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Guo YN, Cui SJ, Liu Y, Fu Y, Zhang JN, Zhou YH, Wang XD. Quantitative evaluation of vertical control in orthodontic camouflage treatment for skeletal class II with hyperdivergent facial type. Head Face Med 2024; 20:31. [PMID: 38745246 PMCID: PMC11092056 DOI: 10.1186/s13005-024-00432-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND In this study, we sought to quantify the influence of vertical control assisted by a temporary anchorage device (TAD) on orthodontic treatment efficacy for skeletal class II patients with a hyperdivergent facial type and probe into the critical factors of profile improvement. METHODS A total of 36 adult patients with skeletal class II and a hyperdivergent facial type were included in this retrospective case-control study. To exclude the effect of sagittal anchorage reinforcement, the patients were divided into two groups: a maxillary maximum anchorage (MMA) group (N = 17), in which TADs were only used to help with anterior tooth retraction, and the MMA with vertical control (MMA + VC) group (N = 19), for which TADs were also used to intrude the maxillary molars and incisors. The treatment outcome was evaluated using dental, skeletal, and soft-tissue-related parameters via a cephalometric analysis and cast superimposition. RESULTS A significant decrease in ANB (P < 0.05 for both groups), the retraction and uprighting of the maxillary and mandibular incisors, and the retraction of protruded upper and lower lips were observed in both groups. Moreover, a significant intrusion of the maxillary molars was observed via the cephalometric analysis (- 1.56 ± 1.52 mm, P < 0.05) and cast superimposition (- 2.25 ± 1.03 mm, P < 0.05) of the MMA + VC group but not the MMA group, which resulted in a remarkable decrease in the mandibular plane angle (- 1.82 ± 1.38°, P < 0.05). The Z angle (15.25 ± 5.30°, P < 0.05) and Chin thickness (- 0.97 ± 0.45°, P < 0.05) also improved dramatically in the MMA + VC group, indicating a better profile and a relaxed mentalis. Multivariate regression showed that the improvement in the soft tissue was closely related to the counterclockwise rotation of the mandible plane (P < 0.05). CONCLUSIONS TAD-assisted vertical control can achieve intrusion of approximately 2 mm for the upper first molars and induce mandibular counterclockwise rotation of approximately 1.8°. Moreover, it is especially important for patients without sufficient retraction of the upper incisors or a satisfactory chin shape.
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Affiliation(s)
- Yan-Ning Guo
- Department of Orthodontics, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, No.22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
- Dental Medical Center, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Sheng-Jie Cui
- Department of Orthodontics, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, No.22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
| | - Ye Liu
- Department of Orthodontics, the School of Stomatology, The Key Laboratory of Stomatology, Hebei Medical University, Shijiazhuang, 050017, China
| | - Yu Fu
- Fourth Division Department, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, Beijing, 100081, China
| | - Jie-Ni Zhang
- Department of Orthodontics, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, No.22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
| | - Yan-Heng Zhou
- Department of Orthodontics, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, No.22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, China
| | - Xue-Dong Wang
- Department of Orthodontics, National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Peking University School and Hospital of Stomatology, No.22, Zhongguancun South Avenue, Haidian District, Beijing, 100081, China.
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Alrehaili R, Alhujaili A, Almanjhi W, Alnami H, Alsaiyari S, Alqahtani H, Alabdan R, Baamer D, Khalil A. How Effective Are the Nance Appliance and Transpalatal Arch at Reinforcing Anchorage in Extraction Cases? Cureus 2024; 16:e61171. [PMID: 38933638 PMCID: PMC11204131 DOI: 10.7759/cureus.61171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2024] [Indexed: 06/28/2024] Open
Abstract
OBJECTIVE This narrative review aimed to evaluate, based on current evidence, whether the transpalatal arch (TPA) and Nance appliance can effectively reinforce anchorage during fixed orthodontic treatment while also offering a comprehensive and in-depth overview of the existing literature on this subject. MATERIALS AND METHODS A thorough literature search was performed across multiple electronic databases to identify peer-reviewed articles relevant to the review. RESULTS Evidence suggests that the Nance appliance does not provide absolute anchorage. Additionally, patients experienced discomfort and inflammation of the palatal tissues. The transpalatal arch is also insufficient for maximum anteroposterior anchorage, and existing studies on its effectiveness in vertical anchorage control are inconsistent with conflicting data. CONCLUSIONS For patients with critical anchorage demand, mini-screws may be the method of choice, either solely or in combination with Nance or transpalatal arch, though they carry a risk of failure.
