Space In Dental Arch Research Articles

Management and Outcomes of Severe Submergence in Second Premolar

General Background: The early loss of primary molars is a prevalent dental issue that can lead to significant occlusal disturbances, including space reduction and misalignment of permanent teeth. Specific Background: Submergence of the second permanent molar following premature exfoliation of primary molars exacerbates these issues, complicating the eruption pattern and dental arch integrity. Knowledge Gap: Despite existing treatment modalities, there is limited evidence on the effectiveness of specific appliances in managing severe submergence cases in pediatric patients. Aims: This study aims to evaluate the efficacy of the Gerber Space Regainer in restoring lost space and correcting the alignment of submerged second premolars in a pediatric patient. Results: A 10-year-old patient experiencing significant space loss due to premature exfoliation of tooth 85 was treated with a Gerber Space Regainer. Over a 7-week period, the appliance successfully regained 8 mm of space, with notable uprighting of the affected premolar, achieving complete recovery of the dental arch. Novelty: This case report highlights the practical application and success of the Gerber Space Regainer, emphasizing its efficiency in a short time frame, which has not been extensively documented in similar clinical scenarios. Implications: The findings suggest that the Gerber Space Regainer is an effective and reliable option for managing complex orthodontic cases involving submergence and space loss, contributing to the enhancement of treatment protocols in pediatric dentistry. Highlights: Effective space recovery: The Gerber Space Regainer successfully restored 8 mm of lost dental arch space in 7 weeks. Improved alignment: The treatment led to the uprighting of the submerged second premolar, ensuring proper occlusion. Pediatric applicability: The appliance demonstrated high efficiency and compliance in a young patient, showcasing its potential in pediatric cases. Keywords: Premature Loss, Space Regainer, Submergence, Second Premolar, Eruption Disturbance

Comparative Evaluation of Dental Enamel Microhardness Following Various Methods of Interproximal Reduction: A Vickers Hardness Tester Investigation.

Interproximal enamel reduction, also known as stripping, is a common orthodontic procedure that reduces the mesiodistal diameter of teeth, allowing for a balance of available space in dental arches. The aim of this study was to assess the enamel surface microhardness resulting from the application of currently available methods for interproximal reduction. Forty-two extracted human permanent teeth were divided into six different groups, each subjected to a therapeutic stripping procedure using various methods (i.e., diamond burs, abrasive strips of 90 μm, 60 μm, 40 μm, and 15 μm, and abrasive discs). Stripping was performed by a single individual in accordance with the manufacturers' recommendations for the various systems used. One of the proximal faces of the tooth underwent IPR, while the other side remained untreated for control. The hardness of the enamel surface was measured using a Vickers hardness tester. The control group achieved the hardest enamel surface (354.4 ± 41.02 HV1), while the lowest was observed for enamel surfaces treated with 90 µm abrasive strips (213.7 ± 118.6). The only statistically significant difference was identified in comparisons between the values measured for the control group and those obtained after stripping with diamond burs (p = 0.0159). Enamel microhardness varied depending on the stripping instrument used, but no statistically significant differences were found (p > 0.05). Optimal microhardness values, close to those of healthy enamel, were achieved after mechanical treatment with 15 µm abrasive strips and abrasive discs. Dental stripping is a safe therapeutic procedure that has a relatively minor influence on the microhardness of surface enamel.

Modalities used to gain space in dental arch

Most of orthodontic patients seek treatment to improve their facial and dental esthetics which is compromised due to variety of malocclusions. Malocclusion can be caused by skeletal or dental factors. Dental malocclusion includes crowding, spacing, increased overjet, and overbite, rotations of teeth etc. Correction of some malocclusions like crowding and increased overjet needs space in the dental arch. There are various methods for creating space in the dental arch such as proximal stripping, distalization of molars, extractions, expansion of arch, and proclination of anterior teeth, and derotation of posterior teeth. In this article, we will briefly discuss about these methods.

