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Kusaibati AM, Sultan K, Hajeer MY, Gkantidis N. Digital setup accuracy for moderate crowding correction with fixed orthodontic appliances: a prospective study. Prog Orthod 2024; 25:13. [PMID: 38584176 PMCID: PMC10999400 DOI: 10.1186/s40510-024-00513-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/08/2024] [Indexed: 04/09/2024] Open
Abstract
OBJECTIVES To evaluate the accuracy of a semi-automatic 3D digital setup process in predicting the orthodontic treatment outcome achieved by labial fixed appliances. SUBJECTS AND METHODS Twenty-five adult patients (18 to 24 years old) with class I malocclusion and moderate crowding were prospectively enrolled and received treatment on both jaws through the straight-wire technique. Prior to treatment commencement, a semi-automatic digital setup simulating the predicted treatment outcome was performed for each patient through Orthoanalyzer software (3Shape®, Copenhagen, Denmark) to obtain the prediction model. This was compared to the final outcome model through 3D superimposition methods. Metric variables and inspection of color-coded distance maps were used to detect how accurately the digital setup predicts the actual treatment outcome. RESULTS The mean absolute distances (MAD) between the superimposed dental arches of the predicted and the final models were: 0.77 ± 0.13 mm following superimposition on the palate, 0.52 ± 0.06 mm following superimposition on the maxillary dental arch, and 0.55 ± 0.15 mm following superimposition on the mandibular dental arch. The MAD at the palatal reference area was 0.09 ± 0.04 mm. Visualization of color-coded distance maps indicated that the digital setup accurately predicted the final teeth position in a few cases. Almost half of the cases had posteriorly wider upper and lower dental arches and palatally/lingually positioned or inclined anterior teeth, whereas the rest still showed errors within 2-3 mm, distributed over the entire dental arches with no distinct pattern. CONCLUSIONS The accuracy of semi-automatic prediction of the labial fixed appliance treatment outcome in Class I cases with moderate crowding is not yet sufficient. While average measures showed deviations less than 1 mm, examination of individual color-coded distance maps revealed significant disparities between the simulated and the actual results.
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Affiliation(s)
| | - Kinda Sultan
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Mohammad Younis Hajeer
- Department of Orthodontics, Faculty of Dentistry, University of Damascus, Damascus, Syria
| | - Nikolaos Gkantidis
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland.
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Akbulut S, Bayrak S. Evaluation´ of mandibular alveolar bone in patients with different vertical facial patterns : A cross-sectional CBCT study. J Orofac Orthop 2024; 85:89-97. [PMID: 35788398 DOI: 10.1007/s00056-022-00408-4] [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: 08/26/2021] [Accepted: 05/23/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE The study aimed to investigate the morphological and structural differences of mandibular alveolar bone between different vertical facial patterns (VFP). METHODS In all, 66 CBCT scans of patients were selected for the study: 24 were designated as hyperdivergent, 25 as normodivergent, and 17 as hypodivergent. Fractal values of the interdental alveolus were measured at the incisor, canine, premolar, and molar regions. The minimum trabecular bone width (MTBW) of the alveolus, the buccal and lingual cortical bone thicknesses, and the total alveolar width (AW) at the minimum trabecular bone level were measured. One-way analysis of variance and Tukey test were used to compare the groups. The correlations between FMA (Frankfurt mandibular plane angle) and other measurements were analyzed by Pearson analysis. RESULTS No significant differences were detected in fractal values and buccal and lingual cortical bone thicknesses between the groups. The MTBW and AW of the hypodivergent individuals were found to be higher in the anterior and premolar interdental sites. FMA was found to be significantly correlated with MTBW and AW. CONCLUSIONS The patients with different VFPs did not exhibit significant differences in the trabecular complexity of the mandibular alveolus. Hypodivergent patients tend to have thicker trabecular and alveolar bone widths than normodivergent and hyperdivergent individuals.
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Affiliation(s)
- Sibel Akbulut
- Faculty of Dentistry, Department of Orthodontics, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Seval Bayrak
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Bolu Abant Izzet Baysal University, Bolu, Turkey.
