scholarly journals Effectiveness of an anterior mini-screw in achieving incisor intrusion and palatal root torque for anterior retraction with clear aligners:

2021 ◽  
Author(s):  
Lu Liu ◽  
Qi Zhan ◽  
Jing Zhou ◽  
Qianyun Kuang ◽  
Xinyu Yan ◽  
...  

ABSTRACT Objectives To analyze the biomechanical system of anterior retraction with clear aligner therapy (CAT) with and without an anterior mini-screw and elastics. Materials and Methods Models including a maxillary dentition (without first premolars), maxilla, periodontal ligaments (PDLs), attachments, and aligners were constructed and imported to finite element software. Three model groups were created: (1) control (CAT alone), (2) labial elastics (CAT with elastics between the anterior mini-screw and buttons on central incisors), and (3) linguoincisal elastics (CAT with elastics between the anterior mini-screw and precision cuts on the lingual sides of the aligner). Elastic forces (0–300 g, in 50 g increments) were applied. Results CAT alone caused lingual tipping and extrusion of the incisors. Labial elastics caused palatal root torquing and intrusion and mesial tipping of the central incisors, while linguoincisal elastics produced palatal root torquing and intrusion of both central and lateral incisors. Second premolars were intruded in all three groups, with less intrusion in the linguoincisal elastics group. For the control group, stress was concentrated on both labial and lingual root surfaces, alveolar ridge, and cervical and apical PDLs. Stress was more concentrated in the labial elastics group and less concentrated in the linguoincisal elastics group. Conclusions CAT produced lingual tipping and extrusion of incisors during anterior retraction. Anterior mini-screws and elastics can achieve incisor intrusion and palatal root torquing. Linguoincisal elastics are superior to labial elastics with a lower likelihood of buccal open bite. Root resorption and alveolar defects may occur in CAT, more likely for labial elastics and less likely for linguoincisal elastics.

2015 ◽  
Vol 86 (1) ◽  
pp. 39-45 ◽  
Author(s):  
Débora C Martins ◽  
Bernardo Q Souki ◽  
Paula L Cheib ◽  
Gerluza A.B Silva ◽  
Igor D.G Reis ◽  
...  

ABSTRACT Objective:  To compare external root resorption (ERR) when bands and wires are used as orthodontic anchorage during rapid maxillary expansion (RME). Materials and Methods:  Histologic analysis was performed on 108 sites from 18 maxillary first premolars and on 36 sites from six mandibular first premolars in nine subjects (mean age = 15.2 ± 1.4 years) 3 months after RME. Maxillary teeth were pooled into two groups (n = 54 each) according to the type of orthodontic anchorage (band group [BG] vs wire group [WG]). Anchorage type was randomly chosen in a split-mouth design. Mandibular first premolars, which were not subjected to orthodontic forces, were used as the control group (CG). Results:  All premolars in the BG and WG showed ERR at the level of the cementum and dentin. Repair with cementum cells was observed in all resorption areas, but complete repair was rarely found. No statistically significant difference was found between the BG and WG with regard to the ERR. No association was found between the root height position (middle or cervical third) and the incidence of ERR. Buccal root surfaces showed a higher amount of ERR compared with the palatal and interproximal surfaces. ERR was not found in any teeth in the CG. Conclusion:  All maxillary first premolars subjected to RME showed ERR and partial cementum repair. Banded teeth did not develop more ERR than nonbanded anchorage teeth.


2016 ◽  
Vol 87 (1) ◽  
pp. 41-48 ◽  
Author(s):  
Yayoi Matsuda ◽  
Masahide Motokawa ◽  
Masato Kaku ◽  
Hiromi Sumi ◽  
Kazuo Tanne ◽  
...  

ABSTRACT Objective: To immunohistochemically investigate the longitudinal changes in root resorption by jiggling force in experimental animal models. Materials and Methods: Fifty-six 12-week-old male Wistar rats were used. The maxillary first molars were alternately moved in the buccal and lingual direction in 28 rats (experimental group) using an experimental appliance to produce jiggling forces of 10 g. In another 28 rats (control group), the maxillary first molars were moved in only the lingual direction with a force of 10 g. After 1, 3, 7, 10, 14, 17, and 21 days, the maxillae were resected and subjected to immunohistochemical analysis. The resorption area was quantified histomorphometrically and the number of odontoclasts on the root surface was counted. Expression of RANKL and OPG was also examined by immunohistochemical staining. Results: The root resorption area and the number of odontoclasts were significantly greater in the experimental group than in controls. Odontoclasts were detected in the resorption lacunae and PDL in the experimental group, whereas osteoclasts were located only along the alveolar bone in controls. OPG was detected on the alveolar bone in the experimental group and on the root surfaces of the controls. Conclusions: Jiggling force is a critical factor in severe root resorption, affecting RANKL and OPG expression, which accelerates and inhibits odontoclastic induction, respectively.


