Premolar Extraction Research Articles

Influence of freeze-dried bone allograft on free gingival graft survival and alveolar ridge maintenance in socket seal procedures: a randomized controlled clinical trial.

This study aimed to investigate the viability of free gingival grafts (FGG) and assess clinical and radiographic changes in the alveolar ridge following socket seal surgery with or without freeze-dried bone allograft (FDBA). Twenty-eight anterior and premolar tooth extractions were randomly allocated to 2 groups: socket graft of FDBA sealed with FGG (n = 15) and control with empty sockets sealed solely with FGG (n = 13). Photographs taken at 3, 7, 14, and 30 days post-surgery assessed FGG viability. Alveolar ridge volume was clinically evaluated via intraoral scanners before surgery and at 1 and 3 months post-surgery. CBCT scans taken immediately post-surgery and 3 months later assessed alveolar ridge dimensions. FGG viability in both groups increased from day 3 and reached the maximum score on day 14. Alveolar ridge volume reduction at 3 months in the FDBA group was comparable to the control group. Buccal alveolar bone height reduction was significantly higher in the FDBA group than the control group, while palatal alveolar bone height was comparable. Alveolar bone width reduction was evident but not statistically significant between the groups. The FDBA group exhibited a significant alteration in bone volume compared to the control group. Viability of FGG was not affected by graft filling materials. Sealing the socket with FGG effectively preserved socket integrity and ridge volume in minor socket defects using either graft filling material or not. This study was registered on 4 January 2021 on Thai Clinical Trials Registry (TCTR20210104001).

Risk factors for gingival invagination: A retrospective study.

This study aimed to identify the risk factors for gingival invagination during orthodontic treatment after premolar extraction. The medical records of 135 patients who had undergone interdental space closure after premolar extraction were collected, and cone beam computed tomography was performed to determine the presence of gingival invagination. The risk factors were examined using mixed-effects models and generalized propensity score weighting (GPSW) to develop a predictive model. Univariate analysis revealed that the extraction site, buccal bone thickness 4 mm apical to the cemento-enamel junction (MB1), mid-root buccal bone thickness (MB2) and vertical skeletal relationships were related to gingival invagination (p < .05). Furthermore, a subsequent multivariable mixed-effects model analysis indicated a significantly increased risk of gingival invagination at MB1 < 1 mm (p < .001; odds ratio [ORMB1≤0.5mm] = 29.304; 95% confidence interval [CI]: 8.986-93.807; OR0.5<MB1<1mm = 22.309; 95% CI: 9.890-50.320). Row mixing model analysis performed after balancing covariates using GPSW showed that MB1 and vertical skeletal relationships were associated with gingival invagination (p < .05) with an increase in ORs. Therefore, in addition to MB1, the risk of gingival invagination is higher in hyperdivergent and normodivergent patients. During the establishment and internal validation of the predictive model, the area under the curve for all three models exceeded 0.7. The risk of gingival invagination is higher in patients with MB1 < 1 mm and in normodivergent or hyperdivergent patients.

Comparative Analysis of Pharyngeal Airway Changes Following All Four Versus All Five Premolar Extractions in Orthodontic Treatments: A Cephalometric Study.

Orthodontic treatment, particularly involving premolar extractions, has been a subject of ongoing debate within the orthodontic community. The impact of such interventions on the pharyngeal airway, a critical component of the respiratory system, remains a topic of exploration. This retrospective cephalometric study aims to investigate changes in pharyngeal airway dimensions following orthodontic treatment involving either all four or all five premolar extractions. A sample of 68 participants, extracted from orthodontic records, underwent cephalometric analysis to quantify changes in pharyngeal airway dimensions. The study compared two groups: those treated with all four premolar extractions (n=34) and those treated with all five premolar extractions (n=34). Cephalometric radiographs taken before and after treatment were analyzed, focusing on airway width, length, and volume. Preliminary findings indicate significant changes in airway dimensions within each group. In the all four premolar extraction group, there was a statistically significant decrease in airway width (p=0.02) and volume (p=0.04). Similarly, the all five premolar extraction group exhibited significant reductions in airway width (p=0.03) and volume (p=0.02). However, the between-group comparisons revealed no significant differences in changes between the two groups. This study sheds light on the intricate relationship between orthodontic interventions, specifically premolar extractions, and changes in pharyngeal airway dimensions. While significant changes were observed within each group, the lack of significant differences between the all fourand all five premolar extraction groups raises intriguing questions about the specific impact of premolar extraction patterns on the upper airway.

