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Albertini P, Barbara L, Albertini E, Willeit P, Lombardo L. Soft-tissue profile changes in adult patients treated with premolar extractions. Am J Orthod Dentofacial Orthop 2024; 166:171-178. [PMID: 38762811 DOI: 10.1016/j.ajodo.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 05/20/2024]
Abstract
INTRODUCTION The objective of this study was to identify the soft-tissue profile changes and the potential pretreatment cephalometric parameters that clinicians could use to predict the lip response after premolar extraction treatment in adult patients. METHODS Pretreatment and posttreatment lateral cephalograms of 75 white patients treated with premolar extractions were analyzed. The following initial cephalometric measurements were recorded: upper and lower lip to E-plane, vermilion thickness, lip length, maxillary and mandibular incisor inclination, and mentolabial and nasolabial angle. Pretreatment and posttreatment radiographs were superimposed using the Björk structural method to record lip retraction and incisor/lip retraction ratio. Pearson correlation and Kruskal-Wallis tests were used to compare lip retraction and incisor/lip retraction ratio with the cephalometric variables. The sample was divided according to different extraction patterns. RESULTS The mean upper and lower lip retraction values were 1.4 mm and 1.7 mm, respectively. Vermilion thickness showed a negative and statistically significant correlation (P <0.05) with lip retraction and incisor/lip retraction ratio. In addition, the mean incisor/lip retraction ratio was 61% and 98% for the upper and lower thin lip, respectively, whereas the mean incisor/lip retraction ratio was 17% and 44% for the upper and lower thick lip, respectively. The comparison among extraction patterns did not highlight any noticeable difference. CONCLUSIONS The choice of a specific extraction pattern did not impact lip response. The vermilion thickness was the key factor influencing lip retraction: an increase in this parameter was related to a decrease in lip retraction and vice versa.
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Affiliation(s)
- Paolo Albertini
- From the Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy.
| | - Lorenza Barbara
- From the Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Enrico Albertini
- From the Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Paul Willeit
- From the Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - Luca Lombardo
- From the Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
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Köktürk B, Pamukçu H, Gözüaçık Ö. Evaluation of different machine learning algorithms for extraction decision in orthodontic treatment. Orthod Craniofac Res 2024. [PMID: 38764408 DOI: 10.1111/ocr.12811] [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] [Accepted: 05/08/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION The extraction decision significantly affects the treatment process and outcome. Therefore, it is crucial to make this decision with a more objective and standardized method. The objectives of this study were (1) to identify the best-performing model among seven machine learning (ML) models, which will standardize the extraction decision and serve as a guide for inexperienced clinicians, and (2) to determine the important variables for the extraction decision. METHODS This study included 1000 patients who received orthodontic treatment with or without extraction (500 extraction and 500 non-extraction). The success criteria of the study were the decisions made by the four experienced orthodontists. Seven ML models were trained using 36 variables; including demographic information, cephalometric and model measurements. First, the extraction decision was performed, and then the extraction type was identified. Accuracy and area under the curve (AUC) of the receiver operating characteristics (ROC) curve were used to measure the success of ML models. RESULTS The Stacking Classifier model, which consists of Gradient Boosted Trees, Support Vector Machine, and Random Forest models, showed the highest performance in extraction decision with 91.2% AUC. The most important features determining extraction decision were maxillary and mandibular arch length discrepancy, Wits Appraisal, and ANS-Me length. Likewise, the Stacking Classifier showed the highest performance with 76.3% accuracy in extraction type decisions. The most important variables for the extraction type decision were mandibular arch length discrepancy, Class I molar relationship, cephalometric overbite, Wits Appraisal, and L1-NB distance. CONCLUSION The Stacking Classifier model exhibited the best performance for the extraction decision. While ML models showed a high performance in extraction decision, they could not able to achieve the same level of performance in extraction type decision.
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Affiliation(s)
- Begüm Köktürk
- Department of Orthodontics, Faculty of Dentistry, Başkent University, Ankara, Turkey
| | - Hande Pamukçu
- Department of Orthodontics, Faculty of Dentistry, Başkent University, Ankara, Turkey
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Kazimierczak N, Kazimierczak W, Serafin Z, Nowicki P, Nożewski J, Janiszewska-Olszowska J. AI in Orthodontics: Revolutionizing Diagnostics and Treatment Planning-A Comprehensive Review. J Clin Med 2024; 13:344. [PMID: 38256478 PMCID: PMC10816993 DOI: 10.3390/jcm13020344] [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: 11/19/2023] [Revised: 12/29/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
The advent of artificial intelligence (AI) in medicine has transformed various medical specialties, including orthodontics. AI has shown promising results in enhancing the accuracy of diagnoses, treatment planning, and predicting treatment outcomes. Its usage in orthodontic practices worldwide has increased with the availability of various AI applications and tools. This review explores the principles of AI, its applications in orthodontics, and its implementation in clinical practice. A comprehensive literature review was conducted, focusing on AI applications in dental diagnostics, cephalometric evaluation, skeletal age determination, temporomandibular joint (TMJ) evaluation, decision making, and patient telemonitoring. Due to study heterogeneity, no meta-analysis was possible. AI has demonstrated high efficacy in all these areas, but variations in performance and the need for manual supervision suggest caution in clinical settings. The complexity and unpredictability of AI algorithms call for cautious implementation and regular manual validation. Continuous AI learning, proper governance, and addressing privacy and ethical concerns are crucial for successful integration into orthodontic practice.
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Affiliation(s)
- Natalia Kazimierczak
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland
| | - Wojciech Kazimierczak
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland
- Department of Radiology and Diagnostic Imaging, Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, 85-067 Bydgoszcz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Collegium Medicum, Nicolaus Copernicus University in Torun, Jagiellońska 13-15, 85-067 Bydgoszcz, Poland
| | - Paweł Nowicki
- Kazimierczak Private Medical Practice, Dworcowa 13/u6a, 85-009 Bydgoszcz, Poland
| | - Jakub Nożewski
- Department of Emeregncy Medicine, University Hospital No 2 in Bydgoszcz, Ujejskiego 75, 85-168 Bydgoszcz, Poland
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Xu X, Peng D, Zhou B, Lin K, Wang S, Zhao W, Zheng M, Yang J, Guo J. Demineralized dentin matrix promotes gingival healing in alveolar ridge preservation of premolars extracted for orthodontic reason: a split-mouth study. Front Endocrinol (Lausanne) 2023; 14:1281649. [PMID: 37929019 PMCID: PMC10622762 DOI: 10.3389/fendo.2023.1281649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 10/03/2023] [Indexed: 11/07/2023] Open
Abstract
Objective The purpose of this study was to prospectively evaluate the efficacy of a demineralized dentin matrix (DDM) in decreasing the initial inflammatory response of the gingiva and facilitating the repair and regeneration of soft tissue in alveolar ridge preservation. Methods This clinical study employed a split-mouth design. Fourteen patients with a total of forty-four sites underwent extraction and alveolar ridge preservation (ARP) procedures. A Bilaterally symmetrical extraction operation were conducted on the premolars of each patient. The experimental group received DDM as a graft material for ARP, while the control group underwent natural healing. Within the first month postoperatively, the pain condition, color, and swelling status of the extraction sites were initially assessed at different time points Subsequently, measurements were taken for buccal gingival margin height, buccal-lingual width, extraction socket contour, and the extraction socket area and healing rate were digitally measured. Additionally, Alcian Blue staining was used for histological evaluation of the content during alveolar socket healing. Results Both groups experienced uneventful healing, with no adverse reactions observed at any of the extraction sites. The differences in VAS pain scores between the two groups postoperatively were not statistically significant. In the early stage of gingival tissue healing (3 days postoperatively), there were statistically significant differences in gingival condition and buccal gingival margin height between the two groups. In the later stage of gingival tissue healing (7, 14, and 30 days postoperatively), there were statistically significant differences in buccal-lingual width, extraction socket healing area, and healing rate between the two groups. Furthermore, the histological results from Alcian Blue staining suggested that the experimental group may play a significant role in promoting gingival tissue healing, possibly by regulating inflammatory responses when compared to the control group. Conclusion The application of DDM in alveolar ridge preservation has been found to diminish initial gingival inflammation after tooth extraction. Additionally, it has shown the ability to accelerate early gingival soft tissue healing and preserve its anatomical contour. Clinical trial registration chictr.org.cn, identifier ChiCTR2100050650.
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Affiliation(s)
- Xiaofeng Xu
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Department of Stomatology, Affiliated Hospital of Putian University, Putian, China
| | - Dongsheng Peng
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Department of Stomatology, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China
- Department of Stomatology, Fujian Obstetrics and Gynecology Hospital, Fuzhou, China
| | - Bowei Zhou
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Kaijin Lin
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Siyi Wang
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Wei Zhao
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Minqian Zheng
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, China
| | - Jin Yang
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, China
| | - Jianbin Guo
- Fujian Provincial Engineering Research Center of Oral Biomaterial, Fujian Medical University