Use Of Removable Appliances Research Articles

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.

Investigation of the force reactions’ magnitude around the mounts of orthodontic appliances in the process of orthodontic treatment of children with congenital unilateral cleft lip and palate

For the purpose of orthodontic treatment of children with congenital cleft lip and palate, various orthodontic constructions are used. The use of removable appliances indicated for narrowing or shortening of the dental arches, anomalies of the individual teeth position. The question of determining the magnitude of force reactions around special devices (clasps) that are designed to fix appliances on teeth during treatment, under the conditions of the specificity of the development of the upper jaw and the impact of surgical interventions on it, requires detailing, which determined the purpose of this research. A three-dimensional 3D simulation model was created based on digital data of the spatial geometry of a sample of orthodontic appliance used for orthodontic treatment of children with congenital unilateral cleft lip and palate. Mathematical modeling methods were used to study the stress-deformed state of the appliance and estimate the magnitudes and distribution of the amplitudes of force reactions around its fasteners (clasps). Force reactions around of the supports of the orthodontic appliance when the screw is rotated from 0° to 360° (axial movement by 1 mm) are unevenly distributed, with a minimum value of force amplitudes of 10.3 N and a maximum of 30.9 N. It was noted that in the area of fasteners (clasps) placed more distally, the values are higher (30.9 N and 27.6 N) than in the medially placed fasteners (10.3 N and 12.5 N). It is also worth noting that on the side of the base of the appliance, which corresponds to the location of the small fragment of the jaw, the values of the force amplitudes are greater (30.9 N and 12.5 N) than on the side of the large fragment (27.6 N and 10.3 N). A significant dependence of the values of force reactions on the stiffness characteristics of the jaw and the type of force transmission from the orthodontic appliance to its areas was established. Keywords: 3D simulation model, force reactions, clasps.

Assessment of Growth Changes in the Width of Dental Arches Caused by Removable Appliances over a Period of 10 Months in Children with Malocclusion.

(1) Background: A large number of patients of orthodontic clinics are diagnosed with improper jaw relationships. Intraoral scanners have become an important part of orthodontic practice and provide an opportunity to measure the changes in the width of dental arches. The purpose of the study was to evaluate the impact of removable appliances used over a 10-month period on growth changes in children with narrowed jaw dimensions. (2) Methods: Twenty four patients were included in the study (a study group—patients, treated with removable appliances in the upper dental arch for a minimum of 10 months; a control group—patients with no craniofacial abnormalities and who did not require orthodontic treatment). A panoramic radiograph and digital intraoral scan were taken, followed by palatal width measurements in Ortho-CAD before treatment, and after a period of 10 months of treatment with removable appliances. (3) Results: After a period of 10 months of the treatment, the study group had a statistically significantly greater mean change in the anterior width of the upper dental arch than the control group. (4) Conclusions: The use of removable appliances in children with narrowed maxillary transverse dimension contributes to offsetting growth changes in comparison to children with normal occlusion.

ORAL MUCOSAL LESIONS IN PATIENTS FROM CLINICS OF THE SCHOOL OF DENTISTRY, UNIVERSITY OF ANTIOQUIA, MEDELLÍN, COLOMBIA

<h3>Background</h3> To our knowledge, there are no studies in Colombia that describe the frequency of oral mucosal lesions. Only the ENSAB IV evaluated potentially malignant lesions and lesions associated with a removable prosthesis. <h3>Objective</h3> The aim of this study was to determine the frequency of oral mucosal lesions and their risk indicators in patients attending clinics of the School of Dentistry, University of Antioquia. <h3>Methods</h3> Structured interviews, clinical examination, and a biopsy, if deemed necessary, were conducted in a nonprobabilistic sample of 539 patients. <h3>Results</h3> Eight hundred forty mucosal lesions were found in 409 patients (75.9%). The average age was 35.26 years (SD = 23.4); 69.7% of patients were female. The most frequent lesions were exfoliative cheilitis (17.4%), frictional keratosis (15.4%), and vascular lesions (11.5%). In exploring the relationship between the number of lesions and sociodemographic characteristics and habits, a correlation was found with age (<i>P</i> = .001), use of removable appliances (<i>P</i> = .042), type of appliance (<i>P</i> = .001), and the variable "you have seen or felt something in your mouth" (<i>P</i> = .004). <h3>Conclusions</h3> The most frequent lesions in this study were exfoliative cheilitis. There was a low percentage of potentially malignant disorders, and no malignant lesions were found. In the teaching programs of dentistry and even to establish the diagnosis of presumption, it is necessary to know the frequency of lesions of the oral mucosa in the region.

