Removable Appliances Research Articles

Correction of Maxillary Multiple Diastem and Mandibular Crowding with Removable Orthodontic

Crowding and diastema are common malocclusion conditions that occur due to a discrepancy between tooth size and jaw size. The treatment that can be done is based on the severity of the case. Mild cases of malposition can be treated with removable orthodontic appliances. This article aims to show the analysis how an active plate device with a simple spring was used to treat multiple maxillary diastemas and anterior crowding of the mandible. The patient complained that his upper front teeth gap and his lower teeth were crowded. It does not interfere with the appearance, but sometimes open food is tucked between the front teeth. The patient has never used an orthodontic appliance before. Molar relation: Malocclusion Angle class 1 type dental with mild individual tooth malposition. Twenty-two treatment visits were performed. Treatment was carried out using an active plate with a simple spring on teeth 13, interdental 31-41, and 43; retentive components using Adam Clamer on teeth 16, 26, 36, and 46; long labial arch with U loops on the right and left permanent 1st premolar teeth. In the 22nd control, the results showed that teeth 11, 21, and 43 malpositions were corrected, and the diastema was closed on tooth 14 against 13 and tooth 21 against 22. In addition, the width of the diastema on interdental 13-12, 12-11, and 22-23 was reduced to 0.05 mm. An active plate with a simple spring can correct diastema and mild crowding of the anterior teeth

The analysis of the most common problems associated with wearing removable orthodontic appliances by patients attending dental clinics at the universities of Kerbala

Objective: To evaluate the problems patients perceive during orthodontic treatment with removable and myofunctional appliances. Study Design: Cross-sectional study. Place and Duration of Study: Prosthodontic Department, College of Dentistry, University of Kerbala, from March 2021 to July 2021. Methodology: A total of 210 orthodontic patients who had been wearing removable and myo-functional orthodontic appliances for at least four months were included in the study. Patients were divided into two groups aged between 10 to 40 years. A questionnaire comprising 11 items covering physical, functional, psychological, and social problems associated with wearing removable and myofunctional orthodontic appliances was used to analyze the outcome variables. Patients were interviewed at Kerbala University. Results: In this study, 107 (51%) patients were male, and 103 (49%) were female, with ages ranging from 10 to 40 years. Forty-four (21%) patients reported reeling pain after insertion of removable and myofunctional appliances. A relatively higher percentage of male patients (44.5%) believed the appliance was effective, and 40% found it comfortable. Difficulty in speaking (36.7%) was the most frequent problem reported by the patients in the studied population. Conclusion: Despite a few problems, wearing removable and myofunctional orthodontic appliances remained an effective and viable treatment option for uncomplicated malocclusions.

A Three-Dimensional Evaluation of Skeletal and Dentoalveolar Changes in Growing Class II Patients after Functional Appliance Therapy: A Retrospective Case-Control Study.

Background: The aim was to assess three-dimensionally mandibular and maxillary changes in growing Class II patients treated with removable functional appliances followed by fixed appliances. Methods: Twenty-four Class II patients (age range: 9 to 14, mean: 12.1 ± 1.1 years) treated with removable functional appliances followed by fixed appliances (functional appliance group-FAG) were retrospectively selected and compared to an age-matched control group (CG) treated with fixed appliances only. To be included in the study, pre- and post-treatment CBCT scans had to be available. The CBCTs were used to analyze, in 3D, the changes following treatment and growth. Results: Before treatment, overjet (FAG: 9 mm ± 2.8 (mean ± standard deviation); CG: 4 mm ± 1.7), ANB (FAG: 5.7° ± 2.0; CG: 3.2° ± 1.4), and effective mandibular length (FAG: 113.0 mm ± 4.1; CG: 116.6 mm ± 5.9) were statistically significantly different between the two groups. After treatment, overjet (FAG: -6.8 mm ± 2.8; CG: -1.8 mm ± 1.8) and effective mandibular length (FAG: 6.3 mm ± 2.6; CG: 3.9 mm ± 2.6) statistically significantly changed. There was a significant difference in the treatment effect between the FAG and the CG in overjet, ANB, and effective mandibular length. Conclusions: The results indicate that functional appliances are effective in correcting Class II malocclusions. The growth modification in the FAG resulted in an increase in mandibular length. Yet, the final length of the mandible in the FAG was smaller when compared to the CG.

