scholarly journals Molar Uprighting: A Considerable and Safe Decision to Avoid Prosthetic Treatment

2017 ◽  
Vol 11 (1) ◽  
pp. 466-475 ◽  
Author(s):  
Taísa Boamorte Raveli ◽  
Dirceu Barnabé Raveli ◽  
Kelei Cristina de Mathias Almeida ◽  
Ary dos Santos Pinto

Background: Tipped lower molar over edentulous space is very common in orthodontics practice when adults seek treatment. The segmented arch technique features a predictable force system that provides a controlled release of force that can produce light and continuous tooth movement. Case Description: A female adult patient, who lost a permanent lower first molar, needed correction of the position of her permanent first molar place. Instead of making space for rehabilitation, it was closed after second molar uprighting and a balanced interdigitation was created without prosthetics. The patient was successfully treated with segmented arch technique using root correction spring activated with geometry VI to promote uprighting of a tipped molar and Niti spring coil to promote space closure. Practical Implications: Segmented arch technique is known to provide predictable light and continuous forces, which is very much indicated in adult treatment. There are several things to consider when orthodontically treating adult patients. Their periodontal conditions might not be ideal, less bone apposition may occur, and side effects of orthodontic tooth movement are expected. Thus, a predictable and controlled orthodontic treatment is needed.

2017 ◽  
Vol 90 (1) ◽  
pp. 93-98
Author(s):  
Adela Zimbran ◽  
Diana Dudea ◽  
Cristina Gasparik ◽  
Sorin Dudea

Background and aim. Orthodontic tooth movement (OTM) is a process whereby the application of a force induces bone resorption on the pressure side and bone apposition on the tension side of the lamina dura. However, only limited data are available on the in vivo behavior of the periodontal tissues. The aim of this study was to assess the changes of periodontal tissues, induced by the orthodontic canine retraction, using 40 MHz ultrasonography.Methods. Ultrasonographic evaluation of periodontal tissues was conducted in 5 patients with indication for orthodontic treatment. The upper first premolars were extracted bilaterally due to severe crowding, and the canines were distalized using elastomeric chain with a net force of 100 cN. Ultrasonographic scans (US scans) were performed before, during and after retraction, in three distinct areas of the canines buccal surface: mesial, middle and distal. The reference point was the bracket, which appeared hyperechoic on the US scan. Four different dimensions were obtained: D1 (depth of the sulcus), D2 (thickness of the gingiva), D3 (length of the supracrestal fibers), D4 (width of periodontal space).Results. An increase of D1 was observed in all three areas of the periodontium, during orthodontic treatment.  D3 was strongly correlated before and immediately after force delivery only for the mesial area (r=0.828, p<0.05). In total, 228 variables were statistically analyzed using Pearson’s correlation coefficients, in order to demonstrate the relationship between periodontal findings during orthodontic tooth movement.Conclusions. High-resolution ultrasonography has the capability to obviate changes in periodontal ligament space and free gingiva during orthodontic tooth movement.


2020 ◽  
Vol 8 (1) ◽  
pp. 19
Author(s):  
Silvia Caruso ◽  
Atanaz Darvizeh ◽  
Stefano Zema ◽  
Roberto Gatto ◽  
Alessandro Nota

Accelerating orthodontic tooth movement has become a topical issue and the corticotomy seems to be the only effective and safe technique reported in the literature. Simultaneously, aesthetic orthodontic treatment with removable clear aligners has become commonly requested. The aim of this paper is to illustrate the management of facilitated aesthetic orthodontic treatment, a combined approach including piezocision corticotomy and clear aligners for orthodontic treatment. Orthodontic planning for traditional clear aligners should be modified to take advantage of the corticotomy technique in order to facilitate the most difficult orthodontic movements needed to achieve treatment completion, where each aligner will be used for four days rather than 15 days for a total time of four months. A corticotomy with a modified minimally invasive flapless piezocision technique should be performed in both jaws at the same time, before the time window of the orthodontic treatment, where the most difficult orthodontic movements are planned. Treatment planning where difficult orthodontic movements, such as anterior open-bite closure and extraction space closure, are easily managed with clear aligners and are presented as examples of facilitated aesthetic orthodontic treatment application. The combination between aesthetic treatment with clear aligners and modified piezocision corticotomy, if carefully planned, seems to represent a synergy that achieves the current goals of orthodontic treatment. The primary objectives of this combination should be facilitating difficult orthodontic movements and reducing treatment duration.