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Affiliation(s)
| | | | | | - Huda Alnami
- Dentistry, King Khalid University, Abha, SAU
| | | | | | - Reem Alabdan
- Dentistry, Armed Forces Hospital, Khamis Mushait, SAU
| | - Dalia Baamer
- Dentistry, King Abdulaziz University, Jeddah, SAU
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Mohan K, Sivarajan S, Lau MN, Othman SA, Fayed MMS. Soft tissue changes with skeletal anchorage in comparison to conventional anchorage protocols in the treatment of bimaxillary proclination patients treated with premolar extraction : A systematic review. J Orofac Orthop 2024; 85:146-162. [PMID: 35829730 DOI: 10.1007/s00056-022-00411-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 05/29/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE This review systematically evaluates the evidence related to comparisons between skeletal and conventional anchorage protocols in the treatment of bimaxillary proclination patients who underwent premolars extraction with respect to soft tissue profile changes, treatment duration and three-dimensional (3D) soft tissue changes. METHODS Electronic database search and hand search with no language limitations were conducted in the Cochrane Library, PubMed, Ovid, Web of Science, Scopus and ClinicalTrials.gov. The selection criteria were set to include studies with patients aged 13 years and above requiring extractions of upper and lower first premolars to treat bimaxillary proclination with high anchorage demand. Risk of bias assessment was undertaken with Cochrane's Risk Of Bias tool 2.0 (ROB 2.0) for randomised controlled trials (RCTs) and ROBINS‑I tool for nonrandomised prospective studies. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used for quality assessment. Results were summarised qualitatively; no meta-analysis was conducted. RESULTS Two RCTs and two nonrandomised prospective studies were included. According to the GRADE approach, there is low to very low quality of evidence that treatment using mini-implant anchorage may significantly change nasolabial angle, upper and lower lip procumbence, and facial convexity angle compared to treatment with conventional anchorage. Similarly, very low quality evidence exists showing no differences in treatment duration between treatments with skeletal or conventional anchorage. CONCLUSIONS The overall existing evidence regarding the effect of anchorage protocols on soft tissue changes in patients with bimaxillary protrusion and premolar extraction treatment plans is of low quality. TRIAL REGISTRATION NUMBER PROSPERO CRD42020216684.
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Affiliation(s)
- Kumeran Mohan
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, 50603, Lembah Pantai, Kuala Lumpur, Malaysia
- Department of Orthodontics, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Malaysia
| | - Saritha Sivarajan
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, 50603, Lembah Pantai, Kuala Lumpur, Malaysia.
| | - May Nak Lau
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, 50603, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Siti Adibah Othman
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, 50603, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Mona M Salah Fayed
- Department of Orthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Mayahara K, Kawai S, Fujisaki T, Shimizu N. Dental, skeletal and soft tissue changes after bimaxillary protrusion treatment with temporary anchorage devices using different retraction mechanics. BMC Oral Health 2024; 24:135. [PMID: 38280986 PMCID: PMC10821290 DOI: 10.1186/s12903-024-03927-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 01/23/2024] [Indexed: 01/29/2024] Open
Abstract
BACKGROUND Temporary anchorage devices (TADs), which are absolute anchorage, are used for retraction of the anterior teeth in cases of severe bimaxillary protrusion. There have been a number of studies regarding anterior tooth movement using TADs performed by simulation systems and actual treated materials with sliding mechanics. However, there are few studies regarding anterior tooth movement using TADs treated by loop mechanics The purpose of this study was to investigate the effect of TADs in anterior tooth movement using loop mechanics performed in actual cases of bimaxillary protrusion. METHODS This study was performed in 20 adult patients with severe bimaxillary protrusion treated with four bicuspid extraction with sliding or loop mechanics (n = 10 in each mechanics) using TADs. The skeletal and denture patterns, as well as the soft tissue profile from pre-treatment (T0) and post-treatment (T1) lateral cephalograms, were compared between sliding and closing loop mechanics. RESULTS The use of TADs is useful for retraction of anterior teeth without molar anchorage loss. in sliding and loop mechanics. The upper anterior teeth were less lingual tipped and lower anterior teeth were more upright resulting in less clockwise rotation of the occlusal plane in loop mechanics compared to sliding mechanics. CONCLUSION An oblique retraction force vector with a lower point of application causes less intrusion and more lingual tipping of upper anterior teeth as well as more clockwise rotation of the occlusal plane compared to a parallel retraction force vector.
