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Janson G, Niederberger ALG, Janson G, Valerio MV, Caldas W, Valarelli FP. Stability of Class II malocclusion treatment with Class II elastics. Am J Orthod Dentofacial Orthop 2023; 163:609-617. [PMID: 36775752 DOI: 10.1016/j.ajodo.2021.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 10/01/2021] [Accepted: 10/01/2021] [Indexed: 02/13/2023]
Abstract
INTRODUCTION The objective of this study was to compare the long-term cephalometric stability after successful therapy of nonextraction Class II malocclusion with elastics and with headgear. METHODS The sample comprised 43 patients with Class II malocclusion and was divided into 2 groups. The elastic group (EG) consisted of 20 patients treated with fixed appliances associated with Class II elastics, and the headgear group (HG) consisted of 23 patients treated with fixed appliances and extraoral headgear. Pretreatment, posttreatment, and long-term posttreatment lateral radiographs were evaluated; t tests were used to compare the long-term posttreatment changes between the groups. RESULTS The groups were matched regarding initial age, time of long-term posttreatment evaluation, initial malocclusion severity, quality of treatment result, and all pretreatment cephalometric variables. Intergroup comparisons of long-term posttreatment changes showed that the HG group presented significantly greater mandibular protrusion, occlusal plane angle decrease, and maxillary molar mesialization. However, long-term posttreatment stability was similar in overjet, overbite, and molar relationships. CONCLUSIONS Nonextraction Class II malocclusion treatment with elastics or extraoral headgear have similar long-term posttreatment stability.
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Affiliation(s)
- Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Gabriela Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Marcelo Vinicius Valerio
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil.
| | - Waleska Caldas
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
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Südwasser S, Bock NC, Jost J, Killat S, Ruf S. Herbst-multibracket appliance treatment: is there an association between lower incisor position changes and the development of labial gingival recessions? J Orofac Orthop 2021; 82:363-371. [PMID: 33442753 PMCID: PMC8550700 DOI: 10.1007/s00056-020-00272-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 10/31/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To assess a potential association between lower incisor (LI) position changes during Herbst-multibracket appliance (Herbst-MBA) treatment and the development of labial gingival recessions (LGR). METHODS All class II patients (Department of Orthodontics, University of Giessen, Giessen, Germany) who had undergone Herbst-MBA treatment until 2015 with study models and lateral cephalograms available from before (T0) and after treatment plus ≥24 months of retention (T3) were included (n = 259). Lateral cephalograms were evaluated regarding LI position changes: iiL/ML (angle between LI long axis and mandibular plane [MP]), ii-MLPg (distance between LI incisal edge and a line perpendicular to MP through pogonion), apex-MLPg (distance between LI apex and a line perpendicular to MP through pogonion), ii-MLii (distance between LI incisal edge and MP on a line perpendicular to MP through incisal edge). Using study models the distance between the cementoenamel junction and the deepest point of the gingival margin was defined as LGR. RESULTS The following cephalometric mean changes were recorded (T0-T3): iiL/ML +5.9 ± 5.76° (p = 0.929), ii-MLPg -0.2 ± 0.25 mm (p = 0.430), apex-MLPg +0.1 ± 0.32 mm (p = 0.363), ii-MLii +0.1 ± 0.36 mm (p = 0.206). The mean increase of LGR magnitude measured on the study models was 0.1 ± 0.35 mm. However, no association with the cephalometric LI position changes was found (|R| ≤ 0.2). CONCLUSION There is no association between the amount of LI position changes and the development of LGR during Herbst-MBA treatment plus retention. Nevertheless, individual predisposition or excessive treatment changes and extraordinary treatment approaches, respectively, might still lead to development of LGR.
