scholarly journals Stability of aligned maxillary anterior teeth after orthodontic treatment: amount of changes with different retention methods and without retention

2021 ◽  
Author(s):  
◽  
Sasan Naraghi
Keyword(s):  
Orthodontic Treatment ◽  
Contact Point ◽  
Clinical Results ◽  
Post Treatment ◽  
Short Term ◽  
Retention Capacity ◽  
Anterior Teeth ◽  
Retention Group ◽  
One Year ◽  
Bonded Retainers

Well-aligned anterior teeth are the major reason for the patients seeking orthodontic treatment, and keeping teeth aligned and stable afterwards is a goal for the orthodontist and the patient. Relapse after treatment is a common problem, and it is defined as when teeth go back to their previous positions. Removable or fixed retainers have been used to avoid relapse after treatment. It has been common practice to use removable retention to retain anterior teeth in the maxilla. However, in recent decades, it has become increasingly common to retain with bonded retainers. Almost all previous studies on retention devices in the maxilla were based on removable retainers. Consequently, there existed knowledge gaps and lack of short-term and long-term studies on the capability to maintain the stability of the maxillary anterior teeth with bonded retainers. Hence, the reason for the papers in this study. In addition, it is not known if retentionis needed in all orthodontic patients or if there are patients, based on their initial malocclusion and individual variations, who may not need retention after treatment. The research questions addressed in this thesis thus originate from knowledgegaps and clinical needs concerning retention strategies after orthodontic treatments. To provide strong clinical evidence, randomised controlled trials (RCT) as well as intention to treat (ITT) methodology has been assessed. The results are expected to be beneficial for the patients who will be offered the most effective retention strategy for maxillary anterior teeth based on patients’ preferences. In Paper I and II, 45 and 27 adolescents’ patients were collected from the Orthodontic Clinic in Mariestad, Sweden. At the time when Paper Iand II were conducted, there were no studies that had evaluated the longterm effect of bonded retainers in the maxilla. In two RCTs, Paper III and IV, 90 and 63 adolescents’ patients were collected from the Orthodontic Clinic in Växjö, Region Kronoberg, Sweden. Paper I: The aim was to investigate the amount and pattern of relapse of maxillary anterior teeth previously retained with a bonded retainer. Paper II: The aim was to investigate the amount and pattern of changes of maxillary anterior teeth seven years post-retention, which previously were retained with a bonded retainer. Paper III: The aim was to evaluate post-treatment changes in the irregularity of the maxillary six anterior teeth and single tooth Contact Point Discrepancy (CPD) of three different retention methods. Paper IV: The aim was to evaluate whether retention is needed after orthodontic treatment for impacted maxillary canines and with moderate pre-treatment irregularity in the maxilla. Key findings in Paper I • The contact relationship between the laterals and the centrals is the most unstable contact. Canines are the most stable teeth. • There was no difference in the relapse pattern between rotational displacements and labiolingual displacement. Key findings in Paper II • There was a strong correlation between irregularity at one- and seven-years post-retention. Stable cases one-year post-retention were stable and unstable cases deteriorated with time. Key findings in Paper III • All three retention methods showed equally effective retention capacity and all the changes found in the three groups were small and considered clinically insignificant. Thus, the null hypothesis was confirmed. All three methods can be recommended. Key findings in Paper IV • Changes between the retention and the non-retention group were statistically but not clinically significant. Since satisfactory clinical results one-year post-treatment were found in the non-retention group, retention does not appear always to be needed. • Most of the changes occur within the first 10-week period after treatment with no retention. Key conclusions and clinical implications Both removable and bonded retainers are effective for holding teeth inposition and can be used for preventing the relapse. It can be enough toretain with bonded retainer 12-22 instead of 13-23. It might be possibleto avoid retention in selected cases in the short-term, but a longer evaluationperiod is needed.

scholarly journals Comparison of post-treatment changes with and without retention in adolescents treated for maxillary impacted canines—a randomized controlled trial

