Orthodontic Procedures Research Articles

Space regaining and transverse correction in early mixed dentition: A case report

The premature loss of primary teeth can lead to significant orthodontic issues, including the loss of space and improper alignment of permanent teeth. Space regainers, particularly non-compliant ones, are orthodontic devices designed to restore lost space without relying on patient compliance. These devices are especially valuable in pediatric orthodontics, where maintaining patient cooperation can be challenging. This report aims to demonstrate the use of non-compliant space regainers, specifically an open coil spring and AJ Wilcock wire, to recover space following the early loss of the upper second deciduous molar. Additionally, the effectiveness of these devices in addressing crossbite and correcting molar relations will be assessed.A case study was conducted on a pediatric patient who experienced the premature loss of the upper second deciduous molar. Non-compliant space regainers, including an open coil spring and AJ Wilcock wire, were utilized to distalize the molars and correct the crossbite using a transpalatal arch (TPA). Treatment progress was monitored, with final evaluations scheduled after the eruption of the premolars to assess the completeness of molar relation and crossbite correction. The use of open coil spring and AJ Wilcock wire successfully regained space, with significant improvements in molar relation and crossbite correction. The results closely matched the planned treatment goals. Further correction of the molar relation and crossbite will be evaluated post-eruption of the premolars.Non-compliant space regainers provide a dependable solution for managing space loss and crossbite, particularly in situations where patient cooperation is difficult. These devices have proven to be effective in achieving early correction, reducing the need for more complex orthodontic procedures. Continued research is needed to optimize the use of non-compliant space regainers and evaluate their long-term efficacy in various orthodontic scenarios.

Surface Precision in Orthodontics: A Comprehensive Analysis of Interproximal Reduction Methods Using Atomic Force Microscopy

ABSTRACT Background: Interproximal reduction (IPR) is a common orthodontic procedure aimed at creating space between teeth for proper alignment. Objective: The objective of this study is to comprehensively evaluate and compare the impact of three distinct IPR methods on the surface roughness of mandibular teeth using atomic force microscopy (AFM). Methods: A total of 128 extracted human mandibular teeth were allocated evenly into three groups: Group A (manual IPR), Group B (rotary-disc IPR), and Group C (laser-assisted IPR). Each group underwent specific IPR procedures, and the surface roughness was evaluated using AFM. The study employed rigorous randomization and precise calibration of instruments. Results: The findings indicate that Group A (manual IPR) exhibited the smoothest surfaces, while Group C (laser-assisted IPR) demonstrated the highest surface roughness. Statistical analyses revealed significant differences among the groups (P < 0.05). Location-specific analysis highlighted variations across different areas of the interproximal surfaces. Conclusion: The choice of IPR method significantly influences the surface roughness of mandibular teeth. Manual IPR appears to yield the smoothest surfaces, while laser-assisted IPR may result in increased roughness. These findings have implications for clinical decision-making in orthodontic practices.

Patch-based convolutional neural networks for automatic landmark detection of 3D facial images in clinical settings.

The facial landmark annotation of 3D facial images is crucial in clinical orthodontics and orthognathic surgeries for accurate diagnosis and treatment planning. While manual landmarking has traditionally been the gold standard, it is labour-intensive and prone to variability. This study presents a framework for automated landmark detection in 3D facial images within a clinical context, using convolutional neural networks (CNNs), and it assesses its accuracy in comparison to that of ground-truth data. Initially, an in-house dataset of 408 3D facial images, each annotated with 37 landmarks by an expert, was constructed. Subsequently, a 2.5D patch-based CNN architecture was trained using this dataset to detect the same set of landmarks automatically. The developed CNN model demonstrated high accuracy, with an overall mean localization error of 0.83 ± 0.49mm. The majority of the landmarks had low localization errors, with 95% exhibiting a mean error of less than 1mm across all axes. Moreover, the method achieved a high success detection rate, with 88% of detections having an error below 1.5mm and 94% below 2mm. The automated method used in this study demonstrated accuracy comparable to that achieved with manual annotations within clinical settings. In addition, the proposed framework for automatic landmark localization exhibited improved accuracy over existing models in the literature. Despite these advancements, it is important to acknowledge the limitations of this research, such as that it was based on a single-centre study and a single annotator. Future work should address computational time challenges to achieve further enhancements. This approach has significant potential to improve the efficiency and accuracy of orthodontic and orthognathic procedures.