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Wei X, Lin Y, Zhang G, Zheng J, Zhang L, Yang Y, Zhao Q. Evaluation of cuspid cortical anchorage with different sagittal patterns using cone-beam computed tomography: a retrospective study. BMC Oral Health 2023; 23:216. [PMID: 37061704 PMCID: PMC10105966 DOI: 10.1186/s12903-023-02912-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Accepted: 03/26/2023] [Indexed: 04/17/2023] Open
Abstract
BACKGROUND No studies have focused on cortical anchorage resistance in cuspids, this study aimed to characterize the cortical anchorage according to sagittal skeletal classes using cone-beam computed tomography (CBCT). METHODS CBCT images of 104 men and 104 women were divided into skeletal class I, II, and III malocclusion groups. Skeletal and dental evaluations were performed on the sagittal and axial cross-sections. One-way analysis of variance followed by least significant difference post-hoc tests was used for group differences. Multiple linear regression was performed to evaluate the relationship between influential factors and cuspid cortical anchorage. RESULTS All cuspids were close to the labial bone cortex in different sagittal skeletal patterns and had different inclinations. There was a significant difference in the apical root position of cuspids in the alveolar bone; however, no significant difference in the middle or cervical portions of the root was found between different sagittal facial patterns. The middle of the cuspid root was embedded to the greatest extent in the labial bone cortex, with no significant difference between the sagittal patterns. For all sagittal patterns, 6.03 ± 4.41° (men) and 6.08 ± 4.45° (women) may be appropriate root control angles to keep maxillary cuspids' roots detached from the labial bone cortex. CONCLUSIONS Comparison of skeletal class I, II, and III malocclusion patients showed that dental compensation alleviated sagittal skeletal discrepancies in the cuspid positions of all patients, regardless of the malocclusion class. Detailed treatment procedures and clear treatment boundaries of cuspids with different skeletal patterns can improve the treatment time, periodontal bone remodeling, and post-treatment long-term stability. Future studies on cuspids with different dentofacial patterns and considering cuspid morphology and periodontal condition may provide more evidence for clinical treatment.
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Affiliation(s)
- Xiaoyu Wei
- Orthodontic Centre, West China College of Stomatology, Sichuan University, 14#, 3rd Section, Renmin South Road, Chengdu, 610041, China
- State Key Laboratory of Oral Diseases, Sichuan University, 14#, 3rd Section, Renmin South Road, Chengdu, 610041, China
| | - Yaqi Lin
- State Key Laboratory of Oral Diseases, Sichuan University, 14#, 3rd Section, Renmin South Road, Chengdu, 610041, China
| | - Guanning Zhang
- Orthodontic Centre, West China College of Stomatology, Sichuan University, 14#, 3rd Section, Renmin South Road, Chengdu, 610041, China
- State Key Laboratory of Oral Diseases, Sichuan University, 14#, 3rd Section, Renmin South Road, Chengdu, 610041, China
| | - Jiawen Zheng
- Orthodontic Centre, West China College of Stomatology, Sichuan University, 14#, 3rd Section, Renmin South Road, Chengdu, 610041, China
- State Key Laboratory of Oral Diseases, Sichuan University, 14#, 3rd Section, Renmin South Road, Chengdu, 610041, China
| | - Lanxin Zhang
- Orthodontic Centre, West China College of Stomatology, Sichuan University, 14#, 3rd Section, Renmin South Road, Chengdu, 610041, China
- State Key Laboratory of Oral Diseases, Sichuan University, 14#, 3rd Section, Renmin South Road, Chengdu, 610041, China
| | - Yuqing Yang
- Orthodontic Centre, West China College of Stomatology, Sichuan University, 14#, 3rd Section, Renmin South Road, Chengdu, 610041, China
- State Key Laboratory of Oral Diseases, Sichuan University, 14#, 3rd Section, Renmin South Road, Chengdu, 610041, China
| | - Qing Zhao
- Orthodontic Centre, West China College of Stomatology, Sichuan University, 14#, 3rd Section, Renmin South Road, Chengdu, 610041, China.
- State Key Laboratory of Oral Diseases, Sichuan University, 14#, 3rd Section, Renmin South Road, Chengdu, 610041, China.