Beyond the ARCH: Examining mandibular third molar movements in response to premolar and single incisor extractions in orthodontic practice

Mandibular third molars have been the interest of the orthodontic professionals, not only because of their Position Eruptive pattern, also because of their possible role in the development of late incisor crowding. The impaction rate of the third molars (mandible &amp;#62; maxilla) is high compared to any other teeth. The impaction incidence of M3s may be lower in patients with orthodontic premolar extraction due to mesial movement of the posterior teeth. In this study angular and positional changes of mandibular 3 molars will be evaluated with premolars as well as single incisor extraction.: This study includes 30 Pre-treatment and post-treatment orthopantomogram (OPG) of patients seeking orthodontic treatment with extractions of premolars, single incisor are categorized into 2 groups -Group I includes premolar extractions, Group II includes single incisor extractions.The study concluded that extracting premolars or single incisors did not result in improved mandibular M3 angulation on both left and right sides during the observation period.The insignificant change in angulation suggests that there are other factors that play a role in the process of alteration of third molar angulation

Patient-reported outcomes during accelerating the en-masse retraction of the upper anterior teeth using low-intensity electrical stimulation: a randomized controlled trial

BackgroundLow-intensity electrical stimulation (LIES) is considered a relatively recent technology that has received little attention in orthodontics as a method of acceleration. This study aimed to evaluate patient-reported outcome measures when LIES is used to accelerate the en-masse retraction of the upper anterior teeth.Materials and methodsThe sample consisted of 40 patients (8 males, 32 females; mean age 21.1 ± 2.3 years), with Class II division I malocclusion who required extraction of the first premolars to retract upper anterior teeth. They were randomly assigned to the LIES group (n = 20) and the conventional en-masse retraction group (CER; n = 20). Patient responses regarding pain, discomfort, burning sensation, swelling, chewing difficulty, speech difficulty, and painkillers’ consumption were recorded at these nine assessment times: 24 h (T1), 3 days (T2), and 7 days (T3) after force application, then in the second month after 24 h (T4), 3 days (T5), and 7 days (T6) of force re-activation, and finally after 24 h (T7), 3 days (T8), and 7 days (T9) of force re-activation in the third month.ResultsThe mean values of pain perception were smaller in the LIES group than those in the CER group at all assessment times with no statistically significant differences between the two groups except during the second and third months (T5, T6, T8, and T9; P < 0.005). However, discomfort mean values were greater in the LIES group with significant differences compared to CER group during the first week of the follow-up only (T1, T2, and T3; P < 0.005). Burning sensation levels were very mild in the LIES group, with significant differences between the two groups at T1 and T2 only (P < 0.001). Speech difficulty was significantly greater in the LIES group compared to CER group at all studied times (P < 0.001). High levels of satisfaction and acceptance were reported in both groups, without any significant difference.ConclusionBoth the LIES-based acceleration of en-masse retraction of upper anterior teeth and the conventional retraction were accompanied by mild to moderate pain, discomfort, and chewing difficulty on the first day of retraction. These sensations gradually decreased and almost disappeared over a week after force application or re-activation.Trial registrationClinicalTrials.gov, ClinicalTrials.gov, NCT05920525. Registered 17 June 2023 - retrospectively registered, http://clinicaltrials.gov/study/NCT05920525?term=NCT05920525&rank=1.

Corkscrew Technique for Extraction of Premolars and Molars in Standing Sedated Horses: Cadaveric Study and Clinical Cases.