2020 ◽  
Author(s):  
Sasan Naraghi ◽  
Niels Ganzer ◽  
Lars Bondemark ◽  
Mikael Sonesson
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Contact Point ◽  
Final Analysis ◽  
Post Treatment ◽  
Single Centre ◽  
Randomized Controlled ◽  
Anterior Teeth ◽  
Retention Group ◽  
Interim Period

Summary Objective To evaluate whether retention is needed after orthodontic treatment of impacted maxillary canines. Trial design Two-arm parallel group single-centre randomized controlled trial. Materials and methods Sixty-three patients, 39 girls and 24 boys, were recruited to the study. The inclusion criteria were patients with at least one impacted or unerupted maxillary canine, and moderate irregularity of the maxillary six anterior teeth according to Little’s index (LI). After gaining informed consent from the patient and their custodians, the patients were randomized to one of two groups, i.e. to a non-retention group or a retention group. The randomization process was prepared and carried out by an independent person not involved in the trial and the randomization used blocks of 20 (10 + 10). Primary outcomes were changes in single contact point discrepancy, and LI measured on digitalized three-dimensional study casts 1-year post-treatment. The study casts were anonymized before assessment and the changes were blinded for the assessor. Data were evaluated on an intention-to-treat basis. Thus, all randomized patients were incorporated into the final analysis. In the non-retention group a 10-week interim period was used to detect patients who eventually have a relapse immediately after treatment. If so, the patient got the arch-wire reinserted. Most patients in the retention group received a vacuum-formed retainer and pretreatment spacing cases got a bonded retainer. Results Mean irregularity change was 0.4 mm in the retention and 1.3 mm in the non-retention group (P < 0.001). Maximum change was 2.5 mm in the retention and 3.2 mm in the non-retention group (P < 0.001). Most changes in the non-retention group occurred during the 10-week interim period. In the non-retention group, one patient developed contact point discrepancy of >2 mm during the interim period and was realigned. Harms One patient met the stopping guideline criteria. This patient had the arch wire reinserted for 2 months. After realignment, the patient received a retention appliance. Limitations The trial was a single-centre study and short-term changes were evaluated. Conclusions Changes between the retention and the non-retention group were statistically but not clinically significant. Since satisfactory clinical results 1-year post-treatment were found in the non-retention group, retention does not appear to be needed. The 10-week interim period was useful in detecting patients who might have a relapse immediately after treatment. Trial registration The trial was not registered.

The Bonded Mandibular Lingual Retainer

1986 ◽  
Vol 13 (3) ◽  
pp. 159-163 ◽  
Author(s):  
Shabbir T. Adenwalla ◽  
Fereidoon Attarzadeh
Keyword(s):  
Orthodontic Treatment ◽  
Anterior Teeth ◽  
Lingual Retainer ◽  
Bonded Retainers

The lower fixed retainer from cuspid to cuspid has been one of the commonly used methods of retention at the end of the orthodontic treatment. Orthodontists mostly use the lingual wire soldered to cuspid bands for the fixed lower retainer. With the advent of the new effective bonding materials many orthodontists prefer to use cuspid-to-cuspid/biscuspid-to-biscuspid bonded retainers to obtain optimal retention of lower anterior teeth both functionally and aesthetically. After experimenting with a variety of previous methods, such as the use of rubber bands, elastic threads, cotton pliers, ligature wires and silastic trays for the accurate placement and immobilization of a lower lingual retainer during the bonding, we have found that the use of two 1 to 1½ inch pieces of 0·016 inch wires tack welded to lingual wire gives the best results. It is more accurate, simple, inexpensive and designed to save the orthodontist chair time.

scholarly journals Apical root resorption during orthodontic treatment with aligners? A retrospective radiometric study

2013 ◽  
Vol 9 (1) ◽  
Author(s):  
Elena Krieger ◽  
Thomas Drechsler ◽  
Irene Schmidtmann ◽  
Collin Jacobs ◽  
Simeon Haag ◽  
...  
Keyword(s):  
Root Length ◽  
Orthodontic Treatment ◽  
Influence Factor ◽  
Root Resorption ◽  
Post Treatment ◽  
Anterior Crowding ◽  
Anterior Teeth ◽  
Lateral Cephalograms ◽  
Length Changes ◽  
Pre Treatment