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Affiliation(s)
- Kotoe Mayahara
- Department of Orthodontics, Nihon University School of Dentistry, 1-8-13, Kanda Surugadai, Chiyoda-ku, Tokyo, 101-8310, Japan
- Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry, Tokyo, Japan
| | | | | | - Noriyoshi Shimizu
- Department of Orthodontics, Nihon University School of Dentistry, 1-8-13, Kanda Surugadai, Chiyoda-ku, Tokyo, 101-8310, Japan.
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Zhu F, Ji L, Zhou C, Cao Y, Chen Z, Wu X, Zou J, Gao Y. Accuracy of Microimplant Placement Using a 3D Guide Plate for Orthodontic Anchorage. Appl Bionics Biomech 2023; 2023:9060046. [PMID: 37404956 PMCID: PMC10317578 DOI: 10.1155/2023/9060046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 03/31/2023] [Accepted: 06/07/2023] [Indexed: 07/06/2023] Open
Abstract
This study aimed to design a three-dimensional (3D) guide plate using computer-aided design and a 3D printing system for precise implantation of microimplants for orthodontic treatment and investigate the accuracy and feasibility of a 3D guide plate in clinical practice. A total of 30 microimplants were placed in 15 patients in the Department of Stomatology, Affiliated Hospital of Jiangnan University. Before surgery, DICOM data from cone-beam computed tomography (CBCT) scans and STereoLithography data from the 3D model scan were imported to 3Shape Dental System. Data fitting and matching were performed, and 3D guide plates were designed primarily focusing on the thickness of guide plates, amount of concave compensation, and dimensions of the ring. Assist implantation method was used to place the microimplants, and postoperative CBCT images were used to evaluate the position and implantation angle. The feasibility of placing microimplants and precise implantation guided by the 3D guide plate. CBCT data before and after the placement of microimplants were compared. Regarding the secure positioning of microimplants based on CBCT data, 26 implants were categorized as Grade i, four as Grade ii, and none as Grade iii. No loosening of microimplants 1 and 3 months after surgery was reported. The implantation of microimplants is more accurate under the guidance of a 3D guide plate. This technology can achieve accurate implant positioning, thus ensuring safety, stability, and improved success rates after implantation.
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Affiliation(s)
- Fangyong Zhu
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Lian Ji
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Chen Zhou
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Yannan Cao
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Zhifei Chen
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Xiangbing Wu
- Department of Stomatology, Wuxi People's Hospital, 214000 Wuxi, China
| | - Jianming Zou
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
| | - Yufeng Gao
- Department of Stomatology, Affiliated Hospital of Jiangnan University, 1000 Hefeng Road, 214000 Wuxi, China
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Effectiveness of micro-implant in vertical control during orthodontic extraction treatment in class II adults and adolescents after pubertal growth peak: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:2149-2162. [PMID: 36738320 DOI: 10.1007/s00784-023-04881-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 01/24/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To compare the effectiveness of micro-implant (MI) and conventional anchorage (CA) in vertical control during orthodontic extraction treatment of class II adults and adolescents after pubertal growth peak. MATERIALS AND METHODS Literature search was conducted through Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Database, VIP, China Biology Medicine (CBM), and other sources, from inception to December 2021. Randomized clinical trials (RCTs) and controlled clinical trials (CCTs) were included. Mean differences (MDs) with 95% confidence intervals (CIs) were conducted. A meta-analysis concerning change of mandibular plane, vertical change of upper and lower molar, change of occlusal plane, SNB, chin position, and profile was carried out. RESULTS A total of 10,669 records were identified in the database search, and 19 studies (10 RCTs and 9 CCTs) were included in the final analysis. Compared with CA, MI significantly decreased mandibular plane angle and intruded upper molars. No significant difference was found in vertical change of lower molars, occlusal plane, SNB, chin position, and profile. CONCLUSION MI seems to be more effective than CA in vertical control during orthodontic extraction treatment of class II adults and adolescents after pubertal growth peak. CLINICAL RELEVANCE MI should be given priority when considering the vertical control of class II patients, which is beneficial to the counterclockwise rotation of mandible or at least prevention of deterioration of the profile.