Sleep and other indicators of quality of life during orthodontic treatment with fixed or removable appliance

Sleep and other indicators of quality of life during orthodontic treatment with fixed or removable appliance

Effect of orthodontic appliances on masticatory muscle activity

There is limited and conflicting evidence regarding the impact of orthodontic appliances on masticatory muscle activity (MMA), jaw function, and oral parafunctional behaviours. Investigations in this field frequently utilise surface electromyography (sEMG) to analyse changes in muscle contractile activity. Fixed orthodontics appliances have been associated with significant reductions in MMA post archwire activation. Conversely, elevations in masseter and digastric muscle activity have been reported in response to removable functional appliances. Research into the effect of clear aligner therapy (CAT) on MMA is still in its infancy with few studies published. There is a lack of agreement on whether MMA increases or diminishes in response to CAT though there is evidence this relationship may change over time due to muscle adaptation. The impact of CAT on temporomandibular disorder (TMD) symptoms is unclear, particularly how pre-existing risk factors for TMD may alter and individual's response.

Effects of different orthodontic appliances on Actinomyces spp.

This study aims to identify the presence of Actinomyces species in the oral flora during orthodontic treatments using removable appliances and fixed wire technique, and to track changes throughout the treatment process. In this study, subgingival and supragingival plaque samples obtained from 48 patients undergoing orthodontic treatment at a dental facilities of Ataturk University, Türkiye were utilized as the primary material. The study groups comprised individuals undergoing fixed orthodontic treatment, those using removable appliances, and individuals who had not undergone any orthodontic treatment. Plaque samples were collected from the patients at the initiation of treatment and six months thereafter. After selective culturing in a specific medium, dental plaque samples were purified and subjected to microbial analysis using the VITEK 2 system (Biomerieux). The study aimed to identify and compare the microbial content of plaque samples from different orthodontic treatment groups. Actinomyces species were identified in all groups at both the initiation of treatment (T0) and six months later (T1) periods. At the beginning of treatment, Actinomyces species were found in 33 samples, while at six months, they were present in 18 samples. The curent study revealed similar microorganisms among the groups at both T0 and T1 periods. The Actinomyces species identified in this study include Actinomyces meyeri, Actinomyces naeslundii, and Actinomyces odontolyticus. It is evident that orthodontic treatments significantly impact oral health and that Actinomyces microorganisms are always likely to be present in the oral flora. Asian J. Med. Biol. Res. 2024, 10(1), 1-8

Dental Developmental Anomalies and Their Management: An Orthodontic Perspective

Abstract Dental developmental anomalies present intricate challenges in orthodontic practice, necessitating tailored treatment approaches for optimal outcomes. This review offers a comprehensive examination of current orthodontic strategies for managing such anomalies, emphasizing practical considerations, treatment options, and clinical insights, while delving deeper into the anomalies themselves. From anomaly in number to anomaly in structure, dental developmental anomalies encompass a diverse spectrum of conditions, each characterized by deviations from normal dental development. These anomalies may arise due to genetic factors, environmental influences, or a combination of both, and can significantly impact a patient’s oral health, function, and aesthetics. Early detection and intervention are crucial in addressing dental developmental anomalies effectively, as timely treatment can help mitigate complications and reduce the need for extensive orthodontic interventions later in life. However, the diagnosis of these anomalies can be challenging, often requiring a combination of clinical examination, radiographic imaging, and interdisciplinary collaboration. Orthodontic management often necessitates a multidisciplinary approach, involving collaboration with various dental specialists, including pediatric dentists, oral surgeons, and prosthodontists. Treatment modalities may encompass both fixed and removable appliances, as well as surgical interventions tailored to meet the unique needs of each patient. Surgical interventions may be warranted for severe anomalies but are typically reserved for cases where conservative measures are insufficient. By delving into the nuances of dental developmental anomalies and exploring practical treatment options, this review aims to provide valuable insights for orthodontic practitioners navigating the complexities of these conditions, ultimately contributing to improved patient care and outcomes.