Abstract Introduction Objective of this study was to investigate the incidence and severity of apical root resorptions (ARR) during orthodontic treatment with aligners. Materials and methods The sample comprised 100 patients (17–75 years of age) with a class I occlusion and anterior crowding before treatment, treated exclusively with aligners (Invisalign®, Align Technologies, Santa Clara, CA, USA). The following teeth were assessed: upper and lower anterior teeth and first molars. Root and crown lengths of a total of 1600 teeth were measured twice in pre- and post-treatment panoramic radiographs. Afterwards, relative changes of the root length during treatment were calculated by a root-crown-ratio taking pre- and post-treatment root and crown lengths into consideration. A reduction of this ratio was considered as a shortening of the initial root length. Additionally, tooth movements of the front teeth were assessed by lateral cephalograms and the 3-dimensonal set up of each patient. Results All patients had a reduction of the pre-treatment root length with a minimum of two teeth. On average 7.36 teeth per patient were affected. 54% of 1600 measured teeth showed no measurable root reduction. A reduction of >0%-10% of the pre-treatment root length was found in 27.75%, a distinct reduction of >10%-20% in 11.94%. 6.31% of all teeth were affected with a considerable reduction of >20%. We found no statistically significant correlation between relative root length changes and the individual tooth, gender, age or sagittal and vertical orthodontic tooth movement; except for extrusion of upper front teeth, which was considered as not clinical relevant due to the small amount of mean 4% ARR. Conclusions The present study is the first analyzing ARR in patients with a fully implemented orthodontic treatment with aligners (i.e. resolving anterior crowding). The variety was high and no clinical relevant influence factor could be detected. A minimum of two teeth with a root length reduction was found in every patient. On average, 7.36 teeth per patient were affected.

Stability of maxillary anterior teeth after 2 years of retention in adolescents: a randomized controlled trial comparing two bonded and a vacuum-formed retainer

2020 ◽  
Author(s):  
Sasan Naraghi ◽  
Niels Ganzer ◽  
Lars Bondemark ◽  
Mikael Sonesson
Keyword(s):  
Randomized Controlled Trial ◽  
Controlled Trial ◽  
Contact Point ◽  
Three Dimensional ◽  
Final Analysis ◽  
Single Centre ◽  
Retention Capacity ◽  
Intention To Treat ◽  
Randomized Controlled ◽  
Anterior Teeth

Summary Background Retention of the maxillary anterior teeth is commonly recommended to maintain the teeth in their corrected positions. Both fixed and removable retention methods are used, but the certainty of evidence is low. Objective To evaluate post-treatment changes in irregularity of the maxillary six anterior teeth and single tooth contact point discrepancy (CPD) of three different retention methods. Trial design Three-arm parallel group single-centre randomized controlled trial. Materials and methods Ninety patients, 54 girls and 36 boys, were recruited to the study. The inclusion criteria were adolescent patients treated with fixed appliances at least in the maxilla. After gaining informed consent from the patient and their custodians, the patients were randomized to one of three groups: bonded retainer 13–23, bonded retainer 12–22, and removable vacuum-formed retainer (VFR) covering the maxillary teeth including the second molars. The randomization, prepared by an independent person, used blocks of 30. The primary outcomes were changes in single CPD and Little’s irregularity index (LII) measured on digitalized three-dimensional study casts before and after 2-year retention. The study casts were anonymized before assessment and the changes were blinded for the assessor. Data were evaluated on an intention-to-treat basis. Thus, all randomized patients were incorporated into the final analysis. Results The LII and CPDs increased slightly in all three groups without any statistically significant differences between the groups. The VFR group showed a small intercanine width increase and some more changes of canine rotations than in the other groups. Harms No harm was observed in any subjects and none of the patients needed retreatment. Limitations The trial was a single-centre study and short-term changes were evaluated. Conclusions All three retention methods showed equally effective retention capacity and all the changes found in the three groups were small and considered clinically insignificant. Thus, the null hypothesis was confirmed. All three methods can be recommended. Trial registration NCT04616755