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Li C, Sfogliano L, Jiang W, Lee H, Zheng Z, Chung CH, Jones J. Total maxillary arch distalization by using headgear in an adult patient. Angle Orthod 2021; 91:267-278. [PMID: 33289800 DOI: 10.2319/010320-857.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 08/01/2020] [Indexed: 01/02/2023] Open
Abstract
Although headgear is rarely used in adult patients, its use in adults is mainly for anchorage control. In the current case report, a 24-year-old patient had a skeletal Class I relationship with a Class II tendency, brachyfacial pattern, significant facial asymmetry, and dental 3/4 cusp Class II molar and canine relationships on both sides. The patient declined surgery, and facial asymmetry was not his concern. The final treatment goal was to achieve a stable Class I dental relationship and normal occlusion without significantly compromising the patient's profile. The patient was compliant with the use of cervical-pull headgear after he refused the options of orthodontic-orthognathic combined treatment, maxillary premolar extraction, or temporary skeletal anchorage mini-implants. A 5-mm maxillary arch distal movement was accomplished without significant distal tipping of the molar crowns. The active treatment duration was 31 months. Proper overbite and overjet, balanced occlusion, and an acceptable facial profile were achieved. The treatment results inspire reconsideration of the possibility of using headgear in dental Class II correction in adult patients.
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Li GF, Yang ZJ, Wang TC, Zhang CX, Zhang JIY, Chen JD, Cheng Y, Zhou J, Liu C. Meta-analysis dataset comparing orthodontic mini-implants and conventional anchorage reinforcement for maximum orthodontic anchorage. Data Brief 2020; 32:106010. [PMID: 32793770 PMCID: PMC7415823 DOI: 10.1016/j.dib.2020.106010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/03/2020] [Accepted: 07/08/2020] [Indexed: 11/16/2022] Open
Abstract
The present article describes data from systematic review and meta-analysis investigating the efficacy and safety outcomes comparing mini-implants (MIs) and conventional anchorage reinforcement in patients with maximum dentoalveolar protrusion. All relevant RCTs and non-RCTs published up to 2018 were collected from PubMed, Embase and Cochrane database. Thirteen studies assessing the effect of mini-implants were included, of which 4 were randomized controlled trials (RCTs) and 9 observational studies. The efficacy parameters include mesiodistal movements of molars and incisors and vertical movements of molars and incisors. Whereas, the safety parameters were angular and linear measurement of soft tissue change. Subgroup analysis data was provided in terms of patients average age (<18 years and ≥18 years) at the initiation of treatment. This dataset is suitable for research purpose in the field of orthodontics and also helps dental doctors to determine their treatment preferences in the choice of anchorage reinforcement.
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Affiliation(s)
- Gui-Feng Li
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China
| | - Zhen-Jin Yang
- Department of Orthodontics, The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Tiang-Cong Wang
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China
| | - Cai-Xia Zhang
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China
| | - JIan-Yun Zhang
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China
| | - Jin-Dong Chen
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China
| | - Ye Cheng
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China
| | - Jing Zhou
- Department of Stomatology, Yanan Hospital of Kunming City, Kunming, China
| | - Chao Liu
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, Jiangsu Province, China
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Zuppardo ML, Santamaria M, Ferreira CL, Longo M, Cirelli JA, Santamaria MP, Jardini MAN. Effect of two corticotomy protocols on periodontal tissue and orthodontic movement. J Appl Oral Sci 2020; 28:e20190766. [PMID: 32638830 PMCID: PMC7340209 DOI: 10.1590/1678-7757-2019-0766] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 05/19/2020] [Indexed: 11/25/2022] Open
Abstract
Objective To compare two corticotomy surgical protocols in rats to verify whether they alter conventional orthodontic movement. Methodology Sixty Wistar rats were divided into three groups – orthodontic movement (CG), orthodontic movement and corticotomy (G1) and orthodontic movement with corticotomy and decortication (G2) – and euthanized after 7 and 14 days. Tooth movement (mm), bone volume fraction and bone volume ratio to total volume (BV/TV), and bone mineral density (BMD) were evaluated by micro-CT. The total amount of bone was measured in square millimeters and expressed as the percentage of bone area in the histomorphometry. The number of positive TRAP cells and RANK/RANKL/OPG interaction were also investigated. Results Day 14 showed a statistically significant difference in orthodontic tooth movement in CG compared with G1 (7.52 mm; p=0.009) and G2 (7.36 mm; p=0.016). A micro-CT analysis revealed a difference between CG, G1 and G2 regarding BV/TV, with G1 and G2 presenting a lower BV/TV ratio at 14 days (0.77 and 0.73 respectively); we found no statistically significant differences regarding BMD. There was a difference in the total amount of bone in the CG group between 7 and 14 days. At 14 days, CG presented a significantly higher bone percentage than G1 and G2. Regarding TRAP, G2 had more positive cells at 7 and 14 days compared with CG and G1. Conclusion Corticotomy accelerates orthodontic movement. Decortication does not improve corticotomy efficiency.