Several tooth extraction techniques are described in equine literature, and oral extraction techniques in standing sedated horses are popular among equine practitioners. The objectives of this study were to develop the corkscrew technique for cheek tooth extraction (CSET) in equine cadaver heads and evaluate this technique in clinical cases. We hypothesized that the CSET could be performed safely to extract cheek teeth in standing sedated horses. First, the CSET was attempted and developed in eight equine cadaver heads. Second, the CSET was performed in clinical cases between 2016 and 2020, and the following information was recorded: diagnosis, affected tooth, procedure duration, intraoperative difficulties, tooth size, postoperative complications, medication, hospitalization time, and 1-year follow-up. Sixteen CSET procedures were performed in eight equine skulls with a 75% success rate. In 24 clinical cases, 25 CSET procedures were attempted to extract 22 superior and 3 inferior cheek teeth. CSET was successful in 76% of procedures. Fractures of the tooth and stripping of screw threads were the major complications that led to the failure of CSET. CSET is a viable and safe technique to extract cheek teeth in standing sedated horses. Longitudinal drilling is a must for this technique to be successful.

Comparison of Amount of Space Closure During En- Masse Retraction of Maxillary Anterior Teeth Using Three Accelerated Orthodontic Treatment Techniques- Micro Osteo-Perforation, Photo Bio-Modulation and Peizocision : A Retrospective Study

AIM: The study aimed at comparing the amount of space closure using peizocision (PZ) and micro- osteoperforation (MOP) and low-level laser therapy (LLLT). Materials and methods: A retrospective study consisted of 3 groups, sample number of minimum 8 patients per group were estimated using statistical model called an Analysis of Variance, or ANOVA model. Three sets of data were collected. Which included patients who were treated with upper first premolar extraction for en- masse retraction of maxillary anterior teeth using NiTi closed coil spring with regional acceleratory procedures. The data collected was divided into 3 groups, GROUP 1- micro osteo perforations (n=8), GROUP 2- photo bio modulation (n=8), GROUP 3- peizocision (n=8).sing digital Vernier calipers, a direct approach was used to measure all the stone casts obtained before canine retraction (T0) and after the retraction was completed after three months (T1). The statistical analysis was performed on the data acquired about the amount of space closure of en-masse retraction of maxillary anteriors in the PZ, LLLT, and MOP groups. Results: Compared to MOP (2.60mm) and LLLT (2.44mm), the PZ group had a greater mean amount of space closure (5.06mm). In conclusion, the quantity of space closure in piezocision was significantly higher than that in MOP and LLLT, although there was no statistically significant difference between the two. It is imperative that treatment duration be shortened. Finding the most effective and practical method to speed up tooth movement using the biomechanical mechanisms that are currently in place is therefore necessary

Orthodontic treatment outcome predictive performance differences between artificial intelligence and conventional methods.

To evaluate an artificial intelligence (AI) model in predicting soft tissue and alveolar bone changes following orthodontic treatment and compare the predictive performance of the AI model with conventional prediction models. A total of 1774 lateral cephalograms of 887 adult patients who had undergone orthodontic treatment were collected. Patients who had orthognathic surgery were excluded. On each cephalogram, 78 landmarks were detected using PIPNet-based AI. Prediction models consisted of 132 predictor variables and 88 outcome variables. Predictor variables were demographics (age, sex), clinical (treatment time, premolar extraction), and Cartesian coordinates of the 64 anatomic landmarks. Outcome variables were Cartesian coordinates of the 22 soft tissue and 22 hard tissue landmarks after orthodontic treatment. The AI prediction model was based on the TabNet deep neural network. Two conventional statistical methods, multivariate multiple linear regression (MMLR) and partial least squares regression (PLSR), were each implemented for comparison. Prediction accuracy among the methods was compared. Overall, MMLR demonstrated the most accurate results, while AI was least accurate. AI showed superior predictions in only 5 of the 44 anatomic landmarks, all of which were soft tissue landmarks inferior to menton to the terminal point of the neck. When predicting changes following orthodontic treatment, AI was not as effective as conventional statistical methods. However, AI had an outstanding advantage in predicting soft tissue landmarks with substantial variability. Overall, results may indicate the need for a hybrid prediction model that combines conventional and AI methods.

