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Allahham DO, Kotsailidi EA, Barmak AB, Rossouw PE, El-Bialy T, Michelogiannakis D. Association between nonextraction clear aligner therapy and alveolar bone dehiscences and fenestrations in adults with mild-to-moderate crowding. Am J Orthod Dentofacial Orthop 2023; 163:22-32.e4. [PMID: 36153200 DOI: 10.1016/j.ajodo.2021.08.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 07/29/2021] [Accepted: 08/07/2021] [Indexed: 12/27/2022]
Abstract
INTRODUCTION This study aimed to assess the association between nonextraction clear aligner therapy (CAT) and the presence of alveolar bone dehiscences (ABDs) and fenestrations (ABFs) in adults with mild-to-moderate crowding. METHODS Cone-beam computed tomography images from 29 adults were obtained before and immediately after nonextraction CAT. Total root lengths were evaluated in axial and cross-sectional slices. Linear measurement for dehiscence (LM-D) was defined as the distance between the alveolar crest to the cementoenamel junction of each root (critical point set at 2 mm). Linear measurement for fenestration (LM-F) was recorded when the defect involved only the apical one-third of a root (critical point set at 2.2 mm). Counts of ABDs/ABFs and magnitudes of LM-Ds/LM-Fs were recorded before and immediately after nonextraction CAT at buccal and lingual root surfaces. Binary logistic regression analyses and repeated measures analyses of variance were performed. RESULTS Counts of ABDs/ABFs and magnitudes of LM-Ds/LM-Fs increased at most jaw locations and root surfaces. Nonextraction CAT was associated with an increased presence of ABDs and ABFs. Nonextraction CAT was associated with a higher magnitude of LM-Ds but not LM-Fs. CONCLUSIONS Immediate posttreatment cone-beam computed tomography scans showed that nonextraction CAT is associated with increased ABDs and ABFs in adults with mild-to-moderate crowding.
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Affiliation(s)
- Diaa Ossama Allahham
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Elli Anna Kotsailidi
- Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Abdul Basir Barmak
- Department of Dentistry, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Paul Emile Rossouw
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY
| | - Tarek El-Bialy
- Division of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Dimitrios Michelogiannakis
- Department of Orthodontics and Dentofacial Orthopedics, Eastman Institute for Oral Health, University of Rochester, Rochester, NY.
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The rationale for orthodontic retention: piecing together the jigsaw. Br Dent J 2021; 230:739-749. [PMID: 34117429 DOI: 10.1038/s41415-021-3012-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/08/2021] [Indexed: 12/12/2022]
Abstract
Retaining teeth in their corrected positions following orthodontic treatment is one of the most challenging aspects of orthodontic practice. Despite much research, the rationale for retention is not entirely clear. Teeth tend to revert to their pre-treatment positions due to periodontal and gingival, soft tissue, occlusal and growth factors. Changes may also follow normal dentofacial ageing and are unpredictable with great variability. In this overview, each of these factors are discussed with their implications for retention, along with adjunctive procedures to minimise relapse. The state of current knowledge, methods used to assess relapse, factors regarded as predictive of or associated with stability as well as overcorrection are outlined. Potential areas requiring further investigation are suggested. The way in which the clinician may manage current retention practice, with a need for individualised retention plans and selective retainer wear, is also considered.
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Alessio Junior LE, Almeida RRD, Guerra JGP, Maranhão OBV, Janson G. Transverse stability of Class II malocclusion correction with the pendulum appliance. Am J Orthod Dentofacial Orthop 2020; 158:357-362. [PMID: 32680657 DOI: 10.1016/j.ajodo.2019.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 08/01/2019] [Accepted: 08/01/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This study aimed to evaluate the stability of transverse changes after Class II malocclusion correction with the pendulum fixed distalizer, followed by preadjusted edgewise fixed orthodontic appliances. METHODS This longitudinal study was conducted in the maxillary dental casts of 20 Class II malocclusion subjects (mean age, 12.5 years; 14 females and 6 males). Eighty 3-dimensional maxillary dental casts were analyzed; 20 at the beginning of treatment, 20 after distalization, 20 after edgewise appliance debonding, and 20 at 5 years posttreatment. Maxillary transverse distances between canines, first premolars, second premolars, first molars, and second molars were analyzed using Geomagic Studio 5 (3D Systems, Rock Hill, SC). RESULTS There were no significant changes in intercanine distance during and after treatment. There were significant interfirst and intersecond premolar distance increases during treatment. There were significant interfirst and intersecond molar distance increases during the distalization phase. However, there were significant decreases in these distances at the end of treatment. There were no significant long-term posttreatment changes. CONCLUSIONS The intercanine distance remains stable during and after treatment. The interfirst and intersecond premolar distances significantly increase during treatment and remain stable after treatment. The interfirst and intersecond molar distances increase during the distalization phase, decrease at the end of treatment, and remain stable after treatment.