Proton radiotherapy for prostate cancer in the Medicare population: Patterns of care and comparison of early toxicity with IMRT.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4651-4651
Author(s):  
James B. Yu ◽  
Pamela R. Soulos ◽  
Laura D. Cramer ◽  
Kenneth B Roberts ◽  
Jeph Herrin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Logistic Regression ◽  
Cancer Patients ◽  
Post Treatment ◽  
Complication Rates ◽  
Proton Radiotherapy ◽  
Short Term ◽  
Significant Difference ◽  
Patient Reported ◽  
One Year

4651 Background: Proton radiotherapy (PRT) is a costly treatment used for prostate cancer despite little evidence supporting its use. We examined patterns of PRT use in the Medicare program and assessed the short-term toxicity of PRT vs. intensity modulated radiation therapy (IMRT). Methods: Using national Medicare claims from 2008-2009, we identified a sample of prostate cancer patients ages 66-94 who had received PRT or IMRT. We used multivariable logistic regression to identify patient and regional factors associated with receipt of PRT. We searched claims for procedure and diagnosis codes indicative of treatment-related complications and grouped the complications into genitourinary (GU), gastrointestinal (GI), and other complications. To compare the effect of PRT and IMRT on short-term toxicity, we used a Mahalanobis distance approach to match each PRT patient to two IMRT patients, achieving balanced distribution of clinical and sociodemographic characteristics. We compared six-month and one-year outcomes between the two treatment groups using conditional logistic regression. Results: We identified 27,647 men; 421 (2%) received PRT and 27,226 (98%) received IMRT. Patients who received PRT were widely geographically distributed, with some patients traveling >500 miles for treatment. PRT patients were younger, healthier, and of higher socioeconomic status. Although PRT was associated with a significant reduction in GU complications at six-months compared with IMRT (6.1% vs. 12.0%, OR 0.60 [95% CI 0.38-0.96], p=0.03), at one-year post-treatment there was no longer any difference in cumulative complication rates (18.9% vs. 21.9%, OR 0.96 [95% CI 0.61-1.53], p=0.88). There was no significant difference in GI or other complications at six-months or one-year post-treatment. Conclusions: Although PRT remains a scarcely used treatment, some prostate cancer patients traveled great distances for treatment. While PRT was associated with a reduction in six-month GU toxicity, there were no differences in toxicity at one-year. Further study on longer-term effects and other clinical and patient-reported outcomes is needed to inform the widespread application of PRT.

scholarly journals External Root Resorption after Orthodontic Treatment with Invisalign®: A Retrospective Study

2020 ◽  
Vol 12 (11) ◽  
pp. 125
Author(s):  
Haya AlSagr ◽  
Shahd AlMujel ◽  
Sadeen AlShiha ◽  
Najlaa AlShathri ◽  
Deema AlShammary
Keyword(s):  
Retrospective Study ◽  
Orthodontic Treatment ◽  
Root Resorption ◽  
Root Apex ◽  
Post Treatment ◽  
Riyadh City ◽  
Crown Length ◽  
Anterior Teeth ◽  
External Root Resorption ◽  
Pre Treatment

