared with the stable group, the loose group at 1, 2 and 3 months after loading got significantly higher levels of MMP-9[(5.68±3.54)ng/mL vs. (1.74±0.88)ng/mL, t=8.496, P=0.000; (6.84±2.82)ng/mL vs. (1.25±0.62)ng/mL, t=9.835, P=0.000; (9.84±4.39)ng/mL vs. (1.21±0.58)ng/mL, t=12.548, P=0.000]. Compared with the stable group, the loose group got significantly lower levels of bone mineral density of maxillary bones around the mini-screw implant before and at 3 months after loading[(620.48±67.82)HU vs. (694.39±84.58)HU, t=2.459, P=0.015; (597.39±58.93)HU vs. (693.59±83.29)HU, t=2.909, P=0.008]. Conclusion The decrease of bone mineral density around the mini-screw implant is related to the loosening of the mini-screw implant, and IL-1β and MMP-9 of the surrounding fluid can reflect the peripheral inflammation. Key words: Bone mineral density; Mini-screw implant; Orthodontic; Peripheral inflammation

Sistemas adesivos em ortodontia

Comentários sobre o artigo: Arinelli AMD, KF Pereira, Prado NAS, Rabello TB. Sistemas adesivos atuais. Rev. Bras. Odontol. 2016; 73 (3): 242-6

Prediction of Mesiodistal Diameter of Unerupted Second Premolars and Canines Non-radiographically

Introduction : Prediction of the mesiodistal width of unerupted permanent canines and premolars is of majorinterest for orthodontic diagnosis and treatment planning. This prediction is used to determine the tooth size-arch length discrepancy in the mixed dentition which is often made before eruption of the permanentcanines and first and second premolars. Method: The intraoral periapical radiograph of mandibular premolar region was taken. Records of 20 patients aged 13 to 14 yrs of Marathwada region with unerupted second premolar was considered. The actual measurements compared with the predicted values derived from the Tanaka and Johnston and Boston university equations. Result: Two prediction method Tanaka Johnston and Boston University show significant result for marathwada population. Conclusion: Depending on the stage of dental development, i.e., which deciduous and permanent teeth are present, the Tanaka/Johnston approach can be used when the four mandibular incisors have completely erupted, whereas the Boston University approach can be used when all the deciduous canines and first molars are still present.

CRANIOMETRIC CHARACTERISTICS OF ADULT SPHENOIDAL SINUSES OBTAINED WITH CONE-RAY COMPUTED TOMOGRAPHY

Aim. To study the life-time linear parameters of the sphenoidal sinus cavities in different reformats of cone-ray computed tomography (CRCT). Materials and methods. Measurements of cranial structures were fulfilled using tomograms of planed examinations, carried out at “Railway Dental Polyclinic” of Samara station “RR” in 2010-2014. They were obtained with cone-ray computed tomograph Galileos, (Sirona Company) with the software Galaxis. Eighty two persons with a mean age of 38,05 ± 0,77 years were examined. Results. The life-time linear parameters of the sphenoidal sinuses in different CRCT reformats were studied through the standard and additional craniometric points. Correlation links between the anatomic indices, characterizing the contour and the internal relief of sphenoidal sinuses were detected. Conclusions. The data on size characteristics and associated variability of the paranasal sinuses, obtained by means of standard CRCT, supplement and concretize the information database of medical craniology that is significant not only for orthodontics, but for otorhinolaryngology, ophthalmology, neurosurgery, as well.

Retracted Article: Use of CBCT in Orthodontics- A Review

The article stands retracted due to double submission by the author Dr. Aakash Shah . It is quite regretful that such authors waste the time and resources of the journal. View the email sent by Dr. Aakash below. Lateral cephalometric radiographs are most commonly used as a diagnostic tool in orthognathic surgery as well as orthodontic treatment. But the limitation of lateral cephalograms is its 2 dimensional nature whereas the human body is 3 dimensional. Conventional 2D lateral cephalograms have numerous drawbacks in terms of investigating the changes in the alveolar bone and roots, particularly in the anterior region, as a consequence of the midsagittal projection. Additionally its accuracy is questionable as it has projection errors. The use of computed tomography in 3D imaging of human body is available in the field of medicine since last 30 years. CT scanning is the three dimensional imaging technique giving quantitative assessments of the buccal and lingual cortical bone plates and labiolingual width of alveolar bone with elevated accuracy and precision. But the use of computed tomography in dentistry is limited because the amount of radiation exposure with this technology is very high. Since the invention of Cone Beam Computed Tomography, the amount of radiation exposure in the patient is reduced. This enhances its use in obtaining the 3D images of the craniofacial structures. This technology helps in visualizing the hard and soft tissues of the craniofacial structures from various perspectives and helps in thorough diagnosis and treatment planning of orthognathic surgery and orthodontic patients. The principles of CBCT and its use in the field of orthodontics will be discussed in detail in this paper.

Surgical orthodontic treatment for the patients with facial deformity.

Surgical orthodontic treatments for patients with facial deformities are performed to improve the occlusal abnormalities and facial deformities caused by skeletal and dental problems such as deformation and disharmony of the upper and lower jaws, crowding, and excessive tooth axis inclination. Such treatments were performed under close and detailed coordination between orthodontists and oral surgeons. The oral maxillofacial region plays an important role in daily life functions such as mastication, respiration, and speech. Surgical orthodontic treatment is very helpful and effective in improving both dysfunctions and dismorphologies in the patients with facial deformity. To make a diagnosis and draw up a treatment plan for surgical orthodontics, it is important to estimate the skeletal and dental morphological abnormality and/or disharmony in individual patients accurately.