Soft-tissue profile changes in adult patients treated with premolar extractions

The objective of this study was to identify the soft-tissue profile changes and the potential pretreatment cephalometric parameters that clinicians could use to predict the lip response after premolar extraction treatment in adult patients. Pretreatment and posttreatment lateral cephalograms of 75 white patients treated with premolar extractions were analyzed. The following initial cephalometric measurements were recorded: upper and lower lip to E-plane, vermilion thickness, lip length, maxillary and mandibular incisor inclination, and mentolabial and nasolabial angle. Pretreatment and posttreatment radiographs were superimposed using the Björk structural method to record lip retraction and incisor/lip retraction ratio. Pearson correlation and Kruskal-Wallis tests were used to compare lip retraction and incisor/lip retraction ratio with the cephalometric variables. The sample was divided according to different extraction patterns. The mean upper and lower lip retraction values were 1.4 mm and 1.7 mm, respectively. Vermilion thickness showed a negative and statistically significant correlation (P<0.05) with lip retraction and incisor/lip retraction ratio. In addition, the mean incisor/lip retraction ratio was 61% and 98% for the upper and lower thin lip, respectively, whereas the mean incisor/lip retraction ratio was 17% and 44% for the upper and lower thick lip, respectively. The comparison among extraction patterns did not highlight any noticeable difference. The choice of a specific extraction pattern did not impact lip response. The vermilion thickness was the key factor influencing lip retraction: an increase in this parameter was related to a decrease in lip retraction and vice versa.

Clinical application of a lingual retractor with temporary anchorage devices (TADs) for patients with lip protrusion and anterior open bite

Anterior open bite (AOB) is considered one of the most difficult malocclusions to correct and achieve successful and stable results. Various treatment approaches have been proposed for the treatment of AOB in adults. Intrusion of the entire maxillary dentition is necessary for AOB patients with severe incisor exposure. In previous reports, a labial appliance with temporary anchorage devices (TADs) implanted in various positions has been used to achieve total intrusion of the maxillary dentition. This article describes the design and biomechanics of an anteroposterior lingual retractor (APLR) to attempt retraction of anterior teeth and total intrusion of maxillary dentition after premolar extraction in patients with both lip protrusion and AOB and the functions of each component of APLR is considered. When force is applied between the anterior lever arm of the APLR and a TAD in the midpalatal area, the anterior teeth are intruded and retracted with torque control. Because the direction of the APLR force and the guide bar are not parallel, intrusive force is generated in the posterior teeth. Due to this total intrusion of the maxillary dentition, the mandible is rotated counterclockwise, improving AOB with severe incisor exposure. Various cases are presented in which APLR was applied to AOB patients, and the clinical considerations behind the treatment are explained in detail.

NON-EXTRACTION ORTHODONTIC MANAGEMENT OF CROWDING OF AN ADOLESCENT BOY-A CASE REPORT

Orthodontic management of crowded dental arches require creation of spaces through certain space gaining methods. Extraction of 1st premolars had been the primary method of gaining space till the beginning of 21st century. This method has been tried to be avoided due to certain reasons such as typical dishing-in of face, re-opening of extraction spaces, longer duration of active orthodontic treatment etc. Recently, certain crowded situations can be managed successfully by means of mid-arch or whole-arch expansion, whole-arch distallization, proximal disking etc. This case report shows how a moderately crowded situation of a young boy can be managed by non-extraction method to reproduce presentable facial aesthetics and smile characteristics.

Low-level laser therapy and laser acupuncture therapy for pain relief after initial archwire placement : Arandomized clinical trial.

