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Bou Malhab S, Karam R, Kaddah F, El Khoury T, Ghosn N, Khoury E, Kassis A, Ghoubril J. Three-dimensional comparison of continuous and segmented arch techniques in the traction of palatally impacted canines using a non-linear finite element analysis. J Orthod 2024; 51:192-201. [PMID: 37470224 DOI: 10.1177/14653125231187422] [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] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To compare the three-dimensional (3D) effects of canine traction on the maxillary teeth when using two different traction methods, the continuous and the segmented arch wire techniques; then to test whether adding a transpalatal arch (TPA) would affect their response to traction. DESIGN Finite element analysis. METHODS A cone-beam computed tomography (CBCT) scan of a patient with bilateral palatally impacted canines was chosen, from which a 3D model was derived and imported into ABAQUS. Two arch wires were modelled, a continuous round one and a segmented rectangular one. Four models were obtained by adding a TPA to both techniques. A 100° imposed rotation was then applied at the intersection between the vertical loop and the horizontal segment of each wire. Initial displacement of the maxillary tooth in the labio-lingual and in the vertical directions was measured. The absolute maximum principal stress of the periodontal ligament (PDL) was also assessed. RESULTS Traction using a continuous arch wire led to different movement patterns of all teeth, some of them were tipped in a labial direction while others were lingually tipped. Traction using a segmented arch wire resulted in a retroclination of the posterior teeth and a proclination of the anterior teeth with a high level of stress on the premolars' PDL. Adding the TPA only affected the displacement of the first molars. The right side showed a maximum displacement of the first premolar, while the left side showed it on the lateral. The total displacement on the right side was higher than the left side. CONCLUSION The segmented technique caused a uniform displacement of all teeth while the continuous one showed a non-uniform displacement. The angulation and position of the vertical loop affected the displacement of the maxillary teeth. The addition of a TPA acted only on the first molars.
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Affiliation(s)
- Stephanie Bou Malhab
- Department of Orthodontics, School of Dental Medicine, Saint Joseph University, Beirut, Lebanon
| | - Richard Karam
- Lebanese Center for Studies and Research of Construction, Faculty of Engineering, Saint Joseph University, Beirut, Lebanon
| | - Fouad Kaddah
- Lebanese Center for Studies and Research of Construction, Faculty of Engineering, Saint Joseph University, Beirut, Lebanon
| | - Tony El Khoury
- Department of Orthodontics, School of Dental Medicine, Saint Joseph University, Beirut, Lebanon
| | - Nabil Ghosn
- Craniofacial Research Laboratory, School of Dental Medicine, Saint Joseph University, Beirut, Lebanon
| | - Elie Khoury
- Department of Orthodontics, School of Dental Medicine, Saint Joseph University, Beirut, Lebanon
| | - Adib Kassis
- Department of Orthodontics, School of Dental Medicine, Saint Joseph University, Beirut, Lebanon
| | - Joseph Ghoubril
- Department of Orthodontics, School of Dental Medicine, Saint Joseph University, Beirut, Lebanon
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Shaga IB, Priya K, Ramar S, Srinidhi S, Mohan GC, Ranganathan S, Moulvi SMM, Mani B. Dentists' Perception of Mysmartalign Clear Aligner Treatment. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S1585-S1587. [PMID: 38882901 PMCID: PMC11174265 DOI: 10.4103/jpbs.jpbs_1095_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 11/02/2023] [Accepted: 12/07/2023] [Indexed: 06/18/2024] Open
Abstract
Aim and Objective To assess the dentist perception of efficiency, treatment outcome, and stability of the tooth movement treated with mysmartalign clear aligner therapy (MSA CAT). Materials and Method A cross-sectional web-based questionnaire survey was carried out to evaluate the dentist perception of MYSMARTALIGN (MSA). To determine the sample size, a pilot study has been carried out and the final sample arrived was 4990 subjects. The current study's inclusion criteria took into account those who had finished their BDS and MDS as well as dentists and orthodontists who had been using the MSA CAT system on their patients for the previous 7 years. Results The result of the study showed that most research participants (3650) used MSA to treat mild to moderate malocclusion, and 3996 participants said that initial digital treatment plans have been authorised with no revisions. In view of efficiency, 3894 doctors were satisfied with the final outcome. Conclusions Finally concluded that recent survey showed that dentists were very satisfied with the effectiveness and treatment results of the MSA clear aligner procedure.