Effectiveness of removable appliances with temperature sensors in orthodontic patients: a systematic review and meta-analysis.

Patient compliance during orthodontic treatment is one of the factors that most affects success in the final result. The use of removable appliances is frequent at an early age and the monitoring of its use is essential to assess the collaboration of the patient. The aim of this study was to establish the effectiveness of microsensors included in removable appliances during orthodontic treatment or in the retention phase to enable a reliable and individualized follow-up of the patient. The article search was carried out in various electronic databases and journals without any language restrictions. Studies using microsensors into removable appliances were selected with the key selection criterion of a minimum follow-up of 4 weeks. The quality of the studies included was evaluated using the Cochrane scale for the randomized controlled trials and the Newcastle Ottawa Scale for control-case, cohort, and transversal studies. The mean of the differences with a 95% confidence interval was expressed for the continuous data. Twenty-nine full-text articles were analysed and included in the qualitative synthesis. In general, the mean daily wear time of removable appliances measured objectively was less than the time that the professional had predetermined. The use of microsensors as an objective measurement method enhances communication and boosts confidence in the orthodontist-patient relationship. More random clinical studies with temperature sensors are needed to establish to what extent they influence the orthodontic outcome. PROSPERO (CRD42019120525).

Fixed versus removable appliances – which one to choose?

The use of removable appliances in modern clinical orthodontic practice can generally be considered an out-dated treatment modality for managing malocclusions. Their use and popularity has declined considerably largely due to their inefficiency at achieving significant quality tooth movement. There are, however, a couple of specific indications where removable appliances come into their own. This article will present and discuss several clinical scenarios where one technique clearly has significant advantages over the other. CPD/Clinical Relevance: Orthodontists and general dental practitioners (GDPs) should be aware of the situations where removable appliances provide a solution in modern clinical orthodontics practice, but also when the fixed counterpart will provide a much more efficient and effective method of moving teeth.

Interceptive Correction of Anterior Crossbite Using Short-Span Wire-Fixed Orthodontic Appliance: A Report of Three Cases

Anterior crossbite is relatively a common presentation in the mixed dentition stage. If left untreated, it can lead to a host of problems and may complicate future orthodontic treatment. One of the major difficulties in performing anterior crossbite correction in young children is treatment compliance. In most cases, poor compliance is due to the unacceptability of the removable appliance used. This article describes three cases of successful correction of anterior crossbite of patients in mixed dentition using short-span wire-fixed orthodontic appliances. This sectional appliance provides an alternative method of correcting anterior crossbite of dental origin and offers many advantages compared to the use of removable appliances.

Hard tissue augmentation for alveolar defects before implant placement

Background. Often when planning implant therapy, there is a need to augment or replace bone that has been lost. The alveolar defects may occur as a result of tooth loss due to extraction, advanced periodontal diseases or trauma, long term use of removable appliances, dehiscence and fenestration defects, developmental defects/clefts, congenitally missing teeth and odontogenic cysts and tumors. Insufficient bone volume can be brought about by hard tissue augmentation. This techniques have led to increased predictability in reconstruction of alveolar ridge defects and functional implant placement. Purpose. To describe the methods of hard tissue augmentation which can be done with block grafts (autografts and allografts), particulate grafts (cortical and cancellous), xenografts, or synthetic materials. Review. The reconstruction of a normal alveolar housing, in height and width, is imperative to achieve a harmonious balance between biology, function, and aesthetics. Depending on the size and morphology of the defect, horizontal or vertical, various augmentation procedures can be used. Soft tissue management is a critical aspect of hard tissue augmentation procedures. Incisions, reflection, and manipulation should be designed to optimize blood supply and wound closure. The design and management of mucoperiosteal flaps must consider the increased dimensions of the ridge after augmentation as well as esthetics and approximation of the wound margins. The surgical procedure needs to be executed with utmost care to preserve the maximum vascularity to the flap and minimize tissue injury. Conclusion. Alveolar ridge defects can be classified by using Seibert’s classification or HVC System. The treatment of alveolar ridge defect before implant placement can be done with hard tissue augmentation.