Pain is among the most unpleasant experience during fixed orthodontic therapy. This study compared the effectiveness of low-level laser therapy (LLLT) and laser acupuncture therapy (LAT) in pain reduction after initial archwire placement. This randomized, parallel-group, single-blind clinical trial included 60female patients who required four premolar extractions to relieve crowding. The subjects were randomly designated into four groups of 15. After placement of the initial orthodontic archwire, patients in group1 took ibuprofen (400 mg), whereas those in group2 received LLLT (808 nm, 200 mW, 2 J/cm2) on both buccal and lingual sides of the teeth. In group3 (LAT), the laser (808 nm, 200 mW, 24 J/cm2) was applied bilaterally to acupuncture points (SI18, ST6, LI4, SJ2, and SJ5). Subjects in group4 received placebo laser treatment. Patients were requested to record the intensity of spontaneous pain, pain while biting with anterior teeth, and pain while biting with posterior teeth at different times using avisual analogue scale (VAS). The intensity of spontaneous and biting pain increased up to the first or second days following initial archwire placement and diminished to anegligible value by the seventh day. No significant difference was found between the study groups concerning spontaneous and biting pain at any timepoint of investigation (P > 0.05). With the protocols used in the study, low-level laser therapy and laser acupuncture therapy were as effective as ibuprofen and placebo laser treatment for pain reduction in orthodontic patients. IRCT, IRCT20200622047886N1. Registered 2020-06-29; https://www.irct.ir/trial/49121.

Comparison of two methods in maxillary canine retraction

The aim of this prospective clinical study is to evaluate the effects of laceback and Uprighter techniques on maxillary canine retraction using digital models and panoramic radiographs and to compare the results.Sixteen patients (10 females, 6 males) with an average chronological age of 16.24±2.99 years, requiring fixed orthodontic treatment with upper canines located in a high vestibular position and the need for bilateral first premolar extraction, were included in this study. 0.018-inch Roth brackets were used in the patients. In this split-mouth design study, while laceback was used on one side, Uprighter was used on the other side. Tooth movements were measured on three-dimensional models and panoramic radiographs obtained at the beginning of treatment (T0), 2 months later (T1), and 3.5 months later (T2). Two-way analysis of variance was applied for the comparison of differences between the groups in repeated measurements.The difference between groups was found to be statistically significant in terms of canine distalization, canine rotation, and molar angulation amounts. There was no statistically significant difference in the other parameters.Both uprighter and laceback techniques can be applied in maxillary canine cases located in the high vestibule. When Uprighter is used, the canine is distalized much more. However, it should be noted that while more molar tipping may occur when laceback is used, more canine distopalatal rotation may occur when uprighter is used.

Comparative evaluation of four types of orthodontic miniscrews in high angle and low angle cases during en mass retraction – A 6 months follow up in vivo study

: To determine the stability and retraction achieved after 6 months of placement of four types of Orthodontic Miniscrews (TADs) in low angle and high angle cases during en masse anterior retraction.: 4 different interradicular miniscrews [FavAnchor (Favourite Supplies), VectorTAS (Ormco), JJ Orthodontics, SK Surgicals] of similar dimensions were placed on the 4 quadrants of maxilla and mandible in 20 patients (10 High Angle and 10 Low Angle) undergoing all I premolar extraction requiring group-A Anchorage and retraction was done using 0.019 x 0.025 Stainless Steel archwire closed coil NiTi springs for 6 months. OPG and Lateral cephalogram was taken before and immediately after 6 months of loading. The retraction, stability and maxillary anterior intrusion achieved by the miniscrews was assessed by measuring the distance of movement occurred in 6 months between marked landmarks before and after retraction.: The most efficient miniscrew in high angle cases was found to be Vector TAS (Retraction=6.11±0.202mm, Displacement=1.40±0.37mm) followed by Favanchor (Displacement=6.00±0.41mm, 1.25±0.44mm) in both maxilla and mandible. Similarly, in low angle cases it was Favanchor (Retraction=6.04±0.24mm, Displacement=0.99±0.46mm) followed by Vector TAS (Retraction=5.91±0.36mm, Displacement=.095±0.35mm) in both maxilla and mandible. There is miniscrew failure with a significant percentage of 1.87% excluding which, there was no statistic difference in the displacement in High angle as well as Low angle cases, whereas, with the inclusion of failure, there is statistically significant difference in the stability. The least efficient in retraction and stability were SK Surgicals and JJ Orthodontics.: There is significant difference in the stability and retraction among the four miniscrews used in High angle and Low angle as well as Maxilla and Mandible owing to the density of the bone at the implant site and the soft tissue present apart from the material and make of individual miniscrew systems.