Prevalence of delayed tooth eruption of permanent maxillary anterior teeth among Ukrainian children: retrospective radiographic study using CBCT data

Background. Tooth eruption is a complex, multi-staged, and well-regulated biological and age specific process that can be affected and influenced by many systemic and local factors. The deviation more than ±2SD from the established norm of tooth eruption terms, while also taking account racial, ethnic, and gender factors, is important for the clinician. 
 Objective. To estimate the prevalence of delayed tooth eruption (DTE) of permanent maxillary anterior teeth among Ukrainian children sample and to investigate the epidemiology distribution of delayed eruption cases according to their causes based on CBCT data.
 Materials and Methods. Cone Beam Computed Tomography (CBCT) data sets of 684 children (304 boys and 380 girls) aged 7–14 years old, who previously have sought for orthodontic diagnostics in Central Laboratory Diagnosis of the Head (CLDH), were collected and examined to detect any delayed eruption of the permanent maxillary anterior teeth. Signs of delayed eruption were identified considering tooth developmental stages, relationships between the chronologic age and dental developmental age, eruption sequence. 
 Results. The total prevalence of delayed tooth eruption of permanent maxillary anterior teeth among the 684 children was 42.84%. 293 children (155 boys and 138 girls) had at least one impacted or retained tooth. The maxillary canines the most frequently demonstrated signs of delayed eruption and compiled 30.7% of all examined cases and 71.67% of all delayed eruption cases, followed by the lateral incisors of the maxilla – 6.58% and 15.36% respectively, and the central incisors – 5.56% and 12.97% respectively. Loss of space in dental arch and the ectopic eruption pathway were the most causative factor of delayed eruption of permanent maxillary anterior teeth. 
 Conclusions. Delayed tooth eruption of permanent maxillary anterior teeth is frequently seen in everyday orthodontic practice and requires a multidisciplinary approach of diagnostics to avoid many treatment-related complications. CBCT data is essential for timely diagnostics of DTE and primary for the causative factors identification in order to provide optimal and effective management plan for each patient.

Redefining tweed’s headplate correction and its implications in dental arch space requirement

The cephalometric appraisal of mandibular incisor teeth in relation to the mandibular basal bone had its origin in the clinical outcomes that Tweed observed in his treated cases. Although was an admirer of Angle’s philosophy, failure to achieve functional and aesthetic harmony in some of the orthodontically treated cases prompted Tweed to introspect his methodology and revisit the records of his patients. Consequently, based on his clinical annotations and cephalometric aid, a Diagnostic Facial Triangle was framed to assess the severity and difficulty in treating various degrees of malocclusions in routine orthodontic practice. Furthermore, a simple and effective method in the form of Headplate/Cephalogram Correction was also developed to quantify the extent of space requirements for rectifying prognathic dentures.

Comparative evaluation of the retention of two different preformed molar bands: An in vitro study

: The purpose of giving space maintainer in primary dentition is to prevent the migration of adjacent teeth, thus holding space in dental arch for succedaneous tooth to erupt. Molar band is the fundamental component of space maintainer. The retention of band to the tooth surface is important to ensure fixed appliance therapy. Several methods have been described to improve the mechanical retentive surfaces of bands including sandblasting, burs, etc. Sandblasting of the metal surfaces improves the retention by roughening, thereby increasing the surface area and improving the potential for degree of mechanical attachment.: The aim of the study was to evaluate and compare the forces require to deband preformed pre- sandblasted and preformed in-office sandblasted molar band and to determine which type is successful to ensure superior band retention.: Twenty sound permanent molars were selected and equally divided into two groups. In group I, pre sandblasted molar bands were cemented onto the molar teeth and in group II, in-office sandblasted molar bands were cemented onto the molar teeth using ReLyX U200 as luting cement in both. The cemented samples were tested for their resistance to dislodgement on Instron Universal testing machine in tensile mode.: The result showed that the debanding forces required to remove the pre-sandblasted bands were higher as compared to in-office sandblasted molar bands.: Pre-sandblasted bands resulted in greater degree of surface roughness by providing a stronger bond between the band and the tooth as compared to in-office sandblasted bands.