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Affiliation(s)
- S Südwasser
- Department of Orthodontics, University of Giessen, Schlangenzahl 14, 35392, Giessen, Germany
| | - N C Bock
- Department of Orthodontics, University of Giessen, Schlangenzahl 14, 35392, Giessen, Germany.
| | - J Jost
- Private Practice, Limburg, Germany
| | - S Killat
- Private Practice, Stuttgart, Germany
| | - S Ruf
- Department of Orthodontics, University of Giessen, Schlangenzahl 14, 35392, Giessen, Germany
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Angst C, Eliades T, Papageorgiou SN. Stability of occlusal outcome during long-term retention: the time-dependent variation of the American Board of Orthodontics index. Eur J Orthod 2021; 43:1-7. [PMID: 32144422 DOI: 10.1093/ejo/cjaa004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND The aim of this retrospective cohort study was to assess long-term occlusal changes at debond and a median of 8 years afterwards (in retention) with the American Board of Orthodontics (ABO) objective grading system and identify risk factors. MATERIALS AND METHOD Fifty patients (median age: 14.3 years at debond; 60% female) treated with fixed appliances (25 with and 25 without premolar extractions) were included. The occlusal outcome was assessed with the ABO tool and analyzed statistically at 5%. RESULTS Extraction treatment was associated with better occlusal outcome than non-extraction treatment (34.2 versus 40.9 points; P = 0.009). In retention, ABO scores improved by 7.4 points, while patients with worse debond finishing improved more afterwards (P = 0.001). Alignment/rotations deteriorated in 58% of the cases and occlusal relationships in 38% of the cases. Marginal ridges improved more for extraction than non-extraction patients (28% versus 0%; P = 0.001). Occlusal relationships improved more for cases that 'passed' the ABO requirements at debond than failed cases (64% versus 28%; P = 0.02). Furthermore, patients with worse debond ABO scores were more likely to deteriorate at alignment/rotations in retention. Finally, the proportion of cases passing the ABO requirements improved considerably between debond (28%) and in retention (54%) as half (47%) of the cases that had failed the ABO requirements at debond passed them in retention. CONCLUSIONS Considerable long-term occlusal changes are seen post-debond, which mostly favour improved settling. Extraction treatment and higher finishing quality at debond significantly influenced the chance for improvement. However, setting a cut-off score to denote treatment excellence showed considerable instability through time.
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Affiliation(s)
- Christine Angst
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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AlQatami FM, Alouini O, Knösel M, Helms HJ, Schwestka-Polly R. Objective treatment outcome assessment of a completely customized lingual appliance: A retrospective study. Int Orthod 2021; 19:445-452. [PMID: 34305012 DOI: 10.1016/j.ortho.2021.06.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To assess the outcome quality of subjects treated with a completely customized lingual appliance (CCLA) in a postgraduate university program, using the ABO Objective Grading System (OGS), by testing the null-hypothesis of a significant proportion of post-treatment cases exceeding an adjusted 'exam failure' threshold value of OGS=24. MATERIALS AND METHODS This retrospective single-arm study included 66 consecutively debonded CCLA cases (m/f 19/47; mean age: 25.1±9 years) treated at Hannover Medical School (MHH, Hannover, Germany). The discrepancy index (DI) was assessed on initial plaster casts. The OGS of the cast-radiograph evaluation was scored for both set-up and post-treatment casts, including the seven components of alignment/rotation, marginal ridges, buccolingual inclination, overjet, occlusal contacts, occlusal relationships and interproximal contacts, to parameterize differences between those. RESULTS DI score distribution (≥20, <20) was 25 (37.9%)/41 (62.1%) subjects. Mean initial DI was 17.3±8.5. Mean set-up OGS was 10.4±4.4 (min-max: 3-21), mean final OGS was 17.7±5.9 (min-max: 7-33), and the difference 7.3 (post-treatment - set-up) was statistically significant (p<0.0001; 95% CI [5.8, 8.7]). The null-hypothesis was rejected: A statistically significant proportion of the final casts (n=58; 87.8%) scored below OGS=24 by exact binomial test (P<0.0001; 95% CI [77.5%, 94.6%]). The rate of a final OGS score<24 was not significantly different (P=0.98) between both DI (≥20, <20) groups. CONCLUSIONS The outcome quality of the CCLA treatment in this postgraduate university setting was high and therefore sufficient for a vast majority of treated cases to pass the ABO-OGS clinical examination.