Clear Aligners in Pediatric Dentistry: A Short Review

Clear aligners are efficient orthodontic appliances widely used in the past few decades gaining immense popularity due to their high aesthetic appeal. These thermoplastic aligners are thin transparent removable appliances which are clear in appearance. Evidence on the effectiveness of clear aligners in pediatric dentistry is generally sparse. Therefore this article explores their use in pediatric dentistry.

Perception of the influence of interceptive orthodontic appliances on malocclusions

The American Association of Orthodontists explains interceptive orthodontic treatment as an orthodontic therapy that regulates and prevents major occlusal problems in permanent dentition. In Northern Ireland, 1 in 3 children up to the year 2000 benefited from interceptive orthodontics. In Ecuador, it has been proven that its application enhances the creation of a normal occlusal relationship. The objective of this study was to evaluate the influence of removable appliances used in interceptive orthodontics on malocclusions in children treated at the orthodontic clinics of the 7th and 8th levels of the San Gregorio University of Portoviejo from October 2022 to March 2023. Mixed-method project with a sample of 56 students applying interviews and surveys. Bibliographic collection was carried out through databases: Scielo, Elsevier, Web of Science, PubMed, and Google Scholar. The sample was distributed among students from clinics A and B of orthodontics who had undergone interceptive treatments from the 7th level, extending their controls to the 8th level. The most commonly employed appliances were identified as: Hawley plate without attachments 94.6% and Hawley with expander screw 55.40 %. A direct relationship was observed between premature changes in dental malocclusions and interceptive orthodontics: alignments of rotated teeth, palatal expansion, and mild crowding, as well as space preservation in prematurely extracted teeth. At the extraoral level, improvement in lip competence was perceived in 41.1% during periods longer than 3 months. The results suggest a positive influence of removable interceptive orthodontics in the clinics of the USGP

Factors Aff ors Affecting the Pr ecting the Preference of Or ence of Orthodontic Appliances thodontic Appliances Among Undergraduate Students in West Jakarta

Malocclusion’s negative impact is not only limited to dentofacial appearance but also related to quality of life. Nowadays, orthodontic treatment can be done using conventional fixed appliances, or removable appliances called clear aligners. The preference for orthodontic appliances can be affected by several factors, including patient characteristics, self-perception, psychosocial, and oral-disorder factors. Objective: This study aims to evaluate the factors affecting the preference for orthodontic appliances among undergraduate students in West Jakarta. Methods: In this cross-sectional study, 244 undergraduate students were retrieved by purposive sampling from 7 universities located in West Jakarta. A self-administered questionnaire was used to collect data, and logistic regression analysis was carried out. Results: Fixed orthodontic appliances were commonly used (79.5%), and the majority of treatment providers were orthodontists (64.8%). Students’ belief that poor dental alignment is related to decreased social attractiveness was significantly associated with the preference for orthodontic appliances (p = 0.026; 95% CI = 1.170-11.317). Orthodontic treatment provider was significantly associated with a preference for orthodontic appliances (p = 0.000; 95% CI = 0.678-3.156). Conclusion: Fixed orthodontic appliances still become the main preference for malocclusion treatment among undergraduate students in West Jakarta. Besides that, the qualification of orthodontic treatment providers affects the preference for orthodontic appliances among undergraduate students in West Jakarta.

Correction of Anterior Crossbite, Using Removable Appliances in Mixed Dentition: 5-Year Follow-Up

The anterior crossbite (ACB) is a malocclusion where the upper anterior teeth are occluding lingually with respect to the lower anterior teeth. Moyers describes anterior crossbites as dental malocclusions resulting from abnormal axial inclinations of the anterior teeth. This type of malocclusion can be dental, functional or skeletal and can occur in the primary, mixed and second dentition. Diagnosis is made using diagnostic aids. While the treatment was carried out through interceptive orthodontics, with the use of different removable appliances. The objective of the study is to present the diagnosis and treatment for 5 years with the use of removable appliances. The results were favorable, being able to uncross the bite in 4 months, it was maintained throughout the dental replacement. One of the conclusions reached is that the treatment time is slightly longer since the use of preventive and interceptive orthodontics takes more time because these treatments are performed during the growth of the patients.