2021 ◽  
Vol 11 (6) ◽  
pp. 120-136
Author(s):  
Justyna Oliwia Szpyt ◽  
Magdalena Gębska

IntroductionAccording to Angle's classification, a correct bite should have, inter alia, the following regularities: the median line of the face should coincide with the line between the central incisors of the upper and lower arches, the lower incisors should be overlapped by the incisal edges of the upper incisors, the top of the canine in the upper arch is inserted between the lower canine and the tangent premolar, each tooth is in contact with two opposing teeth, adjacent teeth both in the upper and lower arch are in contact with each other. Any deviation from these rules may indicate the presence of a malocclusion. We can distinguish here, for example: posteroclusion, open bite, retrusive occlusion, protrusive occlusion, supraclusion bite. They seem to be important not only in terms of functionality, but also psychology. Research shows that the correction of mandibular prognathism increases the level of self-confidence and self-acceptance, which may improve the quality of life of patients.Purpose of researchThe aim of the study was to check the quality of life of orthodontic and surgical patients as well as what factors motivate these people to start treatment in the area of the masticatory system.Material and methods208 people aged 18 to 55 participated in the survey. They were both people with malocclusion and no malocclusion, who constituted the control group. The questionnaire was created on the basis of standardized OQLQ and OHIP-14 questionnaires. It also included questions about the factors that motivate to start treatment in the masticatory system.ResultsThe most common malocclusion among the respondents was progenia (58.8%), followed by retrogenia (34.3%), then open bite (4%) and posteroclusion (2.9%). According to the OHIP-14 form, statistically significant (p <.0001) higher quality of life was seen in people without a masticatory organ defect, compared to people with the malocclusion. A statistically significant difference (p <.0001) between people with present or recent malocclusion (M = 54.29, SD = 16.71) and people without malocclusion (M = 31.93, SD = 18.31) was also visible in the study with using the OQLQ questionnaire.ConclusionsA malocclusion worsens the comfort and quality of life.Incorrect bite, face and smile aesthetics as well as psychological aspects are the most important factors motivating to undertake surgical and orthodontic treatment.Bruxism and facial pain are not factors prompting the initiation of treatment of malocclusion.


2020 ◽  
Vol 99 (4) ◽  
pp. 402-409 ◽  
Author(s):  
G. Avila-Ortiz ◽  
M. Gubler ◽  
M. Romero-Bustillos ◽  
C.L. Nicholas ◽  
M.B. Zimmerman ◽  
...  

Alveolar ridge preservation (ARP) therapy is indicated to attenuate the physiologic resorptive events that occur as a consequence of tooth extraction with the purpose of facilitating tooth replacement therapy. This randomized controlled trial was primarily aimed at testing the efficacy of ARP as compared with unassisted socket healing. A secondary objective was to evaluate the effect that local phenotypic factors play in the volumetric reduction of the alveolar bone. A total of 53 subjects completed the study. Subjects were randomized into either the control group, which involved only tooth extraction (EXT n = 27), or the experimental group, which received ARP using a combination of socket grafting with a particulate bone allograft and socket sealing with a nonabsorbable membrane (dPTFE) following tooth extraction (ARP n = 26). A set of clinical, linear, volumetric, implant-related, and patient-reported outcomes were assessed during a 14-wk healing period. All linear bone assessments (horizontal, midbuccal, and midlingual reduction) revealed that ARP is superior to EXT. Likewise, volumetric bone resorption was significantly higher in the control group (mean ± SD: EXT = −15.83% ± 4.48%, ARP = −8.36% ± 3.81%, P < 0.0001). Linear regression analyses revealed that baseline buccal bone thickness is a strong predictor of alveolar bone resorption in both groups. Interestingly, no significant differences in terms of soft tissue contour change were observed between groups. Additional bone augmentation to facilitate implant placement in a prosthetically acceptable position was deemed necessary in 48.1% of the EXT sites and only 11.5% of the ARP sites ( P < 0.004). Assessment of perceived postoperative discomfort at each follow-up visit revealed a progressive decrease over time, which was comparable between groups. Although some extent of alveolar ridge remodeling occurred in both groups, ARP therapy was superior to EXT as it was more efficacious in the maintenance of alveolar bone and reduced the estimated need for additional bone augmentation at the time of implant placement (ClinicalTrials.gov NCT01794806).