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Affiliation(s)
| | - Milton Santamaria
- Programa de Pós-Graduação em Ortodontia, Centro Universitário Hermínio Ometto, UNIARARAS, Araras, Brasil
| | | | - Mariéllen Longo
- Universidade Estadual Paulista, São José dos Campos, São Paulo, Brasil
| | - Joni Augusto Cirelli
- Faculdade de Odontologia, Universidade Estadual Paulista, Araraquara, São Paulo, Brasil
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Qie H, Kong L, Zhang F, Li C, Lu L, Dou C, Shan L. Three-Dimensional Finite Element Analysis on En-Masse Retraction of the Maxillary Anterior Teeth With Quantitative Combined Loading Control. J ORAL IMPLANTOL 2020; 46:214-220. [PMID: 32068860 DOI: 10.1563/aaid-joi-d-19-00340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This study aims to elucidate the biomechanical effects of combined loading of maxillary anterior and posterior implants using the sliding method on en-masse retraction of the anterior teeth and to quantify the loading ratio (LR) of anterior and posterior implants to achieve controlled retraction of the maxillary anterior teeth. A three-dimensional finite element model of the maxilla-upper dentition appliance was constructed. Implants were placed on the distal (A) and mesial (B) sides of the lateral incisors as well as on the mesial (C) side of the first molar and different amounts of force were loaded between the implants using 2- or 5-mm traction hooks. The labiolingual movement of the anterior teeth was recorded and the relationship between the LR of the implants and the movement of the central incisors was evaluated. With 2-mm traction hooks, the central incisors exhibited a translation tendency during retraction at lower A/C and B/C LR and labial or lingual crown inclination at higher values. With 5-mm traction hooks, the central incisors, lateral incisors, and canine teeth exhibited a labial crown inclination. The results of this study suggest that 2-mm traction hooks can cause labial crown inclination, translation tendency during retraction, or lingual crown inclination of the central incisors due to alterations in the LR of the anterior and posterior implants. The central incisors only exhibited labial crown inclination during combined loading of the anterior and posterior implants when 5-mm traction hooks were used.
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Affiliation(s)
- Hui Qie
- Department of Orthodontics, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lingliang Kong
- Department of Orthodontics, The Jining Hospital of Stomatology, Jining, China
| | - Fan Zhang
- Department of Orthodontics, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chenxi Li
- Department of Orthodontics, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lin Lu
- Department of Orthodontics, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chenlei Dou
- Department of Orthodontics, The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Lihua Shan
- Department of Orthodontics, The Second Hospital of Hebei Medical University, Shijiazhuang, China
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Liu Y, Yang ZJ, Zhou J, Xiong P, Wang Q, Yang Y, Hu Y, Hu JT. Comparison of Anchorage Efficiency of Orthodontic Mini-implant and Conventional Anchorage Reinforcement in Patients Requiring Maximum Orthodontic Anchorage: A Systematic Review and Meta-analysis. J Evid Based Dent Pract 2020; 20:101401. [PMID: 32473793 DOI: 10.1016/j.jebdp.2020.101401] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/17/2019] [Accepted: 01/17/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To compare the clinical effectiveness of mini-implants (MIs) and conventional anchorage appliances used for orthodontic anchorage reinforcement in patients with class I or II malocclusion with bimaxillary protrusion. MATERIALS AND METHODS Literature search was conducted through PubMed, Embase, and Cochrane from inception to July 2018. The following Medical Subject Heading terms were used for the search string: "skeletal anchorage", "temporary anchorage devices", "miniscrew implant", "mini-implant", "micro-implant". Standardized mean difference (SMD) and 95% confidence interval (CI) of horizontal and vertical movements of teeth from baseline were used for comparison. RESULTS A total of 12 studies were included in the final analysis. MI group significantly lowered mesial movement of molars compared to conventional anchorage group (SMD = -1.48, 95% CI = -2.25 to -0.72; P = .0002). There was significantly higher retraction of incisors in the MI group than in the conventional group (SMD = -0.47 mm, 95% CI = -0.87 to -0.07; P = .02). No significant difference was seen in vertical movement of molars (SMD = -0.21 mm, 95% CI = -0.87 to 0.45; P = .52) and incisors (SMD = -0.30, 95% CI = -1.18 to 0.58; P = .5). CONCLUSION MIs seem to be more effective than the conventional anchorage devices in terms of minimizing unintended mesial movement of molars with maximum retraction of anterior teeth.