Effect of laser corticotomy on canine retraction rate: a split-mouth randomized clinical trial

BackgroundThis study assessed the effect of corticotomy with Er: YAG (erbium-doped yttrium aluminium garnet) laser on the rate of canine retraction.MethodsThis randomized split-mouth controlled clinical trial was conducted on 12 patients undergoing orthodontic treatment with extraction of maxillary first premolars. Following initial leveling and alignment, an alginate impression was made from the maxillary arch, and Er: YAG laser corticotomy was performed in one of the maxillary quadrants of each patient. Canine retraction was started immediately after corticotomy by placement of nickel-titanium (NiTi) closed coil springs at both sides. At the end of each month, alginate records were repeated for 4 months. Study models were scanned, and the anteroposterior movement of canine was quantified bilaterally. Pain was also measured by a visual analog scale (VAS). Probing depth (PPD) of canines and two adjacent teeth was also evaluated and pulp vitality was assessed by performing the cold test. Data were analyzed by paired and independent t-test and one-way ANOVA (alpha = 0.05).ResultsThe rate of canine retraction was significantly greater in the laser-assisted corticotomy quadrant than the control (P < 0.05). No significant difference existed in posterior anchorage loss, canine rotation angle, PPD, pulp vitality, or pain score between two groups (P > 0.05).ConclusionsFlapless Er: YAG laser corticotomy significantly enhanced canine retraction rate with no adverse effect on other parameters.

Soft Tissue Responses to Orthodontic Treatment: Impact of Premolar Extraction on Diverse Growth Patterns.

Alteration in facial soft tissue plays an important role in the esthetics of an individual. The first thing a patient wants from orthodontic treatment is how well he/she looks. The degree of soft tissue changes brought about by the retraction of teeth can be influenced byfactors such as extraction pattern, muscle function, age, gender, weight, etc. Aim: The aim of the study was to compare post-orthodontic soft tissue changes among different facial growth patterns in orthodontic patients undergoing extraction of first premolar teeth. Pre-treatment and post-treatment lateral cephalograms of 45 orthodontic patients who underwent therapeutic extraction of the first premolars were included in the study. They were divided into three equal groups based on their facial growth pattern, that is, average, horizontal, and vertical. Eight soft tissue cephalometric measurements were done in all the lateral cephalograms. Paired Student t-tests and analysis of variance (ANOVA) were conducted to statistically analyze the results. The significance level was set as 0.05. The paired Student t-test showed a P-value > 0.05 for lower anterior facial height in all three groupsand for facial angle in vertical growers alone. ANOVA comparing the mean soft tissue changes among the three groups resulted in a P-value > 0.05 for all the measured parameters. Facial growth patterns donot influence the extent of soft tissue profile changes in orthodontic patients treated with extraction of first premolars.

Effects of two-phase treatment with functional appliances versus one-phase treatment with pre-molar extraction in Class II div 1 monozygotic twins: A case study

The aim of the study was to compare the skeletal, dental, or soft-tissue outcomes of a one-phase camouflage treatment with pre-molar extraction versus a two-phase treatment with combined twin-block high-pull headgear followed by fixed orthodontic treatment in monozygotic twins. 12-year-old male monozygotic twins presented to the dental clinic with complaints about their anterior teeth. Cephalometric analysis of the patients revealed skeletal Class II malocclusion and a long facial type. Extraoral examination of the patients revealed incompetence of lip seal and a convex profile. In Patient 1, the use of a high pull headgear combined with a twin block to correct skeletal anteroposterior and vertical malocclusions with growth modification and then fixed orthodontic treatment was planned. Patient 2 did not comply with the treatment, complaining that the use of the device could cause esthetic problems and difficulties in use. Therefore, camouflage treatment with extraction of four pre-molars was planned as another treatment option for Class II patients in Patient 2. With the camouflage treatment, the patient continued to grow normally. The combined treatment with twin block and a high pull occipital headgear resulted in inhibition of maxillary growth and a reduction in the severity of the skeletal Class II malocclusion, but the mandibular changes were similar in both patients at the end of treatment. Despite the different treatment modalities, both twins achieved a Class I canine-molar relationship and ideal overjet and overbite. Patients can close their lips with improved soft-tissue profiles. The criteria for the choice of treatment depend entirely on the requirements of the patient.