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Affiliation(s)
- Fawzi M AlQatami
- Hannover Medical School (MHH), Department of Orthodontics, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Ministry of Health State of Kuwait, Department of Orthodontics, Kuwait.
| | - Ons Alouini
- Hannover Medical School (MHH), Department of Orthodontics, Carl-Neuberg-Str. 1, 30625 Hannover, Germany; Private Practice, Montpellier, France.
| | - Michael Knösel
- Private Practice, Hamburg, Germany; University Medical Centre (UMG), Department of Orthodontics, Göttingen, Germany.
| | - Hans-Joachim Helms
- University Medical Centre (UMG), Department of Medical Statistics, Göttingen, Germany.
| | - Rainer Schwestka-Polly
- Hannover Medical School (MHH), Department of Orthodontics, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
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Chu Y, Zhang L, Zhao Y, Yi F, Lu Y. Effectiveness of modifications to preadjusted appliance prescriptions based on racial dental characteristics assessed by the ABO Cast-Radiograph Evaluation: A propensity score matching study. PeerJ 2021; 9:e10605. [PMID: 33520444 PMCID: PMC7812923 DOI: 10.7717/peerj.10605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 11/28/2020] [Indexed: 12/03/2022] Open
Abstract
Background Because racial discrepancies in dental characteristics are known to exist, designing preadjusted appliances according to racial normal occlusion data would be expected to improve treatment results. However, whether modifications based on racial characteristics can improve treatment outcomes in the clinic remains to be investigated. Methods To study the influence of prescription type on treatment outcomes, 91 patients treated with Chinese or Roth prescription appliances were selected as an initial sample. Two groups of patients were selected by propensity score matching (1:1) to limit the effects of confounding factors, including age, sex, case complexity, and extraction plan. Discrepancy Index and cervical vertebral maturation values were used to quantify case complexity and patient age, respectively. After matching, the final sample of 60 patients consisted of two groups of 30 patients each: group 1 had been treated with a Chinese prescription appliance and group 2 had been treated with a Roth prescription appliance. ABO casts and radiograph evaluation (CR-Eval) and lateral cephalograms were utilized to compare the treatment outcomes of the two groups. Results The total ABO scores of groups 1 and 2 were 22.03 and 23.87, respectively. There were no significant differences between the two groups in total ABO score or in seven other sub-scores; however, there was a significant difference between the two groups in mandibular canine alignment score. Conclusions There are no significant differences in overall treatment outcomes between the Chinese and Roth prescription appliances. The Chinese prescription yielded better alignment results in the mandibular canine for Chinese patients.
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Affiliation(s)
- Yanhao Chu
- Department of Orthodontics, Xiangya School of Stomatology, Hunan Key Laboratory of Oral Health Research, Xiangya Stomatological Hospital, Central South University, Changsha, Hunan, China
| | - Lingling Zhang
- Department of Orthodontics, Xiangya School of Stomatology, Hunan Key Laboratory of Oral Health Research, Xiangya Stomatological Hospital, Central South University, Changsha, Hunan, China
| | - Yatao Zhao
- Department of Orthodontics, Xiangya School of Stomatology, Hunan Key Laboratory of Oral Health Research, Xiangya Stomatological Hospital, Central South University, Changsha, Hunan, China
| | - Fang Yi
- Department of Orthodontics, Xiangya School of Stomatology, Hunan Key Laboratory of Oral Health Research, Xiangya Stomatological Hospital, Central South University, Changsha, Hunan, China
| | - Yanqin Lu
- Department of Orthodontics, Xiangya School of Stomatology, Hunan Key Laboratory of Oral Health Research, Xiangya Stomatological Hospital, Central South University, Changsha, Hunan, China
