Review of maxillary molar distalising appliances with palatal anchorage on miniimplants

2018 ◽  
Vol 14 (4) ◽  
pp. 296-308
Author(s):  
Małgorzata Sanecka ◽  
Katarzyna Becker ◽  
Anna Greń ◽  
Mariusz Świerk

Maxillary molar distalisation is one of treatment methods for patients with Angle class II. Intraoral appliances supported by patient’s own teeth inevitably lead to loss of anchorage. Mini-implants are additionally used to reduce this side effect. The area of the hard palate is the best anatomical place to attach mini-implants, and it provides the lowest risk of complications. <b>Aim.</b> To present issues associated with appliances used for maxillary molar distalisation that are based on bone anchorage in the hard palate region. <b>Material and methods.</b> The literature review using the PubMed database and the Polish Medical Bibliography with the following key words: molar distalisation, orthodontic miniimplants, skeletal anchorage. 37 positions from the years 1996–2018 were selected and analysed. <b>Results.</b> As a result of the literature review, 37 articles describing nine distalisation appliances modelled on three basic constructions: Pendulum, Distal Jet and Keles Slider, and the MCPP appliance were identified. <b>Summary.</b> Distalising appliances supported by palatal mini-implants do not lead to loss of anchorage in the anterior segment. At the stage of anterior teeth retraction they can be used for stabilisation of the distalised segment. They are less visible compared to extraoral appliances or those placed on the external side of the dental arch. They can be used simultaneously with fixed braces or during preparation for subsequent therapy with fixed braces. Depending on the design, they are not free of the side effects typical of the prototypes they originate from, i.e. rotation and inclination of molars. The most parallel distal movement of teeth is made possible by appliances whose force acts at the height of the CR (centre of resistance) of teeth being moved.

2017 ◽  
Vol 22 (5) ◽  
pp. 47-55 ◽  
Author(s):  
A. Sumathi Felicita

ABSTRACT Objective: The aim of the present study was to clarify the biomechanics of en-masse retraction of the upper anterior teeth and attempt to quantify the different forces and moments generated using mini-implants and to calculate the amount of applied force optimal for en-masse intrusion and retraction using mini-implants. Methods: The optimum force required for en-masse intrusion and retraction can be calculated by using simple mathematical formulae. Depending on the position of the mini-implant and the relationship of the attachment to the center of resistance of the anterior segment, different clinical outcomes are encountered. Using certain mathematical formulae, accurate measurements of the magnitude of force and moment generated on the teeth can be calculated for each clinical outcome. Results: Optimum force for en-masse intrusion and retraction of maxillary anterior teeth is 212 grams per side. Force applied at an angle of 5o to 16o from the occlusal plane produce intrusive and retraction force components that are within the physiologic limit. Conclusion: Different clinical outcomes are encountered depending on the position of the mini-implant and the length of the attachment. It is possible to calculate the forces and moments generated for any given magnitude of applied force. The orthodontist can apply the basic biomechanical principles mentioned in this study to calculate the forces and moments for different hypothetical clinical scenarios.


2016 ◽  
Vol 87 (2) ◽  
pp. 320-327 ◽  
Author(s):  
Yanhua Xu ◽  
Jiye Xie

ABSTRACT Objective: To compare the treatment effects of mini-implants as anchor units with conventional methods of anchorage reinforcement in maxillary dentoalveolar protrusion patients in terms of skeletal, dental, and soft tissue changes. Materials and Methods: We searched the databases of the Cochrane Library, PubMed, OVIDSP, CBM, VIP, WanFang Data, and CNKI covering December 1966 to March 2016 for randomized controlled trials (RCTs) and clinical controlled trials that compared the treatment effects of mini-implants with conventional anchorage reinforcement in maxillary dentoalveolar protrusion patients. Literature filtering, data extraction, and methodological quality evaluation were finished independently by two researchers and disagreements were solved by discussion. Meta-analysis was performed when possible; otherwise descriptive assessment was done. Results: Through a predefined search strategy, we finally included 14 eligible studies. Eight outcomes were evaluated in this study: maxillary incisor retraction, maxillary molar movement, U1-SN, SNA, SN-MP, UL-E Plane, NLA and G-Sn-Pg. Conclusions: Mini-implant anchorage was more effective in retracting the anterior teeth, produced less anchorage loss, and had a greater effect on SN-MP for the high-angle patients than did traditional anchorage. Both mini-implants and traditional anchorage underwent decreases in on U1-SN and SNA. More qualified RCTs are required to make reliable recommendations about the anchorage capacity of mini-implant and traditional anchorage in patients with maxillary dentoalveolar protrusion, especially on the UL-E plane, NLA, and G-Sn-Pg.