2021 ◽  
Vol 11 (2) ◽  
pp. 521
Author(s):  
Simina Chelărescu ◽  
Petra Șurlin ◽  
Mioara Decusară ◽  
Mădălina Oprică ◽  
Eugen Bud ◽  
...  

Background: The crevicular fluid analysis represents a useful diagnosis tool, with the help of which noninvasive cellular metabolic activity can be analyzed. The aim of the study is to investigate comparatively IL1β and IL6 in the gingival crevicular fluid of clinically healthy adolescents and young adults during the acute phase of orthodontic treatment. Methods: Gingival crevicular fluid was collected from 20 patients (aged between 11 and 28) undergoing orthodontic treatment. Measurements were taken before (T0) and after 24 h after distalization forces were activated (T1). IL1β and IL 6 were analyzed using Elisa tests. The statistical tests used were two-sided t tests. Results: Between the two time periods there was a significant raise both in the crevicular fluid rate (0.57 µL at T0 vs. 0.95 µL at T1, p = 0.001) and in IL1β levels (15.67 pg/µL at T0 vs. 27.94 pg/µL at T1, p = 0.009). We were able to identify IL6 only in a third of the sites. There is a significantly increased level of ILβ at T1 in adolescents, more than in young adults (42.96 pg/µL vs. 17.93 pg/µL, p = 0.006). Conclusions: In the early stage of orthodontic treatment, the periodontal tissues of adolescents are more responsive to orthodontic forces than those of young adults.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nada Tashkandi ◽  
Yihong Zhao ◽  
Gabrielle Mitchell-Lee ◽  
Danielle Stephens ◽  
Michele Patel ◽  
...  

Abstract Background Vitamin D is critical for bone physiology. In this study, we quantified Vitamin D Binding Protein (VitDBP) levels in saliva as a measure of Vitamin D during orthodontic tooth movement. Methods In this longitudinal study, saliva samples were collected from 73 orthodontic patients for 4 timepoints for the first six months of orthodontic treatment, along with dental casts at the beginning and the end of the study period. The saliva was measured for VitDBP as a biological marker for bone apposition and clinical tooth movement. We used the absolute change in Little's Irregularity Index as a quantitative measure for alignment. In addition, we measured the levels of alkaline phosphatase (ALP) in saliva as a marker of bone turnover. Results Both low (< 2.75 ng/ml) and high (> 6.48 ng/ml) VitDBP levels were associated with reduced tooth movement. Significant (p < 0.05) seasonal changes in VitDBP using a two-season year model were found with lower levels observed in the summer (Apr–Sept) than in the winter (Oct–Mar). Conclusions Clinically significant orthodontic tooth movement is associated with an optimal range of VitDBP in saliva. Normal levels of VitDBP correlated with more orthodontic tooth movement, suggesting a "normal" range of salivary content of VitDBP. Given the strong trend that is independent of the confounding factors (ex. age, race or gender), the predictive value or salivary VitDBP for tooth movement should be studied in larger cohorts in future studies.


2021 ◽  
Vol 22 (5) ◽  
pp. 2388
Author(s):  
Masaru Yamaguchi ◽  
Shinichi Fukasawa