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Papageorgiou SN, Tilen R, Vandevska-Radunovic V, Eliades T. Occlusal outcome after orthodontic treatment with preadjusted straight-wire and standard edgewise appliances : A retrospective cohort study. J Orofac Orthop 2021; 82:321-328. [PMID: 33442754 PMCID: PMC8384812 DOI: 10.1007/s00056-020-00273-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 10/16/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Orthodontic fixed appliances have been proven to be effective in treating a wide variety of malocclusions, and different types of appliances have emerged during recent decades. However, the comparative effects of different appliances have not been adequately assessed. Thus, the aim was to assess the occlusal outcome of orthodontic treatment with preadjusted straight-wire (SWIRE) and standard edgewise (SEDGE) appliances. METHODS In all, 56 patients (mean age: 13.5 years; 45% male) receiving extraction-based treatment with either SWIRE or SEDGE appliances were included. Between-group differences in the occlusal outcome assessed with the American Board of Orthodontists Objective Grading System (ABO-OGS) and treatment duration were analyzed statistically at the 5% level. RESULTS The average ABO-OGS score was 31.3 ± 7.2 points and 34.0 ± 10.4 points in the SWIRE and SEDGE groups with no statistically significant difference between groups (P = 0.26). Treatment duration was significantly shorter in the SWIRE group compared to the SEDGE group, with an average difference of -6.8 months (95% confidence interval [95% CI] = -9.6 to -4.0 months; P < 0.001). Likewise, fewer visits were needed with SWIRE compared to SEDGE appliances with an average difference of -7.2 visits (95% CI = -10.3 to -4.2 visits; P < 0.001). Adjusting for the influence of any potential confounders did not considerably impact the results. CONCLUSION Similar treatment outcomes were observed after premolar extraction treatment with SWIRE and SEDGE appliances. On the other hand, SEDGE appliances were associated with prolonged treatment duration and more visits needed to complete treatment compared to SWIRE appliances.
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Affiliation(s)
- Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstraße 11, Zurich, Switzerland.
| | - Raphael Tilen
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstraße 11, Zurich, Switzerland
| | | | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstraße 11, Zurich, Switzerland
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Mujagic M, Pandis N, Fleming PS, Katsaros C. The Herbst appliance combined with a completely customized lingual appliance: A retrospective cohort study of clinical outcomes using the American Board of Orthodontics Objective Grading System. Int Orthod 2020; 18:732-738. [DOI: 10.1016/j.ortho.2020.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 07/10/2020] [Accepted: 07/14/2020] [Indexed: 11/28/2022]
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Bombonatti R, Aliaga-Del Castillo A, Bombonatti JFS, Garib D, Tompson B, Janson G. Cephalometric and occlusal changes of Class III malocclusion treated with or without extractions. Dental Press J Orthod 2020; 25:24-32. [PMID: 32965384 PMCID: PMC7510493 DOI: 10.1590/2177-6709.25.4.024-032.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 01/22/2020] [Indexed: 12/04/2022] Open
Abstract
Objective: The aim of this retrospective study was to evaluate the cephalometric and
occlusal changes of orthodontically treated Class III malocclusion patients.
Methods: The experimental groups comprised 37 Class III patients treated: G1) without
(n=19) and G2) with extractions (n=18) . The control group (G3), matched by
age and sex with the experimental groups, consisted of 18 subjects with
untreated Class III malocclusion. Cephalometric (radiographs) and occlusal
(study models) changes were assessed between the beginning (T1)
and the end (T2) of treatment. Intergroup comparisons were
performed with one-way ANOVA followed by Kruskal-Wallis tests
(p< 0.05). Occlusal changes were evaluated by the
peer assessment rating (PAR) index (ANOVA and Kruskal-Wallis tests), and the
treatment outcomes were evaluated by the Objective Grading System (OGS)
(t-tests). Results: The experimental groups showed a restrictive effect on mandibular anterior
displacement and a discrete improvement in the maxillomandibular
relationship. Extraction treatment resulted in a greater retrusive movement
of the incisors and significant improvements in the overjet and molar
relationship in both groups. The PAR indexes were significantly reduced with
treatment, and the OGS scores were 25.6 (G1) and 28.6 (G2), with no
significant intergroup difference. Conclusions: Orthodontic treatment of Class III malocclusion patients with fixed
appliances improved the sagittal relationships, with greater incisor
retrusion in the extraction group. Both the extraction and non-extraction
treatments significantly decreased the initial malocclusion severity, with
adequate and similar occlusal outcomes of treatment.