SPACE SEARCH FOR MINOR CROWDING CASES WITH EXPANSION PLATE IN PATIENTS WITH A HISTORY OF ANTIDEPRESSANT DRUG CONSUMPTION

Introduction: Gaining space in malocclusion cases using expansion plate removable orthodontic appliances. Depression is a mental health disorder that is treated with antidepressants. There is a correlation between a history of long-term antidepressant medication use and orthodontic treatment. Case: A 21-year-old female patient with a history of antidepressant medication complained of slightly advanced maxillary front teeth and crowded mandibular front teeth. Clinical examination revealed the first permanent molar relation Angle Class I modified Dewey type 2 malocclusion with malposition of individual teeth. Arch discrepancy analysis showed a space deficiency of 4 mm in the maxilla and 2.85 mm in the mandible. Case Management: The first stage used a removable orthodontic appliance for maxillary and mandibular expansion plates to obtain space deficiency. The expansion results showed that the maxillary dental arch was successfully expanded by 4.52 mm and the mandibular by 4 mm. Discussion: The slow-type expansion plate functions to expand the dental arch. Conclusion and Suggestion: Expansion plate removable orthodontic treatment effectively gains space in patients with a history of antidepressant drug use. Patients' cooperativeness in wearing the appliance influences the expansion plate removable orthodontic appliance treatment result.

Penilaian tingkat keberhasilan perawatan ortodonti dengan piranti lepasan berdasarkan parameter intermolar distance, inter dm2 distance, dan koreksi anterior crowding (Kajian Pada Pasien Anak Usia 7 – 10 Tahun di RSGM-P Universitas Trisakti Tahun 2017 -


 Background: Removable orthodontic appliance is one of the solutions of malocclusion problems in Indonesia. This appliance can treat mild to moderate dental malocclusion, such as Class I Angle, and can be removed by patients under the supervision of a dentist. Assessment of the success rate of removable orthodontic treatment can be performed using intermolar and inter dm2 distance measurements with anterior crowding correction. Objective: To determine orthodontic treatment success rate using removable appliance based on intermolar and inter dm2 distance measurement with anterior crowding correction in children aged 7-10 years at RSGM-P Trisakti University 2017-2019. Methods: The study was observational analytic to perform measurements of anterior crowding, intermolar, and inter dm2 distance on 26 pairs of the study model were selected using a random sampling method. Results: 19 patients have an increase in width at intermolar distance maxillary parameter and 22 patients at the mandibular (range 0.5 - 7 mm). 24 patients have an increase in width at inter dm2 distance maxillary parameter and 23 patients at mandibular (range 0.5 - 4 mm). All patients have an intermolar distance that exceeds the Pont prediction before orthodontic treatment. Conclusion: There were significant differences in maxillary and mandibular intermolar and inter dm2 distance parameters measurement of the study model before and after orthodontic treatment (p <0.05). There was no significant difference in anterior crowding parameter measurement of the study model before and after orthodontic treatment (p> 0.05).

Clinical case of treatment of anterior open bite malocclusion in a pediatric patient using a tongue trap

Anterior open bite is a complex and multifactorial malocclusion that affects both dental function and aesthetics. The objective of the study was to present a clinical case of anterior open bite (AOB) treatment in a pediatric patient using a lingual trap. A case study was conducted on a 7-year-old girl with AOB, employing a removable orthopedic appliance. The treatment consisted of using a lingual trap to correct the open bite and promote proper mandibular growth, with monthly check-ups and a total duration of 12 months. The results showed a significant improvement in occlusion and dental alignment, as well as in the facial profile. It is concluded that the lingual trap is an effective tool in the treatment of anterior open bite in pediatric patients, highlighting the importance of an integral and personalized approach to achieve successful results

Evaluation of the effectiveness and practicality of erbium lasers for ceramic restoration removal: A retrospective clinical analysis