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Affiliation(s)
- Yan Liu
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Zhen-Jin Yang
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Jing Zhou
- Department of Stomatology, Kunming Yanan Hospital, Kunming City, China.
| | - Ping Xiong
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Quan Wang
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Yan Yang
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Yu Hu
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
| | - Jiang-Tian Hu
- The Affiliated Stomatology Hospital of Kunming Medical University, Kunming City, China
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12
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Azeem M, Haq AU, Awaisi ZH, Saleem MM, Tahir MW, Liaquat A. Failure rates of miniscrews inserted in the maxillary tuberosity. Dental Press J Orthod 2019; 24:46-51. [PMID: 31721946 PMCID: PMC6833927 DOI: 10.1590/2177-6709.24.5.046-051.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 12/28/2018] [Indexed: 11/22/2022] Open
Abstract
Introduction: Anchorage conservation in orthodontics has always been a challenge. Objective: The aim of this current study was to find out the failure rate of miniscrews inserted in the maxillary tuberosity (MT) region. Methods: This pilot study consisted of 40 patients (23 female, 17 male; mean age = 20.1±8.9 years) that had received 60 MT miniscrews for orthodontic treatment. Clinical notes and pictures were used to find out the primary outcome of miniscrew failure. Independent failure factors were also investigated. Logistic regression analysis was done for predictor’s relation with MT miniscrews failure. Results: There was no significant correlation in failure rate according to various predictor variables, except for miniscrews installed by lesser experienced operators, which showed significantly more failure. The odds ratio for miniscrew failure placed by inexperienced operators was 4.16. Conclusion: A 26.3% failure rate of mini-implants inserted in the MT region was observed.
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Affiliation(s)
- Muhammad Azeem
- Faisalabad Medical University, Punjab Medical College - Dental Section, Department of Orthodontics (Faisalabad, Pakistan)
| | - Arfan Ul Haq
- De'Montmorency College of Dentistry, Department of Orthodontics (Lahore, Pakistan)
| | | | - Muhammad Mudassar Saleem
- Islamabad Medical & Dental College, Department of Oral and Maxillofacial Surgery (Islamabad, Pakistan)
| | - Muhammad Waheed Tahir
- Allama Iqbal Medical College, Jinnah Hospital, Department of Oral and Maxillofacial Surgery (Lahore, Pakistan)
| | - Ahmad Liaquat
- University of Lahore, Department of Oral and Maxillofacial Surgery (Lahore, Pakistan)
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13
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Mukaida K, Mayahara K, Sanuki-Suzuki R, Tamura T, Shimizu N. Treatment of bimaxillary protrusion with temporary anchorage devices. J Oral Sci 2018; 60:316-319. [PMID: 29925716 DOI: 10.2334/josnusd.17-0152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
For treatment of severe bimaxillary protrusion in adults, a condition known to be among the most difficult to manage, both the maxillary and mandibular anterior teeth must be fully retracted using all the extraction space available. This article reports the treatment of an adult with severe high-angle bimaxillary protrusion. To correct the protrusion of the anterior teeth, orthodontic anchor screws (OASs) were used to provide absolute anchorage during anterior retraction. Acceptable occlusion, facial profile, and balance were achieved. OASs appear to be very useful for treatment of severe bimaxillary protrusion in adults.