2018 ◽  
Vol 14 (2) ◽  
pp. 38-49
Author(s):  
Jakub Baszak ◽  
Anna Sobieszańska ◽  
Izabella Dunin-Wilczyńska

Orthodontic movement of a maxillary canine into the dental arch may be a therapeutic challenge, and it is necessary to analyse a case in detail and to evaluate therapeutic methods, including a difficult decision of tooth extraction in all cases.<b> Aim</b>. The paper aims to discuss orthodontic indications for maxillary canine extraction based on available literature. <b>Material and methods</b>. The PubMed database and the following key words were used for studies: canine impaction, maxillary impacted canine and canine extraction. Literature was supplemented with publications from reviewed journals not included in the PubMed database. 50 papers were selected from the literature list. <b>Results, review and discussion</b>. A decision to extract a maxillary canine should be made based on a detailed clinical examination and analysis of orthodontic records, including photographs, diagnostic models and radiological scans. CBCT imaging test should be performed as standard before treatment in case of impaired tooth eruption. Factors that should be especially considered include: tooth anatomy, periodontal status, position in the bone, occlusion, condition of the adjacent teeth and any pathological processes in the tooth vicinity. Before making a therapeutic decision a patient should be informed about available therapeutic options according to current medical knowledge, as well as about advantages and disadvantages of each of them. <b>Summary</b>. Factors favouring extraction of impacted canines or canines with impaired eruption include: unfavourable position (a horizontal position of a tooth in the bone, position in the zone IV and V according to Kurol, large distance from the edge of the alveolar process), anatomical abnormality (root angulation, external or internal resorption), root ankylosis, patient’s age above 30 years and good occlusion without a canine in the dental arch with the need to extract a premolar for its movement into the dental arch. <b>(Baszak J, Sobieszczańska A, Dunin-Wilczyńska I. Indications for extraction of permanent maxillary canines – a literature review. Orthod Forum 2018; 14: 130-42)</b>.


Prosthesis ◽  
2019 ◽  
Vol 1 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Portelli ◽  
Militi ◽  
Logiudice ◽  
Nucera

Background: Among tooth anomalies, missing teeth is one of the most frequent, and it can be related to different therapeutical sets of problems. Often, an integrated approach that interests both orthodontists and prosthodontists is necessary, and in some cases also the periodontists. Methods: In this paper the authors report a clinical case of a 14-year-old patient, affected by maxillary bilateral incisors agenesis, molar bilateral II class and deep bite, treated in the Department of Orthodontics and Pedodontics of the University of Messina. The orthodontic treatment target was the distal movement of the maxillary molar, and the recovery of the space necessary for the prosthetic restoration of the missing lateral incisor. Maxillary molars distal movement was performed with a Distal Jet apparatus, skeletally supported by two miniscrews (Distal-Screw, American Orthodontics, Sheboygan, WI, USA). After molar relationship correction, a multi-bracket bimaxillary orthodontic appliance was bonded using Empower Brackets (American Orthodontics, Sheboygan, WI, USA). At the end of orthodontic treatment a Maryland bridge, bonded on the central incisors and cuspids, was used in order to maintain the space necessary for the insertion of dental implants in the region of 1.2 and 2.2 Results: A class II molar relationship was corrected, with an improvement of the deep bite, and the space necessary for implant insertion was recovered Conclusion: A skeletally supported Distal Jet was efficient for molar distalization, with the advantage of not having any loss of anchorage in the anterior part of the dental arch. This apparatus does not need patient compliance, have favorable aesthetics and also give the possibility to perform asymmetric activations.


2022 ◽  
pp. 146531252110710
Author(s):  
A Sumathi Felicita ◽  
Thameem UL Wahab

Background: Skeletal anchorage systems have been used for intrusion of the posterior teeth with satisfactory results. To achieve this, mini-implants are placed at anatomically challenging sites such as the palate or require several mini-implants to produce the desired effect. Objective: To determine the magnitude of intrusion of the maxillary posterior teeth achieved on a continuous arch wire using a single buccal mini-implant placed bilaterally in young patients with a tendency towards hyperdivergence and to evaluate its influence on the skeletal, dental and soft-tissue structures. Methods: A total of 17 patients with proclination of the anterior teeth, tendency towards hyperdivergence and clockwise rotation of the mandible were selected. First premolars were extracted as part of treatment protocol. A 0.022-MBT bracket prescription was used. Mini-implants were placed bilaterally on the buccal aspect at the mucogingival junction or slightly gingival to it between the maxillary second premolar and first permanent molar. A total of 200 g of intrusive force was placed from a continuous 0.019 × 0.025 inch stainless-steel arch wire to the mini-implant by means of an elastomeric thread on both sides. Lateral cephalograms and study models were taken before the start of intrusion and six months later. Parametric and non-parametric tests were done to assess treatment results. Results: Significant intrusion was observed in the maxillary molar and premolar region with tendency towards intrusion in the anterior region. There was significant decrease in lower anterior facial height (LAFH) with anti-clockwise mandibular rotation, decrease in facial proportion index and total facial height. No changes were observed in the transverse plane. Conclusion: Intrusion of the permanent maxillary molar can be achieved on a continuous arch wire with a single buccal mini-implant placed bilaterally with improvement in facial aesthetics, especially in the vertical plane. This method may be beneficial in patients with borderline vertical discrepancy treated with conventional friction mechanics during space closure after first premolar extractions.