Background The purpose of this study was to assess the effectiveness and practicality of erbium lasers in the removal of ceramic restorations and appliances from natural teeth and dental implant abutments in clinical practice. Methods A retrospective analysis was conducted, involving 29 clinical cases with a total of 52 abutments requiring the removal of various ceramic restorations. The analysis evaluated the clinical procedures performed, including the type and material of the prosthetic, the type of cement used, laser setting parameters, retrieval time, and retrieval success. Results Out of the 52 abutments, 50 were successfully retrieved without causing any damage (>95%) using either an Er,Cr:YSGG laser (N = 6) or an Er:YAG laser (N = 46). In one case, a crown was partially sectioned to prevent any negative impact of laser irradiation on the adhesive strength between the post and tooth, and in another case, a fracture occurred during debonding. The restorations consisted of 13 lithium disilicate and 39 zirconia units, including six veneers, 38 single crowns, and three fixed partial dentures (FPDs). The retrieval time varied depending on the restoration type, material thickness, cement type, retention form/fitting of the abutment and restoration, ranging from 2.25 ±0.61 minutes for veneers, 6.89 ±8.07 minutes for crowns, to 25 ±10 minutes per abutment for FPDs. Removal of a zirconia crown required more time, 7.12±8.91 minutes, compared to a lithium disilicate crown, 5.86 ±2.41 minutes. The debonding time was influenced by the laser settings as well as materials and types of prosthesis. Conclusions Erbium lasers present a safe and effective alternative to invasive methods for removing ceramic restorations, without causing harm to the abutment or prosthesis. Laser-assisted debonding allows for recementation of the restorations during the same appointment, making it a conservative and viable option for ceramic crown retrieval in clinical settings.

Has the COVID-19 Pandemic Affected Orthodontists' Interest in Various Orthodontic Appliances?

To determine the changes in orthodontists' interest in various orthodontic appliances during the coronavirus disease-2019 (COVID-19) pandemic. A questionnaire probing respondents' interest in orthodontic appliances and techniques, including standard buccal metal brackets, self-ligating brackets, standard ceramic brackets, lingual brackets, clear aligners, orthodontic facemasks, removable functional appliances, fixed functional appliances, orthognathic surgery, orthodontic miniscrews, and lingual retainers, was prepared using Google Forms and then sent to the Turkish Orthodontic Society to invite all members of the society to participate in the survey. Of the 1903 members invited, 230 (response rate, 12.08%) orthodontists completed the questionnaire. The respondents' interest in brackets did not change among 70% of the respondents (standard buccal metal bracket 80%, self-ligating bracket 72.2%, standard ceramic bracket 77%, and lingual bracket 76.5%). A significant difference was observed between the genders only about the interest in standard metal brackets and fixed functional appliances (p<0.05 for both). Interest in standard metal brackets decreased as respondents' work experience increased (p<0.05). The interest in self-ligating brackets was higher among respondents with 1-5 years of experience than among other respondents (p<0.05). Interest in self-ligating brackets increased more among lecturers and residents than among clinicians (p<0.05). The interest of orthodontists in clear aligners showed the highest increase during the COVID-19 pandemic among all orthodontic appliances, whereas their interest in other appliances, particularly standard buccal metal brackets, did not change.

COMBINED ORTHODONTIC AND SURGICAL TREATMEN IN PATIENT WITH MANDIBULAR PROGNATHISM

The aim of this case was to present a combined orthodontic-surgical treatment for a 30-year-old patient. The initial clinical examination revealed a Class III malocclusion, concave profile, 4.5mm overjet, and 2mm overbite. The treatment plan included orthodontic preparation with fixed appliances, surgical correction of skeletal discrepancies, and post-surgical orthodontic treatment. Lateral cephalograms were taken before the orthodontic therapy, just before the surgical intervention, and after the treatment, following the removal of fixed appliances. On the initial lateral cephalogram SNB angle was 88°, ANB -5°, SpP/MP 28°, total Bjork’s polygon angle 405°, I/SpP 71°, i/MP 111° and mandibular corpus length was increased by +11mm. On the final post-surgical lateral cephalogram, after the intervention and appliance removal the SNB angle was 81°, ANB 3°, SpP/MP 25°, total Bjork’s polygon angle 398°, I/SpP 64°, i/MP 96° and man- dibular corpus length was increased by +3mm. The pre-surgical orthodontic treatment lasted 12 months, followed by bimaxillary surgery. The post-surgical orthodontic treatment lasted 12 months. After appliance removal, a retentive phase with night-time wear of retainers was implemented. The result was stable Class I occlusion, satisfactory profile appearance, 2.5mm overbite, and 2mm overjet.