Three-dimensional digital imaging analysis of the palatal bone thickness for orthodontic mini-implant insertion – determination of the safe zone and angulation

BackgroundIn order to successfully perform orthodontic mini-implant procedures successfully for the subsequent anchoring of orthodontic appliances, it is crucial to know the palatal bone thickness. This is usually assessed using two-dimensional radiographs. The purpose of this study was to use a three-dimensional digital imaging measurement method to provide information on palatal bone volume and bone thickness and to make recommendations on the optimal and safe insertion site and angle for palatal mini-implants.MethodsFor this observational, cross-section study, pre-existing cone beam computed tomography scans of 184 patients were converted into 3D Standard Tessellation Language (STL) models of the maxilla. The area between the canine and the first molar was divided into 6 regions of interest (ROIs), three on the left side of the palate and three on the right side. The bone thickness of the palate was analyzed volumetrically and linearly while simulating different mini-implant insertion angles of 0°, 10°, 20° and 30° degrees relative to the palatal surface.ResultsAmong the ROIs, the greatest mean bone thickness was observed in the region of the first premolars with a mean distance (MD) of 10.44 ± 2.53 mm and decreased from anterior to posterior (MD: 3.44 ± 1.16 mm). The highest volume (Vol) values were also measured in the anterior palatal region (Vol: 1127.26 ± 483.91 mm3), while there was also a decrease in the posterior region (Vol: 394.36 ± 180.22 mm3). Regarding the simulated palatal mini-implant insertion sites, the greatest bone thickness was found in the anterior region, at the level of the canines with an angle of 0° (MD: 12.25 ± 3.75 mm). In the more posterior region, at the level between the first and second premolars, the greatest bone thickness was observed at an angle of 30° (MD: 7.93 ± 3.81 mm). Gender differences were found.ConclusionThis clinical study showed that the paramedian region at the level of the first premolar is the safest site for orthodontic mini-implant placement as evaluated by three-dimensional measurements. The results showed that implant insertion angle, gender and age are important aspects to consider when planning and inserting orthodontic palatal mini-implants.Trial registrationN.a.

Healthcare Trajectories of Adolescent Patients With Cleft Lip and/or Palate According to Health Insurance Coverage in Medellin, Colombia.

To describe and compare the healthcare trajectories of patients with CL/P under two different income-based programs for health coverage in Colombia, known in Colombia as a health insurance regime (contributory and subsidized), in Medellín, 2021. Non-experimental, cross-sectional questionnaire-based study. Primary level of clinical care in Medellín, Colombia. Twenty-eight 15- to 21-year-olds with CL/P and primary caregivers. Individuals with CL/P answered the survey. Patients with syndromic CL/P and patients with cognitive disabilities were excluded. The calculation of the probabilistic sample was performed based on the formula for finite populations using databases from 2 health insurance companies. The analysis was descriptive and bivariate. Chi-square and Fisher tests were used to analyze the variables of interest. Continuity of the care pathway was measured with proxy indicators: (1) access to comprehensive CL/P treatment; (2) timeliness of access to comprehensive CL/P treatment; (3) differences in access to and timeliness of comprehensive CL/P treatment between patients under both health insurance coverage. No differences were found when comparing the healthcare trajectories of young patients with CL/P who were in both health coverage. Differences were observed in the timeliness of care for patients with CL/P under the subsidized coverage who were more economically vulnerable. Delays in care were mainly linked to administrative procedures required for orthodontic procedures, bone grafts, and maxillofacial surgeries. Despite the health system's guarantee of equal care across income levels, differences in the timeliness of care persist for patients from lower-income families.