Adherence in orthodontic settings: understanding practitioner views in a UK sample.

To explore predictors of adherence in adult orthodontic patients as reported by orthodontists in the UK. Twenty-three orthodontists (47% female and 53% male) from the UK with approximately 15 years of experience each (M = 14.7; SD = 1.73) completed a questionnaire regarding the importance they give to a number of factors signaled in the literature as adequate predictors of adherence. This cross-sectional quantitative and exploratory survey consisted of four parts, requesting orthodontists to rate a list of predictors of adherence on (1) evaluation-how important they thought the predictor was to assess patient adherence, (2) application-the extent to which they used each predictor to assess adherence in their daily practice, (3) open-ended questions to collect any other perceived predictors of adherence, and (4) demographics. All participating orthodontists agreed that patients' regularity in attending appointments, maintenance of good oral hygiene, and utilization of dental appliances are the most important factors for predicting adherence. In the open-ended portion of the questionnaire, orthodontists also highlighted perceived cost of treatment as an important factor. The remaining factors included in the questionnaire were also rated as important or utilized, though they yielded a more varied pattern of response. Appointment keeping, cooperating in the use of removable appliances, and oral hygiene were rated as the most important factors by orthodontists when assessing adherence in adult patients. The perceived cost of treatment was also highlighted by orthodontists as an important factor for adherence.

Quantification of wear-time adherence of&amp;nbsp;removable appliances in young orthodontic patients in relation to their BMI: a preliminary study

PurposeThe relationship between unhealthy body mass index (BMI) and adherence to orthodontic treatment with removable appliances has not previously been evaluated.ObjectiveThe aim of this study was to quantify the association between BMI and wear time of removable orthodontic appliances and to evaluate BMI changes during orthodontic treatment.Patients and methodsFifty-three normal-weight and 39 overweight/obese children and adolescents (7–15 years old) undergoing orthodontic treatment with removable appliances were enrolled into the study. BMI categories were determined using standardized age-specific and sex-specific BMI criteria, using data measured at the beginning of therapy and once during orthodontic treatment. Wear times of removable appliances were measured at 15-minute intervals over a period of 5 months using implanted microelectronic sensors. Median wear-time values were used in the analysis with the Mann–Whitney U-test used to test statistical differences between groups.ResultsThe median wear time of removable orthodontic appliances was 9.3 hours for normal-weight patients and 9.2 hours for overweight/obese patients. No statistically significant (P>0.05) or clinically relevant differences in usage or adherence were detected between normal-weight and overweight/obese patients. BMI did not influence wear time or behavior of removable orthodontic appliances by young patients. The majority of patients showed qualitative decreases in BMI during therapy.ConclusionThe orthodontic treatment of young patients with removable devices does not require BMI-dependent changes in the treatment strategy. However, the use of removable appliances during meal times raises the possibility of reducing food intake, and in this way the orthodontist may have an active role to play in weight reduction.

The role of a dentist in managing patients with dystonia

Oromandibular dystonia is a neurological condition where the muscles of the mouth and jaw contract in involuntary spasms. Dystonia currently has no cure, but there are treatment options to manage symptoms. This case report describes the treatment of a 41-year-old male who presented at University of Glasgow Dental Hospital and School with established oromandibular dystonia. The use of removable appliances as a treatment option for this condition will be discussed. This case highlights the potential role of the dental practitioner in providing oromandibular dystonia sufferers with an effective and relatively easy treatment modality in the form of a removable appliance.

Localized ridge augmentation using autogenous block bone graft followed by dental implant placement

The placement of endosseous dental implants is often hampered by unfavourable anatomy of the alveolar bone. Most frequently patients lose their teeth due to alveolar bone loss, tooth extraction; trauma and long term use of removable appliances tend to lose the bone making it difficult for the placement of implant in an optimal prosthetic position. The loss of width of the residual alveolar ridge necessitated measures which could refurbish the lost dimensions. Here we report the successful management of such a condition wherein placement of implant was made possible by placement of autogenous bone block graft obtained from the mandibular symphysis region and predictable osseointegration thus achieved.