The aim of this paper is to provide a review on the role of inflammation in orthodontically induced inflammatory root resorption (OIIRR) and accelerating orthodontic tooth movement (AOTM) in orthodontic treatment. Orthodontic tooth movement (OTM) is stimulated by remodeling of the periodontal ligament (PDL) and alveolar bone. These remodeling activities and tooth displacement are involved in the occurrence of an inflammatory process in the periodontium, in response to orthodontic forces. Inflammatory mediators such as prostaglandins (PGs), interleukins (Ils; IL-1, -6, -17), the tumor necrosis factor (TNF)-α superfamily, and receptor activator of nuclear factor (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) are increased in the PDL during OTM. OIIRR is one of the accidental symptoms, and inflammatory mediators have been detected in resorbed roots, PDL, and alveolar bone exposed to heavy orthodontic force. Therefore, these inflammatory mediators are involved with the occurrence of OIIRR during orthodontic tooth movement. On the contrary, regional accelerating phenomenon (RAP) occurs after fractures and surgery such as osteotomies or bone grafting, and bone healing is accelerated by increasing osteoclasts and osteoblasts. Recently, tooth movement after surgical procedures such as corticotomy, corticision, piezocision, and micro-osteoperforation might be accelerated by RAP, which increases the bone metabolism. Therefore, inflammation may be involved in accelerated OTM (AOTM). The knowledge of inflammation during orthodontic treatment could be used in preventing OIIRR and AOTM.


2018 ◽  
Vol 7 (2) ◽  
pp. 47-51
Author(s):  
Neeta Aryal ◽  
Mao Jing

Introduction: Root resorption is the loss of apical root tissue leading to the shortness of root which is often evident in orthodontic tooth movement. Proper management during orthodontic treatment however can minimize this undesirable outcome. The present article attempts to review the etiology of root resorption, methods of diagnosis, and strategies for prevention.Materials & Method: A scoping review was done with the purpose to carry out the narrative integration of the relevant evidences on root resorption and orthodontic treatment from the published literatures. The resulting papers were studied and reviewed thoroughly for the key explanation of root resorption in orthodontic patients. A total of 41 published research articles were reviewed.Discussion: According to the literatures root resorption is common iatrogenic outcome in orthodontic treatment. Biological, mechanical, and combined biological and mechanical factors result in external root resorption. Though most clinicians diagnose root resorption by conventional radiography, researches have clearly shown that CBCT is the promising tool. The clinicians need to counsel orthodontic patients and their parents that the root resorption might be a potential consequence of the treatment lasting for long time. In case of severity; it is essential to reassess the patient and minimize the underlying cause. It is necessary to understand the role of orthodontist in preventing root resorption


2017 ◽  
Vol 16 ◽  
pp. 1-8
Author(s):  
Noraini Abu Bakar ◽  
Wisam Kamil ◽  
Lina Al Bayati ◽  
Basma Ezzat Mustafa

Introduction: During orthodontic tooth movement, the early response of periodontal tissues to mechanical stress is an acute inflammatory reaction. Mechanical stress from orthodontic appliances is believed to induce cells in the periodontal ligament (PDL) to form biologically active substances, such as enzymes and cytokines, responsible for connective tissue remodeling (Nishijima Y et al 2006). Leptin, a polypeptide hormone has been classified as a cytokine (Zhang et al 1994). Earlier findings concluded that leptin at high local concentrations protects the host from inflammation and infection as well as maintaining bone levels. It has been also suggested that leptin plays a significant role in bone formation by its direct effect on osteoblasts (Alparslan et al 2010). This pilot study aimed to study leptin in saliva and its association with tooth movement during initial orthodontic alignment. Objectives: To determine if there are any differences in saliva leptin level before and after orthodontic alignment. Material and methods: Ten orthodontic patients (7 girls and 3 boys; mean age, 16.76 ± 1.1 years) with crowding (up to 5mm) that required orthodontic fixed appliances, on a non-extraction basis as part of the treatment plan, were recruited in this longitudinal study. Orthodontic study models were constructed at baseline and at 6- weeks after orthodontic treatment commenced. Full fixed orthodontic appliances with initial 0.014” Nickel Titanium archwire placed. The amount of crowding was measured, before and after initial alignment with an electronic digital caliper (Max-Cal, Japan Micrometer Ltd, Tokyo, Japan) with an accuracy of up to 0.01mm. Unstimulated morning saliva sample were collected at all visits, after at least an 8-hour period of fasting and no-toothbrushing. After centrifugation (4000x g;10min), the samples were stored at -25C and tested using Leptin Abnova LEP Human ELISA kit (KA3080) which was subsequently analyzed. Subjects’ periodontal health status was also monitored throughout the study. Ethical approval (ID IREC 262) was received on 7th April 2014 from International Islamic University Malaysia Research Ethics Committee (IREC). Results: Leptin concentration in saliva was significantly decreased in a time-dependant manner (t(9)=8.60, p<0.001), from before orthodontic treatment (7016.45± 425.15 pg/mL) and 6 weeks after bond-up (4901.92±  238.64 pg/mL). Conclusion: Leptin concentration in saliva is decreased during orthodontic tooth movement in initial alignment stage.