Evolution of orthodontic services in the Brazilian Unified Health System: a time series analysis (2011–2022)

BackgroundAlthough malocclusion is the third most prevalent oral health condition, orthodontics is not part of the minimum list of mandatory specialties to be offered in the Dental Specialty Centers of the Brazilian public health system, but rather as optional. Since the acknowledgment of this field as a part of the Brazilian Unified Health System (SUS), access to orthodontic procedures has become optional by municipal governments. Therefore, this study analyzed the evolution of orthodontic procedure provision within SUS from 2011 to 2022.MethodologyWe conducted a retrospective observational study of time series analysis trends on the number of orthodontic procedures and municipalities offering them. The presentation of findings followed the recommendations of the Reporting of Studies Conducted using Observational Routinely Collected Data. Secondary data from 2011 to 2022 were collected from the SUS Department of Informatics. Orthodontic procedures were organized by year, region, state, and municipality. The study applied descriptive analyses, and the Prais-Winsten generalized linear regressions for time series analysis.ResultsThe quantity of municipalities offering orthodontic procedures have shown a small increasing during period analyzed (from 128 to 157). Northeast and South macro-regions have increased consistently the municipalities with orthodontic offering. All regions showed stable trends for each procedure, except for the South, which exhibited increasing rates of space maintainer placement (Annual Percentage Change (APC): 72.95; 95% CI: 31.6, 127.3) and maintenance sessions (APC: 15.40; 95% CI: 4.5, 27.5). The study showed decreasing trends for appliance removal in the South (APC: -38.07; 95% CI: -47.1, -27.5) and Northeast (APC: -25.19; 95% CI: -36.5, -11.9) regions.ConclusionFrom 2011 to 2022, there was a small increase in number of municipalities offering orthodontic procedures in the Brazilian public health system, in addition to a stationary trend for almost all types of procedures.

Nanoparticles in Orthodontics: A Review

The advent of nanotechnology has significantly impacted various fields of medicine, including orthodontics. This scientific study delves into the realm of nanotechnology and its implications in orthodontics. It explores various applications such as bolstering the antimicrobial properties of orthodontic resins to mitigate enamel demineralization and management of frictional forces during orthodontic procedures. This review discusses the application of nanoparticles in orthodontics, focusing on their benefits, types, and future prospects.

Effectiveness of high-frequency vibration, cotton rolls and elastomeric wafers in alleviating debonding pain of orthodontic metal brackets: a randomized clinical trial

This study aimed to evaluate the effectiveness of different pain mitigation methods during orthodontic debonding and to evaluate pain sensitivity across various regions of the dentition. A total of 144 participants (50 males and 94 females) with metal brackets were randomly assigned to one of four groups: High-Frequency Vibration (V), Cotton Roll (CR), Elastomeric Wafer (EW), and Open Mouth group (OM). Pain levels were measured using the Visual Analog Scale (VAS) across different sextants of the dentition. The Kruskal-Wallis test and post hoc analyses were conducted to compare VAS scores between groups. The Mann-Whitney test was used to analyse sex-based differences. The V group, utilizing high-frequency vibration, had the lowest total VAS score, indicating superior pain relief compared to CR, EW, and OM groups. No significant difference was observed between the CR and EW groups. Median VAS scores were highest in the lower front sextant, followed by the upper front sextants, and lowest in the posterior regions, indicating greater pain sensitivity in the anterior regions during debonding. High-frequency vibration was the most effective method for reducing pain during orthodontic debonding, particularly in the anterior dental regions. Both CR and EW methods were also effective but to a lesser extent. These findings suggest that high-frequency vibration could significantly improve patient comfort during orthodontic procedures. Utilizing high-frequency vibration for orthodontic debonding can enhance patient comfort, especially in the more sensitive anterior dental regions, thereby potentially improving treatment compliance and experience.Trial registration: NCT05904587.

Root resorption-an overview

Root resorption is a naturally occurring phenomenon in primary dentition for the exfoliation of teeth. Root resorption in permanent teeth is a pathologic process that is not only specific to trauma or infections of pulp but also likely to occur due to untoward sequelae of any orthodontic procedures. There are internal and external types of root resorption, each having its variety. External apical root resorption is primarily asymptomatic, thereby mostly accidentally revealed by radiographic examination. Early diagnosis is essential to prevent, and manage the consequences, and to provide an optimal treatment option for the patient.