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Affiliation(s)
- Roberto Bombonatti
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia, (Bauru/SP, Brazil)
| | - Arón Aliaga-Del Castillo
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia, (Bauru/SP, Brazil)
| | - Juliana Fraga Soares Bombonatti
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Dentística, Endodontia e Materiais Odontológicos (Bauru/SP, Brazil)
| | - Daniela Garib
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia, (Bauru/SP, Brazil).,Hospital de Reabilitação de Anomalias Craniofaciais (Bauru/SP, Brazil)
| | - Bryan Tompson
- Faculty of Dentistry, University of Toronto, (Toronto/ON, Canada).,Hospital for Sick Children, Division of Orthodontics (Toronto/ON, Canada)
| | - Guilherme Janson
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia, (Bauru/SP, Brazil)
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Long-term occlusal changes and patient satisfaction in patients treated with and without extractions: 37 years after treatment. Am J Orthod Dentofacial Orthop 2020; 158:e17-e27. [PMID: 32863088 DOI: 10.1016/j.ajodo.2020.07.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/01/2020] [Accepted: 07/01/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The objective of this research was to evaluate the treatment outcomes, long-term occlusal changes, and patient satisfaction after 37 years of nonextraction and extraction treatments. METHODS Fifty-seven patients with Class I and Class II malocclusion were divided into 2 groups. Group 1 included 16 patients treated with nonextraction therapy, with mean initial (T1), final (T2), and long-term posttreatment (T3) ages of 13.2, 15.0, and 50.3 years, respectively. Mean treatment time (T2 - T1) and long-term follow-up time (T3 - T2) were 1.8 and 35.2 years, respectively. Group 2 included 41 patients treated with extraction of 4 first premolars, with mean ages at T1, T2, and T3 of 13.3, 15.6, and 53.6 years, respectively. Mean treatment (T2 - T1) and long-term follow-up (T3 - T2) times were 2.3 and 37.9 years, respectively. The Peer Assessment Rating (PAR) index and Objective Grading System (OGS) indexes were evaluated at T1, T2, and T3 stages. The subjects also answered an online questionnaire regarding esthetic and occlusal self-perception at T3. Intergroup comparison was performed with t tests. RESULTS The PAR index improved with treatment and similarly worsened at T3 for both groups. OGS scores were close to the passing score at T2 for both groups. The nonextraction group presented worse OGS scores at T3 than the extraction group. Nonextraction patients perceived more changes in alignment over time, but overall satisfaction was similar. CONCLUSIONS The PAR index improved with treatment, and the PAR and OGS scores showed a significant increase, indicating great occlusal changes in the long-term stage. The nonextraction group showed more occlusal changes and perceived more changes in their alignment over time, but overall patient satisfaction was similar in both groups.
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Yassir YA, El-Angbawi AM, McIntyre GT, Revie GF, Bearn DR. A randomized clinical trial of the effectiveness of 0.018-inch and 0.022-inch slot orthodontic bracket systems: part 2-quality of treatment. Eur J Orthod 2019; 41:143-153. [PMID: 30007333 DOI: 10.1093/ejo/cjy038] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To compare the quality of orthodontic treatment between 0.018-inch and 0.022-inch slot bracket systems. SUBJECTS AND METHODS Eligible participants aged 12 years or over were allocated to the 0.018-inch or 0.022-inch slot MBT appliance (3M-Unitek, Monrovia, California, USA) using block randomization in groups of 10. Outcome measures included: 1. ABO cast-radiograph evaluation (CR-EVAL), 2. peer assessment rating (PAR) scores, 3. incisor inclination, and 4. patient perception using the Index of Orthodontic Treatment Need aesthetic component (IOTN AC) and three validated questionnaires before, during and after treatment. Parametric tests [independent samples t-test and two-way analysis of variance (ANOVA)] and non-parametric tests (chi-square with Fisher's exact tests and Mann-Whitney U-test) assessed differences between groups (P < 0.05). RESULTS Of the 187 participants randomized (1:1 ratio), 34 withdrew or were excluded (protocol deviations or poor cooperation). There were 77 patients in the 0.018-inch slot group and 76 patients in the 0.022-inch slot group (overall mean age: 19.1 years). Baseline characteristics were similar between groups (P > 0.05). The mean total ABO CR-EVAL scores were 34.7 and 34.5; mean percentage PAR score reduction 74.1 per cent and 77.1 per cent; mean change for maxillary incisor inclination 2.9 degrees and 1.6 degrees and for mandibular incisor inclination 2.7 degrees and 1.4 degrees for the 0.018-inch and 0.022-inch groups, respectively. Improvement in patient perception of aesthetics after treatment was statistically significant for both groups (P < 0.05). However, there were no statistically significant differences between the two treatment groups for ABO CR-EVAL, percentage PAR score reduction, incisor inclination, and patient perception of treatment (P > 0.05). No adverse events were observed during treatment. LIMITATIONS It was impossible to blind clinicians or patients to allocation and oral hygiene and periodontal outcomes were not assessed. CONCLUSIONS There were no statistically or clinically significant differences in the quality of occlusal outcomes, incisor inclination and patient perception of treatment between 0.018-inch and 0.022-inch slot bracket systems. REGISTRATION The trial was registered with ClinicalTrials.gov on 5 March 2014, registration number: NCT02080338. PROTOCOL The protocol was published at DOI: 10.1186/1745-6215-15-389.