2019 ◽  
Vol 90 (3) ◽  
pp. 321-329
Author(s):  
Adilson Luiz Ramos ◽  
Monique Cimão dos Santos ◽  
Márcio Rodrigues de Almeida ◽  
Carlos Flores Mir

ABSTRACT Objectives To test the null hypothesis that there is no difference in bone dehiscence formation before and after orthodontic tooth movement through an atrophic alveolar ridge. Material and Methods This longitudinal retrospective study evaluated pretreatment and posttreatment cone-beam computed tomography imaging of 15 adult patients. Twenty-five teeth were moved through the atrophic alveolar bone, whereas 25 teeth not subjected to translational movement were considered controls. The distances between the cementoenamel junction and the alveolar bone crest were assessed at the mesial, distal, buccal, and lingual surfaces of all of these teeth. Data were compared using the Wilcoxon test. The Spearman correlation test and multivariate linear regression analysis were also performed. Results In general, crestal bone height was reduced around 0.5 mm in all groups in every direction. Median buccal dehiscence increased significantly (+2.25 mm) (P &lt; .05) in teeth moved through the atrophic ridge. Control teeth also had buccal crest loss (+0.83 mm), but this was not statistically different from that of the experimental teeth. Lingual dehiscence increased significantly for the experimental (+0.17 mm) and control (+0.65 mm) groups. Mesial bone height decreased more in the control group (–0.44mm) than in the experimental group (–0.14mm). There was moderate correlation between amount of tooth movement and alveolar bone loss. Conclusions The null hypothesis was rejected as dehiscence increased after tooth movement through an atrophic alveolar ridge, mainly in the buccal plate.


2020 ◽  
pp. 030157422096350
Author(s):  
Ajit Vikram Parihar ◽  
Shivam Verma ◽  
TP Chaturvedi ◽  
Naresh Kumar ◽  
A Kavin Prasanth ◽  
...  

Introduction: The objective of the study was to assess the rate of canine retraction and secondary outcomes associated with conventional fixed orthodontic treatment (CFO) and CFO with micro-osteoperforation (CFO + MOP), that is, anchorage loss, root resorption, vitality of tooth, pain and discomfort level during the procedure. Methods: A total of 16 patients with Class II Division 1 malocclusion who required upper first premolar extraction with lower non-extraction/single incisor extraction were divided into the test group (MOP) and positive control group (CFO + MOP) for a split-mouth study. Both maxillary canines were retracted with nickel–titanium (NiTi) closed coil springs. Patients were reviewed after 24 hours, 7 days, 28 days, and 4, 8, and 16 weeks to assess the rate of tooth movement, anchorage loss, root resorption, vitality of tooth, pain and discomfort level. Results: There was a statistically significant difference in the rate of tooth movement between the CFO and CFO + MOP groups after the first 4 weeks ( P-value = .026), whereas no statistically significant difference was observed at 8, 12, and 16 weeks ( P-value = .33, .99, and .08, respectively). In the CFO group, there was no statistically significant difference in tooth movement between different time intervals ( P-value > .05). There was no significant difference in root resorption between the groups. The pain level was higher in the MOP group in the first 24 hours ( P-value < .05) after the procedure. Later on, the difference in pain level between the groups was not significant ( P-value > .05). The vitality of retracted canines in both groups was healthy. Conclusion: The study recommends that the CFO + MOP procedure has substantial potential to be used as an adjunct to the routine mechanotherapy for faster tooth movement, as it may reduce the treatment time by half in the first 4 weeks after the MOP procedure. There are no potential differences in anchorage loss, tipping, vitality, and apical and lateral root resorption between the CFO and CFO + MOP groups. This trial was registered at Clinical Trial Registry, India.


2019 ◽  
Vol 13 (6) ◽  
pp. 600-606
Author(s):  
M. Laskowska ◽  
D. Olczak-Kowalczyk ◽  
M. Zadurska ◽  
J. Czubak ◽  
M. Czubak-Wrzosek ◽  
...  