Effects of Attachment Design and Aligner Material on Mandibular Canine Distal Bodily Movement in Aligner Treatment

Abstract Purpose Dental crowding is a result of a mismatch between tooth size and arch dimensions, which leads to malocclusion; treatment often involves premolar extraction before orthodontic alignment. Clear aligners are limited in their ability to achieve canine distal bodily movement, a common orthodontic maneuver. This study investigated the impacts of attachment design and aligner material on the efficacy of canine distal bodily movement. Methods A finite element analysis was conducted to examine the impact of various attachment designs and two aligner materials, thermoplastic polyurethanes/polycarbonate (TPU/PC) and polyethylene terephthalate glycol-modified (PETG), on mandibular canine distal bodily movement. The investigation focused on the biomechanical responses in the periodontal ligament (PDL) and surrounding alveolar bone. Results Attachment configuration exerted a strong influence on mandibular canine movement. Vertically oriented attachment pairs positioned mesially (mesial occlusal–mesial cervical) resulted in the most effective canine distal bodily movement, followed by a rectangular attachment. TPU/PC aligners induced slightly higher principal stresses in the PDL and von Mises stress and strain in the surrounding alveolar bone compared with PETG aligners; however, the difference was negligible, amounting to less than 6%. Conclusion Attachment design, specifically vertically oriented pairs positioned mesially (mesial occlusal–mesial cervical), was determined to be the crucial factor influencing the efficacy of canine distal bodily movement. The choice of aligner material (TPU/PC or PETG) has minimal impact on this orthodontic procedure.

Pain Perception, Knowledge, Attitude, and Diet Diversity in Patients Undergoing Fixed Orthodontic Treatment: A Pilot Study.

This study aimed to determine the correlation between pain perception and knowledge, attitude, and diet diversity in patients undergoing fixed orthodontic treatment. A total of 103 patients (15-40 yrs.; 67 females, 36 males) undergoing orthodontic treatment with a 0.022-inch slot (MBT prescription) in both arches were recruited. Information on pain perception, knowledge, attitude, and diet diversity scores was collected through validated questionnaires using visual analogue scale and close-ended questions at one time point. The correlation between variables was analyzed using the Pearson's correlation coefficient. Of the patients, 48.5% were aged 15 to 19 years old, with 65% females and 73.8% of Chinese ethnicity. Approximately 90% of the orthodontic patients perceived low levels of pain from orthodontic treatment, and 98% had a positive attitude toward orthodontic treatment. The patients had a good level of knowledge (Mean: 6±0.65). Approximately 49.5% of patients reported having moderate diet diversity. No significant correlation was found between pain perception and knowledge, or pain perception and diet diversity (r=0.062, p=0.534). However, a significant weak negative correlation (r=-0.289, p<0.05) between pain perception and attitude was observed. Patients undergoing fixed orthodontic treatment presented with overall low pain perception, a positive attitude, and good knowledge about their treatment with moderate diet diversity. Informing the patient in advance about different orthodontic procedures encourages a positive attitude and facilitates patient cooperation. An interprofessional approach involving nutritionists can provide a holistic patient approach during orthodontic treatment.

An in vitro study of a combined patient-specific device for safe and accurate insertion of infrazygomatic crest miniscrews.

To develop and assess the efficacy of a novel combined patient-specific device (CPSD) for the accurate and safe insertion of infrazygomatic crest miniscrews in orthodontic procedures. Twenty-eight miniscrews were placed in the infrazygomatic crest region of 28 cadaver maxillae using the direct manual method (n = 14) or the CPSD (n = 14) based on preset trajectories. The CPSD, designed based on the integration model, included a positioning guide, an insertion guide, and a depth-limiting groove. Deviations in the insertion site, tip location, insertion angle, and biting depth between the preset and real insertion trajectories were calculated to evaluate the accuracy of miniscrew insertion. Classification frequencies of root proximity, sinus penetration depth, and biting depth of the miniscrew after insertion were also calculated to evaluate the safety of miniscrew insertion. Regarding evaluation of accuracy, significant differences were observed in the deviation values of the insertion site, tip location, insertion angle, and biting depth between the CPSD and freehand groups (P = .001, P < .001, P < .001, P = .039, respectively). Regarding evaluation of safety, a significant difference was observed in the classification frequencies of root proximity between the two groups (P = .016). Compared with manual insertion, CPSD could be a preferred method for safe and accurate insertion of infrazygomatic crest miniscrews for orthodontists.