Author(s):  
Nilanjana Sarkar ◽  
Sumit Goel ◽  
Sumitra Reddy ◽  
Anup Belludi ◽  
Karunakara B.C.

Growing patients with missing teeth in aesthetically prominent areas pose a challenge in restoration of the same. Fracture of anterior teeth in these age groups is very common and often requires removal of the affected tooth. After the decision to maintain the space in the dental arch is made, some other factors have to be borne in mind before restoration of the space. Continuing growth of the alveolar bones, questionable cooperation of the patient and aesthetics are deciding factors that may limit the treatment options. The effective use of mini-implants for space preservation, alveolar bone width maintenance and aesthetics represents an elective way of successfully treating such cases. The aim of this article is to describe as well as highlight the advantages and ease of the procedure with the help of two clinical cases.


DENTA ◽  
2017 ◽  
Vol 11 (1) ◽  
pp. 80
Author(s):  
Chaterina Diyah Nanik K ◽  
Anindita Apsari

<p><strong><em>Background:</em></strong><em> One of the most common inflammation disease in the oral cavity for the past few years is the aggressive form of periodontitis. Common signs of aggressive periodontitis is the mobility of teeth especially in incisive and first molars, and occuring mostly in young patient. Young patients whose losing her anterior teeth, are a real challenge for dentist and prosthodontist. Prosthodontist need to consider both functional and esthetic aspects. <strong>Objective:</strong> Rehabilitation of young adult patient with aggressive periodontitis by an interdisciplinary approach of orthodontist and prosthodontist. <strong>Case Description:</strong> A young woman, suffered from aggressive periodontitis with major complain of her teeth mobility, especially incisive and first molar in mandible. She had undergone periodontal treatment, but the result was failed. The anterior teeth in mandible need to be extracted, therefore patient wished not to be in edentulous state. As preliminary treatment, we choose immediate denture to replace the anterior mandible teeth. We faced difficulties in mandible, because her right canine weren’t in the proper dental arch. So we asked orthodontist to place fixed orthodontics in mandible, to get the canine back in the proper arch. We’ve chosen orthodontic treatment,because we didn’t want to extract the canine teeth. We evaluated in six months and after the canine back in the proper arch, we proceed to long span bridge in mandible as our definitive treatment. <strong>Conclusion:</strong> By not extracting the canine teeth, we got some advantages, especially patient psychically was happier with her own teeth. The collaboration with another dentistry field, provides us better treatment for patient. After treatment, patient had no complaints and was happy with her new smile.</em></p><p><strong><em>Keywords:</em></strong><em>  Prosthodontic rehabilitation, aggressive periodontitis, orthodontic treatment, esthetic</em><em>.</em></p><strong><em>Correspondence:</em></strong><em> Chaterina Diyah Nanik. K; Department of Prostodontitics, Faculty of Dentistry, Hang Tuah University, Arif Rahman Hakim 150, Surabaya; Phone 031-5912191, Email: </em><a href="mailto:[email protected]"><em>[email protected]</em></a>


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
María Dolores Casaña-Ruiz ◽  
Carlos Bellot-Arcís ◽  
Vanessa Paredes-Gallardo ◽  
Verónica García-Sanz ◽  
José Manuel Almerich-Silla ◽  
...  

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Marina Maffoni ◽  
Anna Giardini ◽  
Antonia Pierobon ◽  
Davide Ferrazzoli ◽  
Giuseppe Frazzitta

Parkinson’s disease (PD) is a neurodegenerative disease characterized by motor and nonmotor symptoms. Both of them imply a negative impact on Health-Related Quality of Life. A significant one is the stigma experienced by the parkinsonian patients and their caregivers. Moreover, stigma may affect everyday life and patient’s subjective and relational perception and it may lead to frustration and isolation. Aim of the present work is to qualitatively describe the stigma of PD patients stemming from literature review, in order to catch the subjective experience and the meaning of the stigma construct. Literature review was performed on PubMed database and Google Scholar (keywords: Parkinson Disease, qualitative, stigma, social problem, isolation, discrimination) and was restricted to qualitative data: 14 articles were identified to be suitable to the aim of the present overview. Results are divided into four core constructs: stigma arising from symptoms, stigma linked to relational and communication problems, social stigma arising from sharing perceptions, and caregiver’s stigma. The principal relations to these constructs are deeply analyzed and described subjectively through patients’ and caregiver’s point of view. The qualitative research may allow a better understanding of a subjective symptom such as stigma in parkinsonian patients from an intercultural and a social point of view.


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