Effects of two novel denture cleansers on multispecies microbial biofilms, stain removal and the denture surface: an in vitro study

BackgroundThe continuously increasing demand for removable denture appliances and the importance of adequate denture cleaning have led to the development of various denture cleansing products. The aim of this study was to evaluate the efficacy of two novel denture cleansing agents (GE and TM) and three commonly available cleansers (0.5% sodium hypochlorite; NaClO, 0.12% chlorhexidine gluconate; CHX, and Polident®; POL) on multispecies microbial biofilm formation, stain removal and physical properties of dentures.MethodsThe antimicrobial activities of denture cleansing agents were determined against major oral opportunistic pathogens including Streptococcus mutans, Staphylococcus aureus, Escherichia coli and Candida albicans, using time-kill assays. Multispecies microbial biofilms grown on acrylic resins for 72 h were generated to determine the antibiofilm effects of cleansing agents by confocal laser scanning microscopy (CLSM). Evaluations of the tea and coffee stain removal properties and the alterations in the physical properties of dentures were also performed. The toxicity of cleanser residues released from denture acrylics to fibroblast cells was investigated using MTT assay.ResultsAll denture cleansing agents tested could effectively kill oral bacteria and Candida albicans. Furthermore, after immersion for more than 3 h, the cleansers Polident®, GE and TM could efficiently penetrate and inhibit multispecies denture biofilms with effects similar to 10 min of immersion in 0.5% NaClO. However, immersion in 0.12% CHX for 20 min showed less antibiofilm activity. The NaClO solution had the highest efficacy for removing stains from the artificial teeth. Conversely, the CHX solution enhanced tea and coffee staining, and the teeth immersed in this solution showed clinically unacceptable colour changes (ΔE > 5.5). However, the colour differences of teeth stained and immersed in POL, GE and TM cleansers were in the clinically acceptable range. There was no significant difference among the POL, GE and TM cleansers in terms of stain removal efficacy. The cleansers GE and TM did not alter the surface roughness and colour of the materials, moreover the residues of both cleansers did not exhibit cytotoxicity.ConclusionTwo novel denture cleansing agents containing natural products, GE and TM exhibited effective antimicrobial activity, antibiofilm and stain removal capabilities without toxicity or disturbance of the physical properties of acrylics.

Evaluation of Children\'s Attitude toward Conventional Removable Appliances and Novel Vivid Pedo Appliances: A Randomized Controlled Trial

Evaluation of Children\'s Attitude toward Conventional Removable Appliances and Novel Vivid Pedo Appliances: A Randomized Controlled Trial

Removable Orthodontic Treatment for Managing Relapse Due to Eruption of Third Molars: A Case Report

Relapse is a return to the initial form of malocclusion after correction. Relapse occurred after the patient underwent a fixed orthodontic treatment, and it could be associated with the role of third molar eruption. The use of removable orthodontic appliances can maintain the retention period to prevent relapse. This report aims to report the use of removable orthodontic appliances in correcting a minor relapse case. A 23-year-old patient came to RSGM UMY complaining of misaligned upper and lower front teeth for several months after completing fixed orthodontic treatment. She felt her lower front teeth were crowded and moved more backward than the other teeth. The treatment used maxillary and mandibular expansion plates to gain space. The active plate on the maxilla was a medium labial arch and a simple spring on the mandible. A checkup of the patient was seen once a week which involved cleaning the oral cavity and the plate, measuring the space by the activated expansion screw, and checking for correction of individual teeth. The bilateral expansion plate can be used to correct mild anterior crowding due to relapse, followed by an active plate with a simple spring. The success of treatment was influenced by the patient’s cooperation and compliance with using removable orthodontic appliances.