AIM: To measure the incidence and severity of root resorption after orthodontic treatment with Invisalign. MATERIAL AND METHODS: This retrospective study was conducted at Riyadh, Saudi Arabia from June 2017 to January 2018. Pre- treatment and post-treatment Orthopantographs were obtained from orthodontic records of 29 patients managed with aligners (Invisalign®, Align Technologies, Santa Clara, CA, USA) at different dental clinics in Riyadh City. The selected sample was fulfilled the following criteria: (1) Class I malocclusion, (2) Mild to moderate crowding, (3) Non-extraction orthodontic treatment, (3) No evidence of root resorption before orthodontic treatment, (4) No root abnormalities or dilaceration, and (5) Good quality of pre- and post-treatment Orthopantographs. One examiner performed the measurements directly on the Orthopantographs using electronic digital caliper (Mitutoyo Manufacturing Co. Ltd., Tokyo, Japan) with an accuracy of 0.01mm. The measurements were performed on maxillary and mandibular central incisors, lateral incisors, and canines pre- and post-operatively, resulting in a total of 696 measurements. The crown length was measured from incisal edge to cemento- enamel-junction, while the root length from cemento-enamel-junction to root apex. RESULTS: In our study, 72% of the teeth demonstrated root resorption, in regard to the severity of root resorption, we found that mild root resorption > 0% up to 2% in all the affected teeth. Upper Anterior teeth have more significant resorption rate than lower anterior teeth P<0.05. CONCLUSION: The present study showed that incidence of root resorption was high after orthodontic treatment with Invisalign®, however the severity is very low and it is limited to the surface resorption only.

scholarly journals Optimization of orthodontic treatment using the Centrex System to retract anterior teeth

2012 ◽  
Vol 17 (4) ◽  
pp. 29-44
Author(s):  
José Kleber Soares de Meireles ◽  
Weber Ursi
Keyword(s):  
Orthodontic Treatment ◽  
Clinical Results ◽  
Paradigm Change ◽  
Force Action ◽  
Insertion Technique ◽  
Force Line ◽  
Prosthetic Implants ◽  
Mini Implants ◽  
Anterior Teeth ◽  
Previously Treated

INTRODUCTION: In the end of 90's the adoption of mini-implants as Anchorage allowed a paradigm change influencing even the way of thinking orthodontic mechanics. The overlapping of the specialties of Orthodontics and Implantology started with orthodontic preparations for prosthetic implants insertion, aroused with the use of palatal implants and late with the introduction of mini-implants. The improvement of mini-implants insertion technique with the appearing of self-drilling screws has allowed orthodontists to plan and to place this precious Anchorage piece. Taking into account the versatility of positioning of these screws it was developed a concept that allows the construction of force action lines aiming at optimize the planning and predictability of orthodontic motion. OBJECTIVE: To present some clinical results treatments conduct using Centrex System of orthodontic treatment, approximating the force line action of resistance center of units to be moved. The traced way to its development, previously treated in this journal, will be detailed for better understanding of its functioning.

Orthodontic Bonded Retainers: a Narrative Review

Dental Update ◽  
2020 ◽  
Vol 47 (5) ◽  
pp. 421-432 ◽  
Author(s):  
Maurice J Meade ◽  
Declan T Millett
Keyword(s):  
Clinical Trials ◽  
Clinical Relevance ◽  
Orthodontic Treatment ◽  
Randomized Clinical Trials ◽  
Treatment Compliance ◽  
Post Treatment ◽  
Narrative Review ◽  
Dental Practitioners ◽  
The Future ◽  
Bonded Retainers

Indefinite retention is now considered essential to prevent relapse after orthodontic treatment. Compliance with removable retainer wear is suboptimal and appears to decline with time post-treatment. As a result, use of bonded retainers may become more commonplace in the future. In this narrative review, the characteristics of bonded retainers are outlined and a summary of the evidence from randomized clinical trials regarding their effectiveness is provided. Guidance is also offered regarding care and maintenance. CPD/Clinical Relevance: All general dental practitioners (GDPs) should be familiar with types of bonded retainers, evidence relating to their effectiveness and the GDP's role regarding their care and maintenance.

scholarly journals Comparing Two Fluoride Therapies for Caries Management in Young Children: Study Protocol for a Randomised Clinical Trial

2021 ◽  
Author(s):  
Sherry Shiqian Gao ◽  
Faith Miaomiao Zheng ◽  
Kitty Jieyi Chen ◽  
Duangporn Duangthip ◽  
Edward Chin Man Lo ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Young Children ◽  
Adverse Effects ◽  
Oral Hygiene ◽  
Caries Experience ◽  
Short Term ◽  
Anterior Teeth ◽  
Caries Management ◽  
One Year ◽  
Preventive Effects