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Affiliation(s)
- I Bevin Shaga
- Department of Orthodontics and Dentofacial Orthopedics, Rajas Dental College and Hospital, Kavalkinaru, Tirunelveli, Tamil Nadu, India
| | - K Priya
- Department of Orthodontics and Dentofacial Orthopedics, Adhiparasakthi Dental College and Hospital, Melmaruvathur, Tamil Nadu, India
| | - Selvakumar Ramar
- Department of Orthodontics and Dentofacial Orthopaedics, Meenakshi Ammal Dental College and Hospital, Maduravoyal, Chennai, Tamil Nadu, India
| | - S Srinidhi
- Department of Public Health Dentistry, Karpaga Vinayaga Dental College, Chengelpattu, Chennai, Tamil Nadu, India
| | - G Chandra Mohan
- Department of Orthodontics and Dentofacial Orthopaedics, Mallareddy Dental College for Women, Hyderabad, Telangana, Tamil Nadu, India
| | - Sukanya Ranganathan
- Department of Orthodontics and Dentofacial Orthopedics, Madha Dental College and Hospital, Madha Nagar, Kundrathur, Chennai, Tamil Nadu, India
| | - S M M Moulvi
- Consultant Maxillofacial Surgeon, The FACE OMFS Centre, India
| | - Bhuvaneswari Mani
- Department of Orthodontics and Dentofacial Orthopaedics, Karpaga Vinayaga Institute of Dental Sciences, Chengelpattu, Chennai Tamil Nadu, India
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Varghese C, Ramaiah PT, Setty S, Madhusudhan V, Thimmiah MK, Dakshina CK. Evaluation of stress distribution values at the temporomandibular joint and distalization of teeth during en-masse retraction of the mandibular dentition using buccal shelf bone screws: A FEM study. Int Orthod 2023; 21:100747. [PMID: 36907085 DOI: 10.1016/j.ortho.2023.100747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 03/12/2023]
Abstract
INTRODUCTION Present Finite-element-method (FEM) study evaluates the stress distribution values at the Temporomandibular-Joint (TMJ) during en-masse retraction of the mandibular dentition using buccal shelf bone screws with varying magnitudes of forces. MATERIAL AND METHODS Nine replicas of a pre-existing three-dimensional finite element model of the craniofacial skeleton and articular disc from Cone-Beam-Computed-Tomography (CBCT) data and Magnetic-Resonance-Imaging (MRI) data of a patient were used. Buccal shelf (BS) bone screws were inserted buccal to the mandibular second molar region. Forces of magnitudes 250 gm, 350 gm and 450 gm were applied through NiTi coil springs along with stainless-steel archwires of sizes 0.016 × 0.022-inch, 0.017 × 0.025-inch and 0.019 × 0.025-inch. RESULTS On the articular disc, the maximum stress was observed at the inferior region and the inferior part of the anterior and posterior zone at all force levels. The stress on the articular disc and displacement of teeth increased with increase in force levels in all the 3 archwires. The maximum stress at the articular disc and displacement of teeth was observed for 450 gm force and the least for 250 gm force. No significant difference in the amount of displacement of teeth or the stresses produced at the articular disc was seen with increasing the size of the archwire. CONCLUSION With the present FEM study, we can deduce that it is better to use forces of lower levels on patients with temporomandibular-disorders (TMD) so as to reduce the stresses produced at the TMJ to avoid worsening of the TMD condition.