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Affiliation(s)
- Kyoko Mukaida
- Department of Orthodontics, Nihon University School of Dentistry
| | - Kotoe Mayahara
- Department of Orthodontics, Nihon University School of Dentistry.,Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry
| | - Rina Sanuki-Suzuki
- Department of Orthodontics, Nihon University School of Dentistry.,Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry
| | - Takahiko Tamura
- Department of Orthodontics, Nihon University School of Dentistry.,Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry
| | - Noriyoshi Shimizu
- Department of Orthodontics, Nihon University School of Dentistry.,Division of Clinical Research, Dental Research Center, Nihon University School of Dentistry
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14
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Li J, Zhao Y, Li H, Li H, Lei L. Effects of force magnitude on torque control in the correction of bimaxillary protrusion with mass retraction. J Orthod Sci 2018; 7:13. [PMID: 29963508 PMCID: PMC6004741 DOI: 10.4103/jos.jos_65_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES: This study was designed to explore whether force magnitude would influence incisor torque control and the overall outcome in patients with bimaxillary protrusion who need mass incisor retraction. MATERIALS AND METHODS: Forty-one female patients (aged > 15 years) with bimaxillary protrusion requiring mass incisor retraction were selected. Two sliding mechanics were utilized, with the elastic group receiving a light force of ~100 g by wearing elastics and the power chain group receiving a moderate force of ~250 g by power chain. Lateral cephalograms obtained before and after treatment were traced and measured. RESULTS: Patients in both groups displayed maxillary protrusion with a similar skeletal class II tendency. A longer treatment time was found in the elastic group. No difference in the distance of incisor tip movement was observed between the two groups; however, a larger inclination of upper incisors was found in the elastic group, indicating less loss of torque. In addition, larger reduction in Sella-Nasion-A and A-Nasion-B angle was observed in the elastic group, which was accompanied by a larger ratio of upper lip retraction to upper incisor retraction as well as more upper lip retraction. CONCLUSIONS: Sliding mechanics with elastics to generate light forces can achieve better torque control with more reduction in skeletal and soft tissue protrusion.
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Affiliation(s)
- Jiao Li
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yunhe Zhao
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Houxuan Li
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Huang Li
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Lang Lei
- Department of Orthodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
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15
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Franklin She TT, Keung Chow RL. Aggravation of Gummy Smile by Straight-Wire Mechanics and its Management with or without Orthognathic Surgery Up to 10-Year Follow-Up. APOS TRENDS IN ORTHODONTICS 2018. [DOI: 10.4103/apos.apos_24_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Two female patients presented with gummy smile, maxillary dentoalveolar protrusion and total vertical maxillary excess, retroclined incisors, and increased overbite received orthodontic camouflage with straight-wire mechanics by general dentists. The treatments caused severe bowing of upper occlusal plane which aggravated the gummy smile and had led them to seek specialist care. They were successfully managed by orthodontic camouflage and combined surgical-orthodontic treatment, respectively, in conjunction with the application of miniscrews on straight-wire mechanics. Aggravation of gummy smile by straight-wire mechanics, use of visual treatment objective to differentiate between orthodontic camouflage and surgical cases, and LeFort I segmentalization were discussed.
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Affiliation(s)
- Tsang Tsang Franklin She
- Orthodontics and Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
| | - Raymond Lop Keung Chow
- Orthodontics and Oral and Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China
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16
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Park CO, Sa'aed NL, Bayome M, Park JH, Kook YA, Park YS, Han SH. Comparison of treatment effects between the modified C-palatal plate and cervical pull headgear for total arch distalization in adults. Korean J Orthod 2017; 47:375-383. [PMID: 29090125 PMCID: PMC5653686 DOI: 10.4041/kjod.2017.47.6.375] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 06/06/2017] [Accepted: 06/21/2017] [Indexed: 12/31/2022] Open
Abstract
Objective The purpose of this study was to evaluate the dental and skeletal effects of the modified C-palatal plate (MCPP) for total arch distalization in adult patients with Class II malocclusion and compare the findings with those of cervical pull headgear. Methods The study sample consisted of the lateral cephalograms of 44 adult patients with Class II Division 1 malocclusion, including 22 who received treatment with MCPP (age, 24.7 ± 7.7 years) and 22 who received treatment with cervical pull headgear (age, 23.0 ± 7.7 years). Pre- (T1) and post-treatment (T2) cephalograms were analyzed for 24 linear and angular measurements. Multivariate analysis of variance was performed to evaluate the changes after treatment in each group and differences in treatment effects between the two groups. Results The mean amount of distalization at the crown and root levels of the maxillary first molar and the amount of distal tipping was 4.2 mm, 3.5 mm, and 3.9° in the MCPP group, and 2.3 mm, 0.6 mm, and 8.6° in the headgear group, respectively. In addition, intrusion by 2.5 mm was observed in the MCPP group. In both groups, the distal movement of the upper lip and the increase in the nasolabial angle were statistically significant (p < 0.001). However, none of the skeletal and soft tissue variables exhibited significant differences between the two groups. Conclusions The results of this study suggest that MCPP is an effective treatment modality for total arch distalization in adults.