Molar distalization classification – A review

Esthetics plays a major role from orthodontic treatment to results. Gaining space in dental arch is the most important step in the treatment planning which can be achieved by different methods one of which is molar distalisation. There are a number of methods (Arch expansion, interproximal reduction, proclination of teeth, molar derotation, use of functional appliances) to gain space. Each method has its own advantages and disadvantages and specific indications. A child with class I bases and acceptable profile, with minimal space requirements for relief of crowding or mild protrusion can possibly be best treated without sacrifice of tooth material. Various intaoral and extraoral appliances have been invented using non-extraction treatment to distalise molars. Aim of distalization is to move molars distally so as to gain space. This article provides a comprehensive review of the various methods (intraoral & extraoral) used for molar distalization.

Impact of a new combined preoperative cleft assessment on dental implant success in patients with cleft and palate: a retrospective study

BackgroundBone height assessment alone is frequently used to guide rehabilitation choice, without consideration for soft tissues or adjacent teeth. This study aimed to evaluate the impact of different preoperative cleft assessments on implant success and patient satisfaction.MethodsThe study involved a retrospective assessment of records from 40 patients with cleft lip and palate (CLP). The alveolar cleft score (ACS; clinical criteria), interdental alveolar bone height (IABH) score (radiological criteria), patient compliance score (dental hygiene, medical visit observance, and smoking), and a novel combined score (IABH-ACS-Compliance) were assessed from patient records. Patients who required prosthetic tooth rehabilitation in the cleft dental arch space were included. Twenty-six patients (Group 1) were treated with dental implants, and 14 patients (Group 2) selected another prosthetic option (fixed prosthodontics, removal prosthesis), orthodontic space closure, or no rehabilitation. The main outcomes measured were relative implant success (no implant loss involving marginal bone loss ≤ 1.9 mm) for patients treated with dental implant therapy (Group 1) and patient satisfaction for all patients (Groups 1 and 2).ResultsForty dental implants were placed in the patients in Group 1. Four implants in four patients (Group 1 relative failure, RF) were lost (implant survival rate of 90%) after 36 (± 12.4) months of follow-up. Twenty-two patients who received implants belonged to the relative implant success group (Group 1 RS). The average “IABH-ACS-Compliance” scores were significantly different (p < 0.05): 16.90 ± 2.35 and 12.75 ± 0.43 for the Group 1 RS and RF groups, respectively.ConclusionsPreoperative cleft parameters have an impact on relative implant success and patient satisfaction. The new cleft assessment combined-score (“IABH-ACS-Compliance”) allows an accurate selection of cleft cases eligible for dental implants, thereby improving postoperative outcomes.

The Evolution of Third Molars in Orthodontics: What about Anterior Dental Crowding? - A Systematic Review

Background: Third molar influence on anterior crowding is controversial, However, it is assumed that they play a major role in compromising dental arch space. Aim: To review the literature to clarify the role of third molars in anterior crowding and relapse after orthodontic treatment by means of a systematic review. Material and methods: A systematic search was conducted based on an electronic search of several databases (Pub Med, ScienceDirect, Cochrane Library) covering publications from 2010 to January 2022. The search was performed using the acronym PICOS, limited to the following keywords in English and French: «wisdom tooth» OR« third molar »AND «anterior teeth crowding». Results: On the basis of the keywords, 549 bibliographical references were initially identified. After the elimination of duplicate references and studies, the number of articles was reduced to 315. A review of titles and abstracts resulted in the selection of 23 articles. After reading the full text, 6 articles were included in this systematic review. Conclusion: No relationship between the incisors crowding and the presence of third molars was identified. Therefore, the indication for prophylactic removal of third molars to avoid incisor crowding is not justified.