Evaluation of home disinfection protocols for acrylic baseplates of removable orthodontic appliances: A randomized clinical investigation

In this randomized clinical trial, we investigated, using the microbial culture technique and scanning electron microscopy, the contamination of acrylic baseplates of removable orthodontic appliances by mutans streptococci (MS) and evaluated the efficacy of different home disinfection protocols with a 0.12% chlorhexidine gluconate spray (Periogard, Colgate-Palmolive, São Bernardo do Campo, Brazil). Fifteen dental students were randomly enrolled in a 3-stage changeover system with a 1-week interval between each stage. The acrylic baseplates were worn full time except at meals to simulate the routine use of removable appliances under clinical conditions. Three 1-week home disinfection protocols were tested in all stages by a different group of students: protocol I, toothbrushing+ baseplate brushing+ sterile tap water spraying once a day; protocol II, toothbrushing+ baseplate brushing+ Periogard spraying on the seventh day after appliance placement; and protocol III, toothbrushing+ baseplate brushing+ Periogard spraying on the fourth and seventh days after appliance placement. After the first week, the volunteers received new baseplates, toothbrushes, and dentifrices, and the regimens were repeated 2 more times. At the end of each week, the baseplates had a randomized disinfection protocol and were sent for microbiologic analysis. A scanning electron microscope was used to examine 3 acrylic baseplates representing each home protocol. The Friedman test (α= 0.05) compared the home protocols for the formation of MS colonies or biofilms on the acrylic surfaces. MS colonies or biofilms were found on all acrylic baseplates after protocol I. Protocols II and III reduced significantly (P<0.05) the number of MS colonies and biofilms on the acrylic surfaces. No significant difference (P>0.05) was observed between protocols II and III. The scanning electron microscope analysis confirmed the results of the microbiologic cultures. Disinfection of baseplates of removable orthodontic appliances by using 0.12% chlorhexidine spray once or twice a week reduced the contamination by MS on the acrylic surface invivo.

Effect of removable orthodontic appliances on oral colonisation by mutans streptococci in children.

Little is known about the effect of removable orthodontic appliances on oral colonisation by mutans streptococci (MS). In the present study, the frequency of isolation and serotype distribution of MS were evaluated in two groups of children, one undergoing therapy with removable appliances and the other not subjected to any kind of orthodontic treatment, respectively. Streptococci isolated from dental plaque samples from both groups of children were identified as mutans streptococci on the basis of their morphological and biochemical properties and were then serotyped in an enzyme immuno-assay using monoclonal antibodies. The number of subjects harbouring MS in their dental plaque was statistically higher in the group of orthodontic children without caries experience (CF) in comparison with CF children of the control group (10/12, 83.3% vs. 15/44, 34%). No clear difference was observed in the distribution of the different MS serotypes between the experimental and control group: S. mutans c,f serotype was the most frequently isolated in both groups of children followed by S. mutans serotype e and S. sobrinus serotype g. Such results suggest that the use of removable appliances may lead to the creation of new retentive areas and surfaces, which favour the local adherence and growth of MS. The data obtained stress the importance of a careful monitoring of patients treated orthodontically for risk of caries development.

The consultant orthodontic service--1996 survey.

To evaluate the working patterns and facilities of the consultant orthodontist service. A cross-sectional survey. Consultant orthodontist departments in the UK. All consultant orthodontists in the UK were sent a questionnaire that gathered information on the individual consultant, the facilities available, the new patients referred and patients under current treatment. The consultant orthodontist service provided treatment to a high number of patients who were in definite need of orthodontic treatment. A marked reduction in the use of removable appliances suggests improving standards of care and provision of more complex treatment. The caseload was high and a fair proportion of patients were returned to their referring dentists with treatment plans. The consultant service has not completely evolved into a service that provides treatment at a super-specialist level alone. There has been little change in the consultant orthodontist service over the past ten years. Arguably, this is because of the wishes of the purchasers and the shortage of trained orthodontic manpower as a direct result of poor manpower planning and lack of funds for post-graduate training.

A survey of consultant orthodontists

In brief Objective To evaluate the working patterns and facilities of the consultant orthodontist service. Design A cross-sectional survey. Setting Consultant orthodontist departments in the UK. Subjects and methods All consultant orthodontists in the UK were sent a questionnaire that gathered information on the individual consultant, the facilities available, the new patients referred and patients under current treatment. Results The consultant orthodontist service provided treatment to a high number of patients who were in definite need of orthodontic treatment. A marked reduction in the use of removable appliances suggests improving standards of care and provision of more complex treatment. The caseload was high and a fair proportion of patients were returned to their referring dentists with treatment plans. The consultant service has not completely evolved into a service that provides treatment at a super-specialist level alone. Conclusions There has been little change in the consultant orthodontist service over the past 10 years. Arguably, this is because of the wishes of the purchasers and the shortage of trained orthodontic manpower as a direct result of poor manpower planning and lack of funds for post-graduate training.