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Affiliation(s)
- Chong Ook Park
- Private Practice; Department of Orthodontics, The Catholic University of Korea and Seoul National University, Seoul, Korea
| | - Noor Laith Sa'aed
- Dental Department, Iraqi Armed Hospital, Ministry of Defense, Bagdad, Iraq
| | - Mohamed Bayome
- Dental Department, Iraqi Armed Hospital, Ministry of Defense, Bagdad, Iraq.,Department of Postgraduate Studies, the Universidad Autonóma del Paraguay, Asunción, Paraguay
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, USA.,Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Yoon-Ah Kook
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Seok Park
- Department of Oral Anatomy, Dental Research Institute and School of Dentistry, Seoul National University, Seoul, Korea
| | - Seong Ho Han
- Division of Orthodontics, Department of Dentistry, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
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17
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Xu Y, Xie J. Comparison of the effects of mini-implant and traditional anchorage on patients with maxillary dentoalveolar protrusion. Angle Orthod 2016; 87:320-327. [PMID: 27684189 DOI: 10.2319/051016-375.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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.
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18
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Monga N, Kharbanda OP, Samrit V. Quantitative and qualitative assessment of anchorage loss during en-masse retraction with indirectly loaded miniscrews in patients with bimaxillary protrusion. Am J Orthod Dentofacial Orthop 2016; 150:274-82. [PMID: 27476360 DOI: 10.1016/j.ajodo.2016.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2015] [Revised: 02/01/2016] [Accepted: 02/01/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION This study provides vital insight in assessing anchorage loss when miniscrews are indirectly loaded. METHODS The study sample comprised 18 patients with bimaxillary protrusion (14 girls, 4 boys; mean age, 17.3 ± 4.6 years) selected from a database of 89 patients treated with miniscrews. All subjects who were selected required extraction of all first premolars and maximum anchorage. After initial leveling and aligning, miniscrews were placed between the first molar and the second premolar in all 4 quadrants and loaded by the indirect method at 3 weeks after placement with 200-g nickel-titanium alloy closed-coil springs for en-masse retraction. Mean treatment duration was 29.7 ± 6.8 months. Pretreatment and posttreatment lateral cephalograms were analyzed to measure the amount of anchorage loss, incisor retraction, and the incisors' angular change in reference to the pterygoid vertical reference line and were evaluated by the structural superimposition method. RESULTS The ratio of incisor retraction to molar protraction was 4.2 in the maxilla and 4.7 in the mandible. The first molars showed mean extrusion of 0.20 mm in the maxilla and 0.57 mm in the mandible; these were statistically insignificant. The mean angular change of the first molars was -2.43° in the maxilla and -0.03° in the mandible. The mean anchorage loss in reference to the pterygoid vertical was 1.3 mm in the maxilla and 1.1 mm in the mandible; these were statistically significant. Structural superimpositions showed mean change in molar position of 0.83 mm in the maxilla and 0.87 mm in the mandible, and 5.77 mm in the maxillary incisor and 5.43 mm in the mandibular incisor. These results were compared with the direct anchorage method reported in the literature. CONCLUSIONS Indirect miniscrew anchorage can be a viable alternative to direct anchorage.
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Affiliation(s)
- Nitika Monga
- Senior resident, Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Om Prakash Kharbanda
- Chief, Centre for Dental Education and Research; professor and head, Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
| | - Vilas Samrit
- Assistant professor, Division of Orthodontics and Dentofacial Deformities, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
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