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Affiliation(s)
- Yassir A Yassir
- Orthodontic Department, School of Dentistry, University of Dundee, UK.,Orthodontic Department, College of Dentistry, University of Baghdad, Iraq
| | - Ahmed M El-Angbawi
- Orthodontic Department, College of Dentistry, University of Baghdad, Iraq
| | - Grant T McIntyre
- Orthodontic Department, College of Dentistry, University of Baghdad, Iraq
| | - Gavin F Revie
- Orthodontic Department, College of Dentistry, University of Baghdad, Iraq
| | - David R Bearn
- Orthodontic Department, College of Dentistry, University of Baghdad, Iraq
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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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12
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Neoh SP, Komoltri C, Viwattanatipa N. Treatment outcome differences between pass and fail scores and correlation between cephalometric changes and cast-radiograph evaluation of the American Board of Orthodontics. J Orthod Sci 2018; 7:22. [PMID: 30547018 PMCID: PMC6251237 DOI: 10.4103/jos.jos_33_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVE: Using the cast-radiograph evaluation (CRE) score of the American Board of Orthodontics (ABO), the purpose of this study was 1) to find the post-treatment discrepancies that contributed to low-quality outcomes and 2) to identify if there might be any correlation between cephalometric changes and post-treatment discrepancies. MATERIALS AND METHODS: About 200 records submitted for the Thai Board of Orthodontics examination were analyzed. Overall, 23 parameters of the CRE scores and 12 cephalometric changes were collected. Based on the total CRE score, the cases were classified into three categories: pass (score <20), undetermined (score 20–30), and fail (score >30). Kruskall–Wallis was used to analyze the differences of mean CRE scores among these three categories. In addition, the cases were further classified into fixed appliance, two-phase and orthognathic surgery groups. Correlation tests were carried out to determine if there might be any association between cephalometric changes and CRE parameters. RESULTS: Significant differences of mean CRE scores were found for all CRE components except interproximal contacts. Significant correlation coefficients with the total CRE scores were found for all parameters except interproximal contacts. Significant moderate association was found between lower incisor changes and CRE scores in the two-phase and orthognathic surgery group. CONCLUSIONS: In order to improve treatment outcome quality, the top four parameters that orthodontists should pay attention to are occlusal contacts, occlusal relationship, marginal ridges, and alignment and rotations. Cephalometric changes were not suitable as weighting factors for total CRE scores.
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Affiliation(s)
- Siew Peng Neoh
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
| | - Chulaluk Komoltri
- Department of Epidemiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Nita Viwattanatipa
- Department of Orthodontics, Faculty of Dentistry, Mahidol University, Bangkok, Thailand
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Pariskou A, Athanasiou AE. Assessing Treatment Outcomes of a Graduate Orthodontic Program. Open Dent J 2018. [DOI: 10.2174/1874210601812010896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objectives:
To assess treatment outcomes of a graduate orthodontic program during two different periods.