Facial growth and development during puberty in unilateral cleft lip and palate: A longitudinal study : Smahel Z.; Mullerova Z.J. Craniofac. Genet. Dev. Biol. (Cze) (1994) 14/1 (57–68)

Roentgencephalometry was used for longitudinal assessment of facial growth and development in 20 boys and 23 girls (age range 10-15 years), with complete unilateral cleft lip and palate. A marked limitation of growth showed the depth of the upper jaw and the height of the upper lip whereas the most intense growth was present in variables characterizing the prominence of the nose. The growth rate was always higher in boys than in girls who had a more pronounced prognathia of the lower jaw. However, the development of the face proceeded identically in both sexes. In contrast with the increasing protrusion of the lower jaw was the increase of the retrusion of the upper jaw, and this led to a flattening of the facial profile and an impairment of sagittal jaw relations. The excessively steep mandibular body and the vertical disproportion of the face remained unchanged. Sagittal jaw relations deteriorated in three fourths of the patients, facial convexity in more than 90%, and neither condition showed any signs of improvement. It was possible to maintain the overjet at the same level as it was at the beginning of puberty; an improvement was attained with fixed appliances. The little scatter of developmental changes of mandibular rotation and the assessment of some correlations were suggestive of an individually constant postoperative character of facial development in clefts. Correlation coefficients disclosed that a more unfavorable condition at the age of 10 years did not imply a subsequent more marked deterioration of development during puberty. Mandibular rotation was not correlated with facial convexity, sagittal jaw relations, or overjet. The possibility of an improvement of overjet by the use of removable appliances was limited by the development of the ANB angle. The use of fixed appliances led to a reduction of this limitation.

Evaluation of orthodontic treatment using the Dental Aesthetic Index

This investigation evaluates dental esthetic differences of orthodontic patients before and after treatment. The orthodontic treatment provided for patients in this investigation involved the use of removable appliances in 85% of the cases, use of fixed appliances in 2% of the cases, and a combination of fixed and removable appliances in 13% of the cases. Records of patients treated at a dental school clinic between 1959 and 1984 were reviewed. Inclusion criteria for this study included complete patient records, and the presence of dental casts for estimation of the Dental Aesthetic Index (DAI). Of the 932 patients, 116 patient records were included. Fifty patients began treatment during the mixed dentition (age < or = 144 months), and 66 were treated during the permanent dentition (age > 144 months). Pretreatment DAI values and component factors were measured and compared with posttreatment values. The DAI scores improved significantly (p < or = 0.0001) in both age groups (paired t test; Bonferroni correction). However, 20% of the patients showed a worsening or no change in the DAI with treatment. In the mixed dentition group, maxillary anterior irregularities, diastema, and overjet showed statistically significant improvement after treatment (p < or = 0.0001). Patients in the permanent dentition showed statistically significant improvement in the crowding of lower incisors, maxillary anterior alignment, and overjet (p < or = 0.0001). Logistic regression analysis defined five statistically significant factors (p < or = 0.05) that could differentiate patients with successful and unsuccessful treatment outcomes.(ABSTRACT TRUNCATED AT 250 WORDS)

The Four Thames project: development of training in orthodontics for dental practice.

The Four Thames Project to develop training in orthodontics for dental practice, offered 26 clinical attachments with Consultants, over a 2-year period (October 1984-1986). A course of tuition was provided centrally in four modules. The programme was evaluated using a postal questionnaire and personal interview of the course participants, and with a postal questionnaire of the participating Consultants. The results of the evaluation are discussed and effects on the orthodontics in the participants' practices and consultants' units are outlined. Those on the first 2-year programme changed the range of their orthodontic practice to include more use of fixed appliances and a reduction in the use of removable appliances and of treatment by extraction and observation alone.

The use of removable appliances for forced eruption of teeth: David F. Murchison and Richard S. SchwartzQuintessence Int. 1986;17:497–501

The use of removable appliances for forced eruption of teeth: David F. Murchison and Richard S. SchwartzQuintessence Int. 1986;17:497–501