Abstract Background: Silver diamine fluoride (SDF) and sodium fluoride (NaF) are widely used for caries management. The objectives of this study are i) to compare the caries-arresting and caries-preventive effects of SDF and NaF in young children, ii) to determine children’s and parents’ acceptance of these fluoride therapies, and iii) to investigate the short-term (one-day) and long-term (one-year) adverse effects of these fluoride therapies.Methods/Design: This is a randomised, double-blind, active-controlled clinical trial to be conducted in Hong Kong kindergartens. The study has received approval from the local institutional review board. It has been prospectively registered in ClinicalTrials.gov (No.: NCT04399369) on 22 May 2020. Written consent will be obtained from the parents/guardians before the study. The study will recruit at least 688 healthy 3-year-old children. This sample size is sufficient for an appropriate statistical analysis. Stratified randomisation will be performed for intervention allocation. The two intervention groups are 38% SDF and 5% NaF varnish applied on six primary upper anterior teeth. At baseline, one trained examiner will perform clinical examinations of the children in the kindergartens. The caries experience and oral hygiene status of each child will be recorded using the decayed, missing (due to caries) and filled primary tooth index and visual plaque index, respectively. Then, an independent operator will apply the assigned fluoride after the dental examinations. The examiner, the children and their parents will be blinded to the intervention allocation. In addition, a research assistant will evaluate the child’s acceptance using interval rating scales for children’s uncooperative behaviour. The examiner will then visit the children the next day to study the short-term potential adverse effects of the fluoride therapies. The same examiner will perform a follow-up examination after one year to evaluate the children’s caries experiences, their oral hygiene statuses and the adverse effects of the fluoride. Parental questionnaires will be used to assess parental satisfaction and concerns about the fluoride therapies.Discussion: This study provides essential information about using SDF in an outreach kindergarten service for caries management from different aspects, which include the caries-arresting and caries-preventive effects, the adverse effects, and children’s and parents’ acceptance. The success of the service can help to increase the adoption of SDF to reduce the global burden of early childhood caries.

scholarly journals The Effect of Different Lower Third Molar Conditions on the Re-Crowding of Lower Anterior Teeth in the Absence of Tight Interproximal Contacts One-Year Post Orthodontic Treatment: A Pilot Study

2004 ◽  
Vol 5 (3) ◽  
pp. 66-73 ◽  
Author(s):  
Khalid M. Al-Balkhi
Keyword(s):  
Pilot Study ◽  
Orthodontic Treatment ◽  
Third Molar ◽  
Dental Arch ◽  
Third Molars ◽  
Lower Incisor ◽  
Exact Test ◽  
Anterior Teeth ◽  
One Year ◽  
The One

Abstract The role of lower third molars in lower incisor crowding is a debatable topic. Some believe the presence or eruption of lower third molars is associated with the crowding of mandibular incisors, others negate such association. Thirty-two newly debonded orthodontic patients, with ages ranging from 14-19 years, were randomly selected. No retainers were used for the lower dental arch. Removal of tight interproximal contacts of the lower anterior teeth was created and maintained by periodic abrasive stripping every 2-3 months, if needed. The cases were followed up for one year. Orthopantomographs (OPGs) and study casts were taken at debonding (post-treatment) and at the end of the one year follow up (post retention). Statistical analysis of the lower third molar conditions – erupted, unerupted, or missing with or without sufficient space for their eruption – versus re-crowding of lower incisors was evaluated using Fisher's Exact Test. The results of this pilot study revealed there was no significant correlation between the different conditions of the lower third molars versus lower anterior re-crowding in the absence of tight interproximal incisal contacts; however, a larger sample size is needed to verify such findings. Citation Al-Balkhi KM . The Effect of Different Lower Third Molar Conditions on the Re-Crowding of Lower Anterior Teeth in the Absence of Tight Interproximal Contacts One-Year Post Orthodontic Treatment: A Pilot Study. J Contemp Dent Pract 2004 August;(5)3:066-073.

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