Molar distalization – A review

Esthetics plays a major role from orthodontic treatment to results. Gaining space in dental arch is the most important step in the treatment planning which can be achieved by different methods one of which is molar distalisation. To distalise molars in upper arch using non-extraction treatment, various appliances have been invented. The first attempt for this technique was the use of headgear appliance, but this needed patient compliance and was esthetically unpleasing. Thus, various intra-oral devices were introduced for molar distalisation. Keywords: Disitilisation, Pendulum appliance, Anchorage.

Space conditions, palatal vault height, and tooth size in patients with and without palatally displaced canines: A prospective cohort study.

To assess palatal vault height, tooth size, and dental arch dimensions in patients with unilateral and bilateral palatally displaced canines compared with a control group. A sample of 66 patients (mean age: 11.5 ± 1.0 years) with 22 unilateral palatally displaced canines (UPDCs), 22 bilateral palatally displaced canines (BPDCs), and 22 controls (C) were consecutively recruited. All three groups had dental casts that were scanned digitally using the OrthoX three-dimensional model scanner. Tooth size, palatal vault height, dental arch width, dental arch depth, dental arch length, and dental arch space were measured by the same examiner using the GOM software. Remeasurements were made in 10 randomly identified patients. The palatal vault height was significantly lower in the BPDC group compared with controls. A significantly smaller mesial-distal crown width and, in general, more spacing in the maxilla were found in the UPDC and BPDC groups. No differences in arch length or arch width at the molar region were seen between the groups, while the arch length at the canine region was smaller in the UPDC and BPDC groups. However, this was observed in BPDC patients with both deciduous canines present and in most UPDC patients where the deciduous canine was present, compared with the control group, who had more permanent canines present. Patients with PDC had greater reduction in tooth size compared with the control group. The arch length and arch width were similar in patients with and without PDC.

MCNAMARA’S CEPHALOMETRIC NORMS OF EGYPTIAN CHILDREN

Objective: To establish McNamara Cephalometric Analysis normative data for Egyptian children. Materials and Methods: Twenty boys and forty girls (mean age 9.37, SD 1.60) of Egyptian ethnicity were selected based on the following criteria: Class I molar relationship, lack of crossbite or scissor-bite, adequate amount of space in dental arches, no visible asymmetry, and good facial proportions. Eleven selected variables from McNamara’s cephalometric method were digitally traced and analyzed on the lateral cephalograms of each subject. Results: McNamara’s skeletal and dental variables were assessed and statistically significant inter-gender differences were noted in both effective midface length (condylion to point A) and effective mandibular length (condylion to gnathion). Conclusions: Young Egyptian boys had a lengthier midface and mandible than girls. The Upper incisors to point A vertical and lower incisor to A-PO line were slightly more pronounced in girls.

Evaluation of two techniques to measure the available space in the mandibular dental arch using the method error

PURPOSE: To evaluate the influence of errors when two methods for assessing the available space in the dental arch are used. METHODS: A single investigator measured the available space in 30 plaster models by using two techniques: 1) with a digital caliper; and 2) by contouring the arch with a brass wire and subsequently straightening and measuring this wire with a millimeter ruler. Fifteen days later, data were collected using both methods with duplicate measurements, so that each method was used twice for each model. The random and systematic errors of each method under the conditions of repeatability and reproducibility were calculated. RESULTS: For method reproducibility, systematic errors were statistically significant (P<0.05) only when the brass wire method was used. The random errors were less than 1 mm under both conditions. With the brass wire, random errors were not significant for repeatability; however, for reproducibility, the mean value was 1.69 mm. CONCLUSION: In the digital caliper method, systematic and random errors were considered acceptable. The brass wire measurement method did not present errors under the condition of repeatability; for reproducibility, however, the systematic error was significant and the random error indicates that this method should be considered inappropriate to measure space in the dental arch.