Purpose Idiopathic scoliosis is a developmental deformation of the vertebral column of an unknown aetiology. Its clinical symptoms and hypothetical causative factors may affect the stomatognathic system. The aim of this study was to analyse the relationships between the prevalence and type of malocclusions, and the presence of idiopathic scoliosis, its location and severity. Methods This was a prospective longitudinal study. The study group consisted of 80 patients with idiopathic scoliosis and the control group of 61 healthy individuals. Standard standing long-cassette radiographs were taken of all of the patients in the idiopathic scoliosis group in order to confirm diagnosis, to determine localization and the Cobb angle of the curve. Both groups underwent standard clinical dental examination. Results The most commonly observed types included right main thoracic (R-MT) and thoracolumbar or left lumbar scoliosis (Cobb angle 11° to 125°). In the idiopathic scoliosis group, prevalence of malocclusions was greater than in the control group (95% versus 82%). In the idiopathic scoliosis group more than one type of malocclusion was observed with a higher incidence than that in the control group (63.8% versus 37.7%; p = 0.002). A correlation between the left proximal thoracic (L-PT) curve with anterior partial open bite was demonstrated (p = 0.323), between thoracic dextroscoliosis main thoracic with lateral partial cross bite (p = 0.230) and a correlation between scoliosis severity and malocclusion in the event of L-PT and anterior partial open bite (p = 0.330) and R-MT and scissors bite (p = 0.248). Conclusion The incidence of malocclusions is greater in children with idiopathic scoliosis than in their healthy peers Level of Evidence III


2020 ◽  
Vol 44 (3) ◽  
pp. 161-167
Author(s):  
Cristiana Pereira Malta ◽  
Gabriele Groehs Guerreiro ◽  
Natali Marchezan Dornelles ◽  
Clandio Timm Marques ◽  
Juliana Saibt Martins ◽  
...  

Objectives: The aim of the present study was to compare the perception of caregivers regarding the oral health status of children and adolescents with cerebral palsy (CP) and those with typical development. Study Design: Study group (SG) was composed of 35 children and adolescents with a clinical diagnosis of CP and their caregivers. Control group (CG) was composed of 35 individuals with typical development (matched with the SG for age, sex and caries activity) and their caregivers. Questionnaire was administered to caregivers addressing the oral health of individuals under their care. Caries activity, dmft/DMFT index, visible plaque index (VPI) and occlusal characteristics were determined. Results: Statistically significant differences were found in the perceptions of dental problems (p = 0.004) and gingival bleeding (p = 0.013). Individuals in SG whose caregivers perceived dental problems had a higher mean VPI (50.84 ± 5.11%) than those in CG (27.97 ± 6.50%). The mean dmft/DMFT in the SG was 2.77 ± 3.20. Class II molar relationship, overjet and anterior open bite were more prevalent in the SG. Conclusion: Caregivers of children/adolescents with CP perceive more oral problems, such as visible plaque, gingival bleeding and malocclusion, than caregivers of children/ adolescents with typical development.


2005 ◽  
Vol 31 (6) ◽  
pp. 304-308 ◽  
Author(s):  
Gintaras Juodzbalys ◽  
Rimvydas Giedraitis ◽  
Vita Mačhiulskienė ◽  
Luc W. J. Huys ◽  
Ricardas Kubilius

Abstract Local anesthesia, the well-known method of sedation, usually is insufficient for dental implantation and the augmentation of the alveolar ridge, because the operations last for 1 to 2 hours and patients may experience fear and strain. This article examines a new complex sedation method using ketorolac, midazolam, and a local anesthetic 4% solution of articaine hydrochloride and epinephrine (Septanest) in combination with a vasoconstrictor. This method was applied to 67 patients operated on for dental implantation with screw implants or for the alveolar ridge augmentation with biocompatible materials. The control group, which consisted of 20 patients, received local anesthesia with articaine-epinephrine only. Most of the control patients were found to have experienced fear and strain during the aforementioned surgical procedures; their blood pressure and pulse rate increased, and more than half of them experienced pain. No disorders of hemodynamics or the psychoemotional status of the patients were observed during sedation with ketorolac, midazolam, and articaine-epinephrine. Furthermore, anterograde amnesia was determined for the 80% of the patients in the test group.


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