A pedicled buccal periosteal flap for the closure of oro-antral fistula

BackgroundAn oroantral fistula is a communication between the maxillary antrum and oral cavity. This pathological communication is formed mainly due to dental extraction of maxillary premolars and molars. Adequate management should include closing the oroantral fistula and eliminating sinus infections to prevent recurrence and sinusitis.PurposeThis study aimed to evaluate the effectiveness of using the pedicled buccal periosteal flap for closing an oroantral fistula without changing the native intraoral structure.Patients & MethodsPatients with oroantral fistulas were included in this study. The patients were examined clinically by Valsalva test and cheek-blowing test, the hole was probed, and the extent of the underlying bone defect was determined radiographically using computed tomography preoperatively. All patients underwent surgical closure of oroantral fistula using a pedicled buccal periosteal flap.ResultsAll 10 patients obtained satisfactory results with marked improvement in the function of the maxillary sinus and complete healing of oroantral fistula with no recurrence except in Case No. 5, who had a recurrence of the oroantral fistula, also there was no statistically significant difference between the vestibular depth preoperatively and postoperatively.ConclusionA pedicled buccal periosteal flap is a novel technique for oroantral fistula closure as it preserves vestibular depth with a tension-free closure flap and harbors the advantages of the regenerative potential of the periosteum.Registration date14/8/2023Registration numberNCT05987943

UNILATERAL EXTRACTION

Crowded teeth have a major negative influence on the dentomaxillary system. This article reports the treatment of crowding with unilateral premolar extraction. A 22-year-old male presented with crowding of the upper and lower anterior teeth and bucally placed 13. The patient had chief complaint of irregular upper and lower front teeth. Clinical examination showed a Class I relationship for the teeth and cephalometric measurements showed a Class I skeletal tendency. The right upper and lower first premolar were extracted for anterior crowding correction and segmented T loop was used for canine retraction in right upper arch . It is concluded that upper first premolar extraction is one of the options in the treatment of crowding. Unilateral premolar extraction treatment can be performed to achieve a functionally stable occlusion and aesthetically pleasing appearance of the patient.

Applying artificial intelligence to predict the outcome of orthodontic treatment

Objectives: The study aimed to train an algorithm to predict facial and dental outcomes following orthodontic treatment using artificial intelligence (AI). In addition, the accuracy of the algorithm was evaluated by four distinct groups of evaluators. Material and Methods: The algorithm was trained using pre-treatment and post-treatment frontal smiling and intraoral photographs of 50 bimaxillary patients who underwent all first bicuspid extraction and orthodontic treatment with fixed appliances. A questionnaire was created through Google form and it included 10 actual post-treatment and AI-predicted post-treatment images. The accuracy and acceptability of the AI-predicted outcomes were analyzed by four groups of 140 evaluators (35 orthodontists, 35 oral maxillofacial surgeons, 35 other specialty dentists, and 35 laypersons). Results: The Style-based Generative Adversarial Network-2 algorithm used in this study proved effective in predicting post-treatment outcomes using pre-treatment frontal facial photographs of bimaxillary patients who underwent extraction of all first bicuspids as part of their treatment regimen. The responses from the four different groups of evaluators varied. Laypersons exhibited greater acceptance of the AI-predicted images, whereas oral maxillofacial surgeons showed the least agreement. The base of the nose and the chin demonstrated the most accurate predictions, while gingival visibility and the upper lip-to-teeth relationship exhibited the least prediction accuracy. Conclusion: The outcomes underscore the potential of the method, with a majority of evaluators finding predictions made by the AI algorithm to be generally reliable. Nonetheless, further research is warranted to address constraints such as image tonicity and the proportional accuracy of the predicted images.