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Affiliation(s)
- Cilpa Varghese
- Department of Orthodontics and Dentofacial Orthopedics, Sri-Siddhartha Dental College and Hospital, Sri-Siddhartha Academy of Higher Education, Tumkur, Karnataka, India.
| | - Prasanna T Ramaiah
- Department of Dentistry, Siddaganga Medical College and Research Institute, Tumkur, Karnataka, India
| | - Suhas Setty
- Department of Oral Medicine and Radiology, Siddhartha Dental College and Hospital, Tumkur, Karnataka, India
| | - V Madhusudhan
- Department of Orthodontics and Dentofacial Orthopedics, Sri-Siddhartha Dental College and Hospital, Sri-Siddhartha Academy of Higher Education, Tumkur, Karnataka, India
| | - Manjula K Thimmiah
- Department of Orthodontics and Dentofacial Orthopedics, Sri-Siddhartha Dental College and Hospital, Sri-Siddhartha Academy of Higher Education, Tumkur, Karnataka, India
| | - Chethan K Dakshina
- Department of Orthodontics and Dentofacial Orthopedics, Sri-Siddhartha Dental College and Hospital, Sri-Siddhartha Academy of Higher Education, Tumkur, Karnataka, India
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Montasser MA, Keilig L, Bourauel C. Change in crown inclination accompanying initial tooth alignment with round archwires. Dental Press J Orthod 2022; 27:e2220489. [PMID: 35792791 PMCID: PMC9255984 DOI: 10.1590/2177-6709.27.3.e2220489.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 02/18/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate, in-vitro, the change in crown inclination that occurs during orthodontic leveling and alignment using different archwire-bracket-ligation combinations. MATERIALS AND METHODS Four archwire types were tested: (1) 0.012-in stainless steel and (2) 0.0155-in stainless steel multi-stranded, (3) 0.012-in nitinol Orthonol® and (4) 0.012-in nitinol Thermalloy®. Combinations with five types of 0.022-in slot orthodontic brackets were tested: SmartClipTM and Time3® self-ligating brackets, Mini-Taurus® and Victory SeriesTM conventional brackets, and Synergy® conventional-low friction bracket. Conventional brackets were ligated with both stainless steel and elastomeric ligatures. The simulated malocclusion comprised 2.0mm gingival and 2.0mm labial displacements of a maxillary right central incisor. Rotation around the Y-axis (representing labio-palatal inclination) was measured for the different archwire-bracket-ligation combinations. RESULTS The largest rotation was measured whith Orthonol® and Thermalloy® wires when combined with SmartClipTM brackets (8.07±0.24º and 8.06±0.26º, respectively) and with Synergy® brackets ligated with stainless steel ligatures (8.03±0.49º and 8.0±0.37º, respectively). The lower rotation was recorded when Thermalloy®, multi-stranded, and Orthonol® wires were ligated with elastomeric rings to Mini-Taurus® brackets (1.53±0.18º, 1.65± 0.23º and 1.70±0.28º, respectively) and to Victory SeriesTM brackets (1.68± 0.78º, 2.92± 1.40º and 1.74±0.46º, respectively). CONCLUSIONS All archwire-bracket-ligation combinations produced lingual crown inclination; however, lower changes were observed when the conventional brackets were ligated with elastomeric rings. The multi-stranded archwire produced less rotation with nearly every bracket-ligation combination, compared to the other archwires. The effect of the archwire-bracket-ligation combination on tooth inclination during leveling and alignment should be considered during planning treatment mechanics.