Twelve-month space changes after premature loss of a primary maxillary first molar

Many early investigations concerning space changes following premature extraction of primary molars had a cross-sectional design, a small sample size, and a somewhat crude methodology, which may have led to misunderstandings. The aim of this study was to use established longitudinal data to investigate ongoing (12-month) dental-arch space problems arising as a result of premature loss of a primary maxillary first molar. Thirteen children (mean ± SD age at time of tooth extraction, 6.0 ± 0.74 years) with unilateral premature loss of a primary maxillary first molar were selected for this study. Maxillary dental study casts were obtained from participants 2 or 3 days after the tooth was removed, as well as at a follow-up appointment 12 months later. Six reference lines were measured on the study cast: D + E space, arch width, arch length, intercanine width, intercanine length, and arch perimeter. For each participant, the D + E space of the contralateral intact primary molar served as a control. A paired t-test was used to compare the cast measurements between initial examination and 12-month follow-up. A t-test was used to compare D + E space changes with those of the control group. The D + E space of the extraction side after 12 months was significantly smaller than that of the control side (P < 0.05) and the initial D + E space (P < 0.05). A significantly greater arch perimeter, intercanine width, and intercanine length were found after 12 months compared with the initial parameters. No significant differences were found, however, in arch width or arch length between the initial examination and the 12-month follow-up examination (P > 0.05). The 12-month space changes in the maxillary dental arch after premature loss of a primary maxillary first molar consist mainly of distal drift of the primary canine toward the extraction site. Mesial movement of permanent molars or tilting of the primary molars did not occur. An increased arch dimension was found especially in the anterior segment (intercanine width and length). There is no need for the use of space maintainers from the results in this study in cases of premature loss of a primary first molar.

Evidence indicates minimal short-term space loss after premature loss of primary first molars: A critical summary of Tunison W, Flores-Mir C, ElBadrawy H, Nassar U, El-Bialy T. Dental arch space changes following premature loss of primary first molars: a systematic review. Pediatr Dent 2008;30(4):297–302.

Systematic review conclusion The reported magnitude of space loss after premature loss of primary first molars—1.5 millimeters per arch side in the mandible and 1.0 mm per arch side in the maxilla—is not likely to be of clinical significance in most cases. Critical summary assessment. The reviewers' conclusion was made on the basis of the results of only three studies, which included a total of 70 patients who were followed by investigators for up to eight months. Evidence quality rating. Limited.

Dental Anomaly Patterns (DAP)

Dental Anomaly Patterns (DAP)

Development of occlusal traits and dental arch space from adolescence to adulthood: A 25-year follow-up study of 245 untreated subjects

The purpose of this study was to examine longitudinally the development of specific occlusal traits and space conditions in an Icelandic sample. The sample comprised 245 adolescents examined clinically in the late mixed or permanent dentition and again 25 years later. All subjects were orthodontically untreated, and all had the full complement of teeth at both examinations. A significant increase in the prevalence of mandibular anterior crowding and mesial molar relationships and a decrease in the prevalence of excessive overjet and maxillary anterior spacing were seen. The persistence of malocclusion traits ranged from 17.9% to 53.4% for maxillary anterior spacing and crowding, mandibular spacing, overjet, overbite, and distal molar occlusion, whereas anterior mandibular crowding and molar crossbite were still found in 72.7% and 75.0%, respectively, at the second examination. Normal occlusal traits and space conditions at adolescence stayed mostly unchanged, with the exception of 11.2% of the subjects, who developed mandibular anterior crowding between the first and second examinations. Deterioration of normal occlusal traits and space relationships was uncommon in this study, whereas self-correction of malocclusion traits and space anomalies was relatively frequent.

Comparison of linear dimensions and angular measurements on panoramic images taken with two machines.