2015 ◽  
Vol 16 (9) ◽  
pp. 740-743 ◽  
Author(s):  
HP Raghuveer ◽  
M Hemanth ◽  
MS Rani ◽  
Chathura Hegde ◽  
B Vedavathi ◽  
...  

ABSTRACT Background Orthodontic tooth movement occurs due to various biomechanical changes in the periodontium. Forces within the optimal range yield maximum tooth movement with minimum deleterious effects. Among various types of tooth movements, extrusion and rotational movements are seen to be associated with the least amount of root resorption and have not been studied in detail. Therefore in this study, the stress patterns in the periodontal ligament (PDL) were evaluated with extrusion and rotational movements using the finite element method FEM. Materials and methods A three-dimensional (3D) FEM model of the maxillary incisors was generated using SOLIDWORKS modeling software. Stresses in the PDL were evaluated with extrusive and rotational movements by a 3D FEM using ANSYS software with linear material properties. Results It was observed that with the application of extrusive load, the tensile stresses were seen at the apex, whereas the compressive stress was distributed at the cervical margin. With the application of rotational movements, maximum compressive stress was distributed at the apex and cervical third, whereas the tensile stress was distributed on cervical third of the PDL on the lingual surface. Conclusion For extrusive movements, stress values over the periodontal ligament was within the range of optimal stress value as proposed by Lee, with a given force system by Profitt as optimum forces for orthodontic tooth movement using linear properties. During rotation there are stresses concentrated at the apex, hence due to the concentration of the compressive forces at the apex a clinician must avoid placing heavy stresses during tooth movement. How to cite this article Hemanth M, Raghuveer HP, Rani MS, Hegde C, Kabbur KJ, Vedavathi B, Chaithra D. An Analysis of the Stress Induced in the Periodontal Ligament during Extrusion and Rotation Movements: A Finite Element Method Linear Study Part I. J Contemp Dent Pract 2015;16(9):740-743.


Author(s):  
Marc A. de Gouyon Matignon de Pontouraude ◽  
Johannes W. Von den Hoff ◽  
Frank Baan ◽  
Robin Bruggink ◽  
Marjon Bloemen ◽  
...  

Abstract Objectives Individual orthodontic treatment duration is hard to predict. Individual biological factors are amongst factors influencing individual rate of orthodontically induced tooth movement (OTM). The study aim is to determine the rate of OTM by a novel 3D method and investigate parameters that may predict the rate of tooth movement. Materials and methods In this prospective cohort study, rate of OTM was determined from 90 three-dimensional intra-oral scans in 15 patients (aged 12–15) undergoing orthodontic treatment. For each patient, intra-oral scans were taken every week for up to 6 weeks (T0–T5). The teeth were segmented from the scans and the scans were superimposed on the palatal rugae. The rate of OTM was calculated for each tooth. Other parameters were gingival inflammation, contact-point displacement and the biological markers, matrix metalloproteinases (MMP), MMP-9 and MMP-2 in gingival crevicular fluid (GCF). Results Our study showed a high variation in the rate of OTM, varying from 0.15 to 1.24 mm/week. Teeth in the anterior segment tended to move more compared with the posterior segment. The contact point displacement and gingival inflammation varied greatly amongst the patients. The MMPs measured did not correlate with tooth movement. However, the gingival inflammation index showed a significant correlation with OTM. Future studies should include other biological markers related to bone-remodeling. Conclusion This novel and efficient 3D method is suitable for measuring OTM and showed large individual variation in rate of OTM. Clinical relevance Patients show different rates of OTM. The rate of OTM in an individual patient can provide guidance in timing of follow-up appointments.


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