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Affiliation(s)
- Mona A Montasser
- Mansoura University, Faculty of Dentistry, Orthodontic Department (Mansoura/Egypt)
| | - Ludger Keilig
- University of Bonn, Department of Oral Technology, School of Dentistry (Bonn/Germany)
| | - Christoph Bourauel
- University of Bonn, Department of Oral Technology, School of Dentistry (Bonn/Germany)
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Upadhyay M, Arqub SA. Biomechanics of clear aligners: hidden truths & first principles. J World Fed Orthod 2021; 11:12-21. [PMID: 34965910 DOI: 10.1016/j.ejwf.2021.11.002] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 11/23/2021] [Indexed: 11/19/2022]
Abstract
Over the past two decades clear aligner-based treatment has received remarkableattention from the orthodontic profession and more so from general practitioners.Different companies have emerged using vigorous advertisement to promote theirproducts mainly to patients and clinicians through social media. A variety of concepts,methods, and adjuncts have been introduced to enhance the efficacy andeffectiveness of clear aligners. However, the accuracy of tooth movement (vspredicted) with aligners still hovers around 50%. Fixed appliances fare much better onaccuracy and predictability of treatment. Why is there a discrepancy betweenexpected and actual outcomes? This paper utilizes 'first principles' and the existingevidence to unravel some of the key drawbacks of aligner-based therapy. Severalshortcomings in the biomechanical properties of aligner material (thermoplastics) thataffect clinical performance are discussed. Based on the first principles of alignerbiomechanics, this paper provides clinical insights for improving predictability and effectiveness of aligner therapy.
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Affiliation(s)
- Madhur Upadhyay
- Division of Orthodontics, University of Connecticut Health, Farmington, Connecticut, USA.
| | - Sarah Abu Arqub
- Division of Orthodontics, University of Connecticut Health, Farmington, Connecticut, USA
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Cheng F, Jian ZS, Zhu Y, Zhang CY, Hu L, Chen LL. [Therapeutic effect analysis of skeletal class Ⅲ malocclusion treatment by transmission straight wire technique]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:301-307. [PMID: 32573139 DOI: 10.7518/hxkq.2020.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to investigate the therapeutic effects and advantages of skeletal class Ⅲ malocclusion treatment by transmission straight wire technique. METHODS Ninety-seven patients who received treatment for skeletal class Ⅲ malocclusion at the Department of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from January 2012 to January 2017 were selected for this retrospective study. All these patients refused surgery. They were divided into two groups in accordance with the type of skeletal malocclusion: mild-to-moderate skeletal malocclusion group (-4°≤ANB <0°) and severe skeletal malocclusion group (-8°≤ANB<-4°). Each of the two groups was divided further into two small groups in accordance with the technique used: T group (transmission straight wire technique) and M group (MBT technique). RESULTS The crossbite of all 59 patients in the mild-to-moderate skeletal malocclusion group was successfully treated. The molars were classified as classⅠrelationship, and the facial profile improved. Significant differences were found in the values of U1/SN angle, L1/MP angle, and Lip-Diff between the T and M groups before and after the treatment (P<0.05). The extent of incisor root resorption was lighter in the T group than in the M group (P<0.05). In the severe skeletal malocclusion group, the crossbite of all 38 patients was cured or partially cured. Fourteen patients showed severe lower anterior teeth inclination (five in the T group and nine in the M group), and the profiles did not significantly improve. Significant differences were observed in the values of U1-NA value, U1/SN angle, L1-NB value, L1/MP angle, LLP, and Lip-Diff between the T and M groups before and after the treatment (P<0.05). The extent of incisor root resorption was lighter in the T group than in the M group (P<0.05). CONCLUSIONS Relative to the MBT technique, the transmission straight wire technique has great advantages in improving facial profile, reducing the compensatory inclination of the upper and lower anterior teeth, and reducing the risk of root resorption in the treatment of skeletal class Ⅲ malocclusion.
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Affiliation(s)
- Feng Cheng
- Dept. of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Province Key Laboratory of Oral and Maxillofacial Deve-lopment and Regeneration; Dental School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Zhi-Shan Jian
- Dept. of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Province Key Laboratory of Oral and Maxillofacial Deve-lopment and Regeneration; Dental School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Ying Zhu
- Dept. of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Province Key Laboratory of Oral and Maxillofacial Deve-lopment and Regeneration; Dental School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Chun-Yan Zhang
- Dept. of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Province Key Laboratory of Oral and Maxillofacial Deve-lopment and Regeneration; Dental School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Li Hu
- Dept. of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Province Key Laboratory of Oral and Maxillofacial Deve-lopment and Regeneration; Dental School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Li-Li Chen
- Dept. of Stomatology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology; Hubei Province Key Laboratory of Oral and Maxillofacial Deve-lopment and Regeneration; Dental School, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
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The ideal insertion angle after immediate loading in Jeil, Storm, and Thunder miniscrews: A 3D-FEM study. Int Orthod 2020; 18:503-508. [PMID: 32387220 DOI: 10.1016/j.ortho.2020.03.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The miniscrew is effectively used to provide additional anchorage for orthodontic purposes. The aim of this study was to identify an optimal insertion angle for Jeil, Storm, and Thunder miniscrews on stress distribution at the bone miniscrew interface. MATERIALS AND METHODS To perform 3-dimensional finite element model analysis, a 3-dimensional model with a bone block was constructed with type D2 of bone quality, and with miniscrews of Storm, Thunder, Jeil, with the diameter of 2, 1.5. 1.6mm and length 15.9, 12.4, 14.4mm respectively. The miniscrews were inserted at 15° 30°, 45°, 60°, 75° and 90° to the bone surface. A simulated horizontal orthodontic force of 200 gram was applied to the centre of the miniscrews head in all models, and stress distribution and its magnitude were evaluated with a 3-dimensional finite element analysis program. RESULTS In the cancellous bone, minimum stress was found at placement angles of 90° for Jeil and Storm, which was 0.37 and 0.39MPa respectively, and 15° for Thunder, which was 0.85MPa. The maximum von Mises stresses in the cancellous bone for Jeil was at 60°, which was 0.92MPa, and for Thunder at 90°, which was 1.3MPa. CONCLUSION Each miniscrew has an ideal insertion angle, optimal insertion positions were found within 90° for Jeil and for Storm but 15° for Thunder. Clinical significance 3-dimensional finite element analysis confirmed that each miniscrew has an ideal insertion angle according to its characteristics.
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Comparation of three methods for measuring the Edge Bevel Radius of rectangular orthodontic wires: An in-vitro study. Int Orthod 2020; 18:509-518. [PMID: 32327346 DOI: 10.1016/j.ortho.2020.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/12/2020] [Accepted: 03/17/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To establish a simplified method for measuring the edge bevel radius of 0.019×0.025-in steel rectangular orthodontic wires, achievable in the clinical environment, and to compare it with the photographic method. MATERIALS AND METHODS Aided by the AutoCAD™ 2016 software, the theoretical mathematical relationship was determined between the edge rounding radius and cross-sectional dimensions (height, width, diagonals), through rectangle drawings that represent cross-sections. Two hundred segments (n=20) were obtained from the posterior portions of 100 archwires from 10 brands (Dentaurum™; American-Orthodontics™; GAC™; 3M-Unitek™; Abzil™; Morelli™; Orthometric™; Aditek™; A-Company™; Orthomundi™). The cross-sectional measures of each segment were obtained with a micrometer and a caliper, and the edge bevel radii of these segments were calculated with the use of a mathematical formula. For the "gold standard", the segments were included longitudinally in a phenolic resin cylinder, cross-sectioned, polished, and photographed in scanning electron microscope (SEM). The images were amplified 770× and the radii were measured with an acetate template. The micrometer and caliper measuring methods were subjected to Bland-Altman analysis and compared with the gold standard (SEM), considering ±10μm as the maximum acceptable difference between methods. RESULTS In the micrometre measurement, 95% of the differences from the standard were within the limits of agreement (-7.21 and 5.56μm). For the caliper method, 95% of the differences were between -5.46 and 19.83μm, which exceeded the fixed limit ±10μm. CONCLUSION The calculation method with micrometre measurements is equivalent to the photographic method, but there is no such equivalence for the caliper measurements.
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