Materials and Methods:
Consecutive orthodontic patients’ files were selected from the archives of the Graduate Orthodontic Program, Aristotle University of Thessaloniki, Greece. Following the application of certain inclusion criteria, the final sample consisted of 109 patients. The sample was allocated into two groups depending on the time of treatment [Group A: 1998-2003, (n=60); Group B: 2004-2009 (n=49)]. The first period started a few years after the inception of the program and the second 10 years later. All pre- and post-treatment dental casts were blindly assessed by one investigator using the Peer Assessment Rating (PAR) and the Index of Complexity, Outcome and Need (ICON). Statistical analysis included Student’s t-test, Mann-Whitney U test, Pearson Chi-Square test and Spearman correlation coefficient. The level of significance was set at p < 0.05.
Results:
In Group A, the mean PAR index changed from 28.6 before treatment to 5.5 after treatment and the mean ICON index changed from 71.9 to 23.5. In Group B, the mean PAR index changed from 23.6 before treatment to 4 after treatment and the mean ICON index changed from 62.8 to 19.8. The mean PAR score reduction was 78.4% for the 1st group and 81.4% for the 2nd group, respectively. Ninety percent of the cases of Group A and 89.8% of the cases of Group B had a post-treatment ICON score < 31. The severity of the initial malocclusion was found to be positively correlated with the treatment occlusal outcome. Out of the 109 cases, 68 were considered as substantially or greatly improved, 29 moderately improved, 8 showed minimal improvement and 4 cases were considered as not improved or worse. The mean PAR percentage improvement and the ICON score at the end of treatment were not correlated to the presence or absence of tooth extractions in the treatment plan. There was no correlation between the treatment outcome and the number of graduate residents involved in the therapy. The treatment outcomes were not correlated to the gender or age of patients.
Conclusion:
Patients treated by graduate orthodontic residents during 1998-2009 demonstrated significant improvement of their occlusion and the quality of the treatment remained constant throughout the years. The outcome of orthodontic treatment was not correlated to the gender and the age of patients, the number of postgraduate students performing the treatment, and the presence of tooth extractions in the treatment plan.
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Papageorgiou SN, Höchli D, Eliades T. Outcomes of comprehensive fixed appliance orthodontic treatment: A systematic review with meta-analysis and methodological overview. Korean J Orthod 2017; 47:401-413. [PMID: 29090128 PMCID: PMC5653689 DOI: 10.4041/kjod.2017.47.6.401] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 02/21/2017] [Accepted: 03/29/2017] [Indexed: 12/13/2022] Open
Abstract
Objective The aim of this systematic review was to assess the occlusal outcome and duration of fixed orthodontic therapy from clinical trials in humans with the Objective Grading System (OGS) proposed by the American Board of Orthodontics. Methods Nine databases were searched up to October 2016 for prospective/retrospective clinical trials assessing the outcomes of orthodontic therapy with fixed appliances. After duplicate study selection, data extraction, and risk of bias assessment according to the Cochrane guidelines, random-effects meta-analyses of the mean OGS score and treatment duration were performed and 95% confidence intervals (CIs) were calculated. Results A total of 34 relevant clinical trials including 6,207 patients (40% male, 60% female; average age, 18.4 years) were identified. The average OGS score after treatment was 27.9 points (95% CI, 25.3–30.6 points), while the average treatment duration was 24.9 months (95% CI, 24.6–25.1 months). There was no significant association between occlusal outcome and treatment duration, while considerable heterogeneity was identified. In addition, orthodontic treatment involving extraction of four premolars appeared to have an important effect on both outcomes and duration of treatment. Finally, only 10 (39%) of the identified studies matched compared groups by initial malocclusion severity, although meta-epidemiological evidence suggested that matching may have significantly influenced their results. Conclusions The findings from this systematic review suggest that the occlusal outcomes of fixed appliance treatment vary considerably, with no significant association between treatment outcomes and duration. Prospective matched clinical studies that use the OGS tool are needed to compare the effectiveness of orthodontic appliances.
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Affiliation(s)
- Spyridon N Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Damian Höchli
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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