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Affiliation(s)
| | | | | | | | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, Brazil.
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Deregibus A, Tallone L, Rossini G, Parrini S, Piancino M, Castroflorio T. Morphometric analysis of dental arch form changes in class II patients treated with clear aligners. J Orofac Orthop 2020; 81:229-238. [PMID: 32291482 DOI: 10.1007/s00056-020-00224-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 01/21/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the arch form changes in class II Caucasian patients treated with Invisalign® (Align Technology, San José, CA, USA). METHODS A total of 27 class II patients, for whom a maximum of 4 mm arch expansion was planned, were selected. Both maxillary and mandibular digital casts were compared at three different times: pretreatment (T0), accepted set-up (T1), and retention phase (T2). Each digital model was imported into GOM Inspect© software (GOM GmbH, Braunschweig, Germany) to identify teeth crown facial axis (FA) and cusp points to create a coordinate system. In each model the origin of the coordinates was located at the contact point of central incisors and a system of Cartesian axes was constructed. Using the FA points, an average arch form was obtained for each clinical step and then the following comparisons were performed for each class group: T0-T1, T0-T2, and T1-T2. RESULTS T1 showed wider maxillary and mandibular dental arches compared to T0 with maximum movements observed in the premolar regions (maximum movement 1.94 mm for tooth 15; P < 0.0001). In the T1-T2 comparison, a more buccal position of tooth 22, tooth 23, and tooth 24 (maximum movement 0.56 mm; P < 0.05) and a more lingual position of tooth 37 (maximum movement 0.81 mm; P < 0.01), tooth 36, and tooth 47 were observed at T1 with respect to T2. CONCLUSIONS Although Invisalign® treatment resulted in a significant increase in arch width according to the prescription, some of the outcomes were different than those planned especially in relation to the final position of the lower molars.
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Affiliation(s)
- Andrea Deregibus
- Department of Surgical Sciences, CIR Dental School, University of Turin, Turin, Italy
| | - Luca Tallone
- Department of Surgical Sciences, CIR Dental School, University of Turin, Turin, Italy
| | - Gabriele Rossini
- Department of Mechanical and Aerospace Engineering, Politecnico di Torino, University of Turin, Turin, Italy
| | - Simone Parrini
- Department of Surgical Sciences, CIR Dental School, University of Turin, Turin, Italy.
- Department of Orthodontics, Dental School, University of Turin, Via Nizza 230, Turin, Italy.
| | - Mariagrazia Piancino
- Department of Surgical Sciences, CIR Dental School, University of Turin, Turin, Italy
| | - Tommaso Castroflorio
- Department of Surgical Sciences, CIR Dental School, University of Turin, Turin, Italy
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Swidi AJ, Griffin AE, Buschang PH. Mandibular alignment changes after full-fixed orthodontic treatment: a systematic review and meta-analysis. Eur J Orthod 2019; 41:609-621. [DOI: 10.1093/ejo/cjz004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
SummaryBackgroundAlthough post-treatment mandibular alignment has been extensively investigated, the findings remain controversial.ObjectivesThe objective was to assess mandibular alignment changes, as measured by the irregularity index, of patients who underwent full-fixed orthodontic treatment and were followed up at least 1 year after retention.Search methodsMEDLINE, EMBASE, and Cochrane library, in addition, the reference lists of included studies, were screened. The search was conducted up to April 2018.Selection criteriaThe study designs included both interventional and observational studies of orthodontic patients who received either extraction or non-extraction treatment.Data collection and analysisThe interventional studies were assessed using the Cochrane Collaboration’s risk of bias assessment tool. The quality of the observational studies was evaluated using National Institution of Health quality assessment tools. The first two authors independently applied the eligibility criteria, extracted the data, and assessed the risk of bias. Any conflicts were resolved with consensus discussion with the third author.ResultsThe search retrieved 11 326 articles, 170 of which were assessed for eligibility. There were 44 studies included in the qualitative assessments and 30 in the meta-analyses. The studies included 1 randomized control trial (RCT) and 43 observational studies. The RCT was judged to have a high risk of bias and all of the observational studies had either fair or poor quality. The meta-analysis was based on studies judged to be of fair quality, including a total of 1859 patients. All meta-analyses were performed using random-effect models. The standardized mean difference between post-treatment and post-retention irregularity was 1.22 (95% CI, 1.04–1.40) and 0.85 (95% CI, 0.63–1.07) after extraction and non-extraction treatments, respectively. There was a substantial heterogeneity for the extraction (I2 = 75.2%) and non-extraction (I2 = 70.1%) studies. The follow-up duration (1–10 versus 10–20 years) explained 33% of the heterogeneity, with longer follow-up studies showing more irregularity.LimitationsThe quality of evidence provided by the studies was low. There was a risk of publication bias, and the search was limited to English language.Conclusions and implicationsPost-treatment mandibular irregularity increases are limited. Irregularity increases are slightly greater in patients treated with mandibular premolars extractions, and in patients followed up over longer periods of time.RegistrationThe study protocol was not registered.