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Ammoury MJ, Abou Chebel N, Macari AT. Three-dimensional surgical management of a patient with Pruzansky I hemifacial microsomia and severe facial asymmetry: A 4-year follow-up. Am J Orthod Dentofacial Orthop 2022; 161:708-726. [PMID: 35031193 DOI: 10.1016/j.ajodo.2020.11.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 11/01/2020] [Accepted: 11/01/2020] [Indexed: 11/01/2022]
Abstract
Treatment of hemifacial microsomia is challenging and often requires multiple interventions to restore function and facial esthetics. In this article, the combined orthodontic-surgical treatment of a young patient exhibiting Pruzansky I hemifacial microsomia is reported. The patient was aged 15 years, but his bone age was determined to be 18 years. His facial asymmetry was severe, with the nose and a retrusive chin deviated to the left side and a canted smile. The presurgical phase was aimed at centering the mandibular midline to the center of the chin through the distal movement of the mandibular left buccal dentition. The surgery was planned with 3-dimensional computer-aided surgical simulation and included a LeFort I and unilateral sagittal split osteotomies combined with a genioplasty. This report illustrates the therapeutic stages and a 4-year follow-up of a unique and complex orthognathic surgical approach, chosen among other alternatives and leading to improved function and appearance and stable results.
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Affiliation(s)
- Makram J Ammoury
- Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon
| | - Naji Abou Chebel
- Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon
| | - Anthony T Macari
- Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon.
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Zeitounlouian TS, Zeno KG, Brad BA, Haddad RA. Three-dimensional evaluation of the effects of injectable platelet rich fibrin (i-PRF) on alveolar bone and root length during orthodontic treatment: a randomized split mouth trial. BMC Oral Health 2021; 21:92. [PMID: 33653326 PMCID: PMC7971145 DOI: 10.1186/s12903-021-01456-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 02/18/2021] [Indexed: 11/25/2022] Open
Abstract
Background The role of injectable platelet rich fibrin (i-PRF) in orthodontic treatment has not been investigated with focus on its effect on dental and bony periodontal elements. Objective To evaluate the efficacy of i-PRF in bone preservation and prevention of root resorption. Methods A randomized split-mouth controlled trial included 21 patients aged 16–28 years (20.85 ± 3.85), who were treated for Class II malocclusion with the extraction of the maxillary first premolars. Right and left sides were randomly allocated to either experimental treated with i-PRF or control sides. After the leveling and alignment phase, the canines were retracted with 150gm forces. The i-PRF was prepared from the blood of each patient following a precise protocol, then injected immediately before canine retraction on the buccal and palatal aspects of the extraction sites. Localized maxillary cone beam computed tomography scans were taken before and after canine retraction to measure alveolar bone height and thickness and canine root length (indicative of root resorption), and the presence of dehiscence and fenestration. Paired sample t-tests and Wilcoxon signed rank tests were used to compare the changes between groups. Results No statistically significant differences in bone height, bone thickness were found between sides and between pre- and post-retraction period. However, root length was reduced post retraction but did not differ between sides. In both groups, postoperative dehiscence was observed buccally and palatally and fenestrations were recorded on only the buccal aspect. Conclusions I-PRF did not affect bone quality during canine retraction or prevent canine root resorption. I-PRF did not reduce the prevalence of dehiscence and fenestration. Trial registration ClinicalTrials.gov (identifier number: NCT 03399760. 16/01/2018).
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Affiliation(s)
- Talar S Zeitounlouian
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dental Medicine, Damascus University, Damascus, Syria
| | - Kinan G Zeno
- Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El-Solh, Beirut, 1107 2020, Lebanon.
| | - Bassel A Brad
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Damascus University, Damascus, Syria
| | - Rania A Haddad
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dental Medicine, Damascus University, Damascus, Syria
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Potential and limitations of orthodontic biomechanics: recognizing the gaps between knowledge and practice. J World Fed Orthod 2020; 9:S31-S39. [PMID: 33023730 DOI: 10.1016/j.ejwf.2020.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 11/22/2022]
Abstract
The perennial goals of efficient biomechanics are to obtain more controlled and faster movement and using more discrete appliances. The most recent technological advances have buttressed these goals. Temporary anchorage devices have revolutionized orthodontic practice and loom as a solid cornerstone of orthodontic science, along with the use of light forces, facilitated by "smart" archwires for optimal tooth movement. Accelerated tooth movement with decortication has been successful because of decreasing the resistance of cortical bone but micro-osteoperforation has not matched the same results. Clear aligners and preprogrammed regular or lingual appliances reflect the importance of three-dimensional technology in appliance design based on treatment outcome. These mechanical developments have inched the science closer to the traditional goals, but advances lack regarding their enhancement by biomaterials in a system where the physical stimulus is exerted on the teeth but the expression of tooth displacement is through the biological processes within the surrounding tissues. In this article, present tenets, applications, and advances are explored along with the gaps between knowledge and practice and the possibilities to bridge them. Anchorage control remains the major widely used development but slower is the development of faster noninvasive treatment.
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