Background and aims Panoramic radiography is a method widely used because of low absorbed dose in patients (ap-proximately 10 times less than that in the full mouth survey), reasonable cost and time. Disadvantages of this radiography technique are magnification and distortion as a result of unequal magnification, which can influence dimensional and angular measurements used in clinical dentistry to determine root length, dental arch space, relative angulations of teeth, and implant site assessment. The aim of this study was comparison of linear dimensions and angular measurements on panoramic images taken with two machines (Planmeca and Panoura). Materials and methods Twenty radiographs taken with each apparatus from a human dry skull were scanned. Hori-zontal, vertical and angular dimensions were measured on the skull, which were compared along with the images using Corel DRAW Software, V13. Results Independent t-test analysis showed that horizontal magnification assessed on images from Panoura was more than that from Planmeca (P < 0.00025). There were no significant differences between the two groups in vertical di-mensions (P = 0.66). Mean magnification of angular measurements assessed on images from Panoura was less than that from Planmeca (P < 0.00025). Independent t-test analysis showed that distortion of Planmeca images were more than that of Panoura. One sample t-test showed that angular measurements were more reliable than linear dimensions. Conclusion Panoramic radiography technique can be used for evaluation of angles but it is better to use other ra-diography techniques for vertical and horizontal measurements.

Immediate and six-month space changes after premature loss of a primary maxillary first molar

Premature loss of primary maxillary first molars has been associated with a number of consequences (such as tipping of the first permanent molar). The aim of the authors' study was to investigate dental-arch space problems arising as a result of premature loss of a primary maxillary first molar. This study was composed of 19 children who experienced unilateral premature loss of a primary maxillary first molar. The authors used each patient's intact contralateral arch segment as a control. The authors obtained maxillary dental study casts two or three days after the tooth was extracted, as well as six months later. The D + E space from the extraction side six months after removal of the tooth (mean +/- standard deviation, 15.62 +/- 1.13 millimeters) was significantly smaller than the space on the control side (16.88 +/- 1.12 mm) and the initial D + E space (16.70 +/- 0.69 mm). The authors found a significantly shorter arch length (25.47 +/- 1.58 mm) and larger intercanine width (31.29 +/- 2.49 mm) six months after the tooth was extracted compared with the initial arch length (25.66 +/- 1.64 mm) and intercanine width (30.42 +/- 2.64 mm). The early space changes to the maxillary arch subsequent to premature loss of a primary maxillary first molar are primarily distal drift of the primary canines toward the extraction space and palatal migration of the maxillary incisors. Although 1 mm of space was lost, which is statistically significant, this is not likely to be of sufficient clinical significance to warrant use of a space maintainer. If palatal movement appears to be needed, the dentist should consider use of a palatal arch rather than a band-and-loop maintainer. The effects of space maintainers need to be re-evaluated in cases of unilateral premature loss of a primary maxillary first molar.

Comparison of Dental Arch Parameters of Three Degree of Anterior Crowding of Class I Malocclusion

Aim: To assess the relation between the anterior dental crowding in Class I molar occlusion with the dental arch parameters in both dental arches and for both sexes. Materials and Methods: This study presented data from examination of the study casts for a sample of 106 maxillary and 142 mandibular dental arches of pupils of the intermediate school in Mosul City aged 12–15 years of Iraqi origin. The sample was divided into three main groups according to anterior dental crowding degree (0–2.0 mm, 2.1–4 mm and over 4.0 mm). This was done by calculation of dental arch space available (dental arch perimeter) by utilizing the segment arch technique. The six segment technique assessed by using a modified sliding caliper gauge. The mesio–distal crown width of each tooth was measured, to get the space necessary, and the difference between the space available and the space necessary is negative value represent the amount of crowding. The data was analyzed utilizing statistical analyses at p≤0.05 significant level. Results: all the dental arch parameters were insignificantly decreased throughout the three groups accompanied by increase in the degree of anterior dental crowding except the dental arch perimeter which decreased significantly, while intercanine and the canine–molar parameters were insignificantly increased in both dental arches and for both sexes. Conclusion: The inter–canine parameter increase in crowding case whereas the other parameters are decrease.