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Affiliation(s)
- Ahmad J Swidi
- Orthodontic Department, College of Dentistry, Texas A&M University, Dallas, TX, USA
- Orthodontic Department, College of Dentistry, Jazan University, Saudi Arabia
| | - Andreea E Griffin
- Public Health Sciences Department, College of Dentistry, Texas A&M University, Dallas, TX, USA
| | - Peter H Buschang
- Orthodontic Department, College of Dentistry, Texas A&M University, Dallas, TX, USA
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Allgayer S, Mezomo MB. Do premolar extractions necessarily result in a flat face? No, when properly indicated. Dental Press J Orthod 2018; 23:82-92. [PMID: 30427497 PMCID: PMC6266318 DOI: 10.1590/2177-6709.23.5.082-092.bbo] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 08/28/2018] [Indexed: 11/30/2022] Open
Abstract
The esthetic benefits are among the main goals of orthodontic treatment; therefore, tooth extractions have been avoided as a protocol for orthodontic treatment because they may impair the facial profile. The present article discusses aspects as the magnitude and response of soft tissue profile due to changes in incisor positioning, and the effect of different sequences of premolar extraction. One case report illustrates the subject, with favorable and stable esthetic and occlusal outcomes five years after orthodontic treatment with extraction of second premolars.
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Affiliation(s)
- Susiane Allgayer
- Professor of Orthodontics at Associação Brasileira de Odontologia - Seção Rio Grande do Sul (Porto Alegre/RS, Brazil)
| | - Maurício Barbieri Mezomo
- Professor of Orthodontics at Centro Universitário Franciscano, Faculdade de Odontologia, (Santa Maria/RS, Brazil)
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Ben Mohimd H, Bahije L, Zaoui F, Halimi A, Benyahia H. Faut-il prescrire systématiquement une contention mandibulaire ? Revue systématique. Int Orthod 2018; 16:114-132. [DOI: 10.1016/j.ortho.2018.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Maltagliati LA, Myiahira YI, Fattori L, Filho LC, Cardoso M. Transversal changes in dental arches from non-extraction treatment with self ligating brackets. Dental Press J Orthod 2013; 18:39-45. [PMID: 24094010 DOI: 10.1590/s2176-94512013000300008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The present study aimed at analyzing, with the use of dental casts, the transverse changes of the upper and lower dental arches, after non-extraction orthodontic treatment, with self-ligating brackets. METHODS The sample comprised 29 patients, all presenting Class I malocclusion with upper and lower crowding of at least 4 mm and treated only with a fixed appliance, without stripping, extraction or distalization. The dental casts were obtained before and after leveling with 0.019 x 0.025-in stainless steel archwires. CONCLUSIONS The results indicated that the majority of transverse changes occurred at the premolar areas, both the first and the second, as well as on the upper and lower dental arches. The intercanine distance increased 0.75 mm, on average, in the upper arch and 1.96 mm in the lower arch. The molars also demonstrated a tendency towards an increase in their transverse dimension, however, at a lower intensity comparing to premolars. All measurements presented statistically significant differences with the exception of the maxillary second molars.
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Quaglio CL, Freitas KMSD, Freitas MRD, Janson G, Henriques JFC. Stability of maxillary anterior crowding treatment. Dental Press J Orthod 2012. [DOI: 10.1590/s2176-94512012000400014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: To evaluate the stability and the relapse of maxillary anterior crowding treatment on cases with premolar extraction and evaluate the tendency of the teeth to return to their pretreatment position. METHODS: The experimental sample consisted of 70 patients of both sex with an initial Class I and Class II maloclusion and treated with first premolar extractions. The initial mean age was 13,08 years. Dental casts' measurements were obtained at three stages (pretreatment, posttreatment and posttreatment of 9 years on average) and the variables assessed were Little Irregularity Index, maxillary arch length and intercanine. Pearson correlation coefficient was used to know if some studied variable would have influence on the crowding in the three stages (LII1, LII2, LII3) and in each linear displacement of the Little irregularity index (A, B, C, D, E) in the initial and post-retention phases. RESULTS: The maxillary crowding relapse ( LII3-2) is influenced by the initial ( LII1), and the teeth tend to return to their pretreatment position. CONCLUSION: The results underline the attention that the orthodontist should be given to the maxillary anterior relapse, primarily on those teeth that are crowded before the treatment.