DetSegDiff: A joint periodontal landmark detection and segmentation in intraoral ultrasound using edge-enhanced diffusion-based network

Individuals with malocclusion require an orthodontic diagnosis and treatment plan based on the severity of their condition. Assessing and monitoring changes in periodontal structures before, during, and after orthodontic procedures is crucial, and intraoral ultrasound (US) imaging has been shown a promising diagnostic tool in imaging periodontium. However, accurately delineating and analyzing periodontal structures in US videos is a challenging task for clinicians, as it is time-consuming and subject to interpretation errors. This paper introduces DetSegDiff, an edge-enhanced diffusion-based network developed to simultaneously detect the cementoenamel junction (CEJ) and segment alveolar bone structure in intraoral US videos. An edge feature encoder is designed to enhance edge and texture information for precise delineation of periodontal structures. Additionally, we employed the spatial squeeze-attention module (SSAM) to extract more representative features to perform both detection and segmentation tasks at global and local levels. This study used 169 videos from 17 orthodontic patients for training purposes and was subsequently tested on 41 videos from 4 additional patients. The proposed method achieved a mean distance difference of 0.17 ± 0.19 mm for the CEJ and an average Dice score of 90.1% for alveolar bone structure. As there is a lack of multi-task benchmark networks, thorough experiments were undertaken to assess and benchmark the proposed method against state-of-the-art (SOTA) detection and segmentation individual networks. The experimental results demonstrated that DetSegDiff outperformed SOTA approaches, confirming the feasibility of using automated diagnostic systems for orthodontists.

An Umbrella Review for Assessment of Treatment Effectiveness of Clear Aligners Compared to Conventional Fixed Appliances in Orthodontic Patients

Introduction Orthodontic improvements, mainly through the previous decade, have led to a substantial rise in patients’ esthetic needs. Traditional orthodontic procedures have been linked with a compromise in facial appearance, which increases concern among patients pursuing orthodontic treatment. Methods PubMed, MEDLINE, Google Scholar, and Cochrane Library of Systematic Reviews databases were searched using appropriate entry terms and Boolean operators. Search strategy was conducted till June 2022 for systematic reviews and meta-analyses. Publications were systematically assessed for eligibility, and two observers independently graded the methodologic quality using AMSTAR-2 tool. For each meta-analysis, we estimated the summary effect size by the use of random-effects and fixed-effects models and the 95% confidence interval. We estimated the between-study heterogeneity expressed by I 2 (defined as large for I 2 ≥50%), evidence of small-study effects (i.e., large studies had significantly more conservative results than smaller studies), and evidence of excess significance bias (i.e., more studies than expected with significant results). Results Overall, 16 unique systematic reviews and meta-analyses following the eligibility criteria were selected for umbrella review. The results of qualitative analysis of studies revealed that 4 studies had a critically low risk of bias, 11 showed low risk, and 1 study had moderate risk. The results of the meta-analysis favored clear aligners with respect to oral hygiene and root resorption parameters. When tooth movements were considered, the results favored conventional orthodontic treatment. Conclusion Clear aligner therapy (CAT) has significant advantages with regard to efficiency (treatment time, chair time) in mild-moderate malocclusion cases. The overall accuracy of CAT when compared to fixed orthodontic treatment was found to be 55-82%.

Primary Headache Relief in Paediatric Patients Following Rapid Maxillary Expansion: a Prospective Study and Cephalometric Changes Analysis.

Primary headaches (PH) are a group of disorders greatly impairing quality of life, highly prevalent in growing population. Previous studies suggested a rhinogenic involvement in PH episodes. Modifications of nasal cavities and septum take place during rapid maxillary expansion (RME). This study aims to investigate the role of skeletal modifications due to RME on PH episodes. Sixty-eight growing patients (30/38 MF 7-12 y.o 9.2 ± 1.3 SD) were enrolled. All the selected sample patients reported at least 12 PH episodes in the previous year and were diagnosed with maxillary constriction to be treated with RME. Changes in PH episodes before and after this orthodontic procedure were analysed using paired t-tests. Correlations between age and PH episodes were assessed using Spearman correlation coefficients. Correlations between cephalometric changes and PH episodes were investigated using paired t-tests. RME produces significant modifications in maxillary and nasal width and lower nasal length and decreased monthly episodes of PH significantly. It can be supposed and inferred that RME has beneficial effects on PH in growing patients.

A cross-temporal multimodal fusion system based on deep learning for orthodontic monitoring

IntroductionIn the treatment of malocclusion, continuous monitoring of the three-dimensional relationship between dental roots and the surrounding alveolar bone is essential for preventing complications from orthodontic procedures. Cone-beam computed tomography (CBCT) provides detailed root and bone data, but its high radiation dose limits its frequent use, consequently necessitating an alternative for ongoing monitoring. ObjectivesWe aimed to develop a deep learning-based cross-temporal multimodal image fusion system for acquiring root and jawbone information without additional radiation, enhancing the ability of orthodontists to monitor risk. MethodsUtilizing CBCT and intraoral scans (IOSs) as cross-temporal modalities, we integrated deep learning with multimodal fusion technologies to develop a system that includes a CBCT segmentation model for teeth and jawbones. This model incorporates a dynamic kernel prior model, resolution restoration, and an IOS segmentation network optimized for dense point clouds. Additionally, a coarse-to-fine registration module was developed. This system facilitates the integration of IOS and CBCT images across varying spatial and temporal dimensions, enabling the comprehensive reconstruction of root and jawbone information throughout the orthodontic treatment process. ResultsThe experimental results demonstrate that our system not only maintains the original high resolution but also delivers outstanding segmentation performance on external testing datasets for CBCT and IOSs. CBCT achieved Dice coefficients of 94.1 % and 94.4 % for teeth and jawbones, respectively, and it achieved a Dice coefficient of 91.7 % for the IOSs. Additionally, in the context of real-world registration processes, the system achieved an average distance error (ADE) of 0.43 mm for teeth and 0.52 mm for jawbones, significantly reducing the processing time. ConclusionWe developed the first deep learning-based cross-temporal multimodal fusion system, addressing the critical challenge of continuous risk monitoring in orthodontic treatments without additional radiation exposure. We hope that this study will catalyze transformative advancements in risk management strategies and treatment modalities, fundamentally reshaping the landscape of future orthodontic practice.

Orthodontic and Surgical Management of Meir-Gorlin Syndrome: 7 Years of Follow-Up

Introduction: Meier-Gorlin syndrome (MGS) has three characteristics: short stature, a small or absent patella, and microtia. Objective: This case report aimed to evaluate orthodontic surgical treatment in a patient with MGS during a 7-year follow-up. Methods: A multidisciplinary approach was performed involving orthodontics and maxillofacial surgery. In the initial phase, orthodontic procedures were performed using rapid expansion of the mid-palatal suture. Orthodontic appliances (Roth prescription) were used and orthodontic decompensation was performed, followed by orthodontic surgery to make aesthetic and functional changes. Results: Surgical orthodontic treatment reduced proclination and protrusion and improved overbite. An adequate correlation of the upper and lower arches was achieved. Aesthetic and functional changes were observed, as well as the opening of the airways. Conclusion: This case report highlights the importance of orthodontic surgical correction to achieve symmetry and functionality, given the facial and physical characteristics present in this syndrome.

Evaluation of Biomarkers of Bone Metabolism on Salivary Matrix in the Remodeling of Periodontal Tissue during Orthodontic Treatment.

The aim of this study was to evaluate changes in the concentration of N-terminal type I collagen extension pro-peptide (PINP), tartrate-resistant acid phosphatase (TRAcP), and parathyroid hormone-related protein (PTHrP) in saliva during orthodontic treatment in order to evaluate whether changes in bone turnover marker (BTM) concentration can help highlight the effects of orthodontic mechanical loading in the absence of clinical evidence of tooth movement in terms of tooth movement. Saliva samples from 25 apparently healthy young subjects (10 females and 15 males) were collected using Salivette® (Sarstedt) with cotton swabs and the concentrations of PTHrP, TRAcP 5b, and PINP were analyzed at time 0 (T1), 25 days (T2), and at 45 days (T3). Differences in the median value of biomarker levels between baseline T1 and follow-up of the different groups (T2 and T3) were assessed using the non-parametric Mann-Whitney U test. Trough concentrations of P1NP, PTHrP, and TRAcP were 0.80 µg/L, 0.21 ng/mL, and 0.90 U/L above the method LOD. The non-parametric Mann-Whitney U test confirmed a statistically significant difference in T1 versus concentrations of T2 and T3. All subjects evaluated had a statistically significant difference between T1 vs. T3. when compared with the specific critical difference (RCV) for the analyte The results obtained demonstrate that the evaluation of BTM changes in saliva can help the evaluation of orthodontic procedures and the monitoring of biomechanical therapy.

Perceptions and Knowledge of Orthodontic Treatment by an Adult Group in Romania

This paper aims to study an adult population’s perception and knowledge of orthodontic treatment within the context of Romania, aiming to underscore the pivotal role of this kind of treatment in improving oral health and enhancing quality of life. Acknowledging malocclusion as a prevalent oral health issue, it is observed that while an increasing number of people seek orthodontic treatment, significant misperceptions remain, emphasizing the need for patient adherence to and knowledge of the effective planification of orthodontic treatment plans. Utilizing a cross-sectional methodology, the authors developed a questionnaire and disseminated it via social media platforms to examine the attitudes and awareness levels among 132 Romanian adults regarding orthodontic treatment. The findings reveal a strong awareness concerning orthodontic procedures. Most of the subjects (61.4%) were of the opinion that, during orthodontic treatment, patients look good and 80.3% assessed the treatment as being expensive. In total, 73.5% of the participants were aware that during orthodontic treatment patients have food restrictions and that neglect can affect the treatment, while 78% thought that brackets and wires can break if care is not taken. Notably, respondents with prior orthodontic treatment showed a higher level of comprehension of the process, including an acknowledgment of the necessity for augmented oral hygiene practices and the implications of non-compliance. The results show a generally affirmative opinion on orthodontic treatment, with a recognition of its long-term benefits for oral health and aesthetics. Nevertheless, the perceived economic and physical barriers to access, underscore a need for patient education. In summary, understanding patient perceptions and knowledge of orthodontic treatment not only fosters enhanced patient–orthodontist relationships but also empowers dental professionals to customize educational strategies that amplify treatment efficacy. The study advocates for sustained efforts to disseminate information related to orthodontic care, promoting its benefits as a key aspect of oral health.

Non-surgery Treatment with MEAW Technique in Skeletal Class III Malocclusion and Facial Asymmetry in Adults: A Case Report

Background Treating skeletal Class III malocclusions characterized by mandibular deviation, facial asymmetry, and other complex orthodontic issues is among the most demanding orthodontic procedures. Orthognathic surgery is not recommended to everyone due to the dangers involved. Hence, it is considered to be very difficult to correct face asymmetry with orthodontics alone, much less without surgery. Objective The goals of this case study were to decrease crowding in the upper teeth, manage the vertical dimension, and treat the patient's primary complaints of crossbite in the anterior teeth and facial asymmetry. Case Presentation A female patient, aged 21, came in with many concerns, including an incisor crossbite, facial asymmetry, and an insecurity that manifested only when she smiled. An adult patient with a mandibular deviation to the right and an incisor crossbite received orthodontic treatment for these issues. The patient had asymmetric molar extraction in both the lower and upper jaws to retract the lower incisors and correct the midline of the teeth using intermaxillary elastic. Fixed appliances were utilized in conjunction with overbearing lower anterior braces to manage the torque on the lower anterior teeth. As a result, she had a pleasant smile, a harmonious face, and stable dental and skeletal connections. The whole therapeutic period lasted 30 months. As a result, asymmetric molar extraction may be an acceptable option for retracting mandibular incisors in Class III malocclusion with facial asymmetry. Conclusion The most important step in treating the severe skeletal Class III malocclusion in this patient without surgery was to retract the lower arch. After using the MEAW approach, Class III elastics, posterior bite turbos, and orthopedic splint treatment, the patient reported a satisfactory achievement.