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Quaglio CL, de Freitas KMS, de Freitas MR, Janson G, Henriques JFC. Stability and relapse of maxillary anterior crowding treatment in class I and class II Division 1 malocclusions. Am J Orthod Dentofacial Orthop 2011; 139:768-74. [PMID: 21640883 DOI: 10.1016/j.ajodo.2009.10.044] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Revised: 10/01/2009] [Accepted: 10/01/2009] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The maxillary anterior teeth are the most important to facial esthetics because they are the first to show on a smile. Therefore, stability of the maxillary anterior teeth alignment is an important issue. The objective of this study was to compare the stability of maxillary anterior tooth alignment in Class I and Class II Division 1 malocclusions. METHODS The sample comprised dental casts of 70 patients with Class I and Class II Division 1 malocclusions and a minimum of 3 mm of maxillary anterior crowding measured by an irregularity index. The patients were treated with extractions and evaluated at pretreatment and posttreatment and at least 5 years after treatment. The sample was divided into 3 groups: group 1, Class I malocclusion treated with 4 first premolar extractions comprising 30 subjects, with an initial age of 13.16 years and 8.59 mm of initial maxillary irregularity; group 2, Class II malocclusion treated with 4 first premolar extractions comprising 20 subjects, with an initial age of 12.95 years and 11.10 mm of maxillary irregularity; and group 3, Class II malocclusion treated with 2 first maxillary premolar extractions comprising 20 subjects, with an initial age of 13.09 years and 9.68 mm of maxillary irregularity. RESULTS The decrease in the maxillary irregularity index was significantly greater in group 2 than in group 1 during treatment. The stability of maxillary anterior alignment was 88.12% over the long term; 77% of the linear displacement of the anatomic contact points tended to return to their original positions. CONCLUSIONS Stability of maxillary anterior alignment between the 3 groups was similar. The stability of maxillary anterior alignment was high over the long term, but a high percentage of teeth tended to return to their original positions.
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Affiliation(s)
- Camila Leite Quaglio
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
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Little’s irregularity index: Photographic assessment vs study model assessment. Am J Orthod Dentofacial Orthop 2010; 138:787-94. [DOI: 10.1016/j.ajodo.2009.01.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2008] [Revised: 01/01/2009] [Accepted: 01/01/2009] [Indexed: 11/19/2022]
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Arch-width and perimeter changes in patients with borderline Class I malocclusion treated with extractions or without extractions with air-rotor stripping. Am J Orthod Dentofacial Orthop 2010; 137:734.e1-7; discussion 734-5. [DOI: 10.1016/j.ajodo.2009.12.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Revised: 12/01/2009] [Accepted: 12/01/2009] [Indexed: 11/19/2022]
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Pandis N, Polychronopoulou A, Makou M, Eliades T. Mandibular dental arch changes associated with treatment of crowding using self-ligating and conventional brackets. Eur J Orthod 2009; 32:248-53. [PMID: 19959610 DOI: 10.1093/ejo/cjp123] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this study was to investigate the effect of treatment of mandibular crowding with self-ligating and conventional brackets on dental arch variables. Fifty-six patients were selected from a pool of subjects satisfying the following inclusion criteria: non-extraction treatment in the mandibular or maxillary arches, eruption of all mandibular teeth, no spaces and an irregularity index greater than 2 mm in the mandibular arch, and no adjunct treatment such as etxra- or intraoral appliances. The patients were assigned to two groups: one group received treatment with the self-ligating bracket and the other with a conventional edgewise appliance, both with a 0.022 inch slot. Lateral cephalometric radiographs obtained at the beginning (T1) and end (T2) of treatment were used to assess the alteration in mandibular incisor inclination, and measurements of intercanine and intermolar widths were made on dental casts to investigate changes associated with the correction. The results were analysed with bivariate and multivariate linear regression analysis in order to examine the effect of the bracket systems on arch width or lower incisor inclination, adjusting for the confounding effect of demographic and clinical characteristics. An alignment-induced increase in the proclination of the mandibular incisors was observed for both groups; no difference was identified between self-ligating and conventional brackets with respect to this parameter. Likewise, an increase in intercanine and intermolar widths was noted for both bracket groups; the self-ligating group showed a higher intermolar width increase than the conventional group, whereas the amount of crowding and Angle classification were not significant predictors of post-treatment intermolar width.
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Affiliation(s)
- Nicholas Pandis
- Department of Community and Preventive Dentistry, School of Dentistry, University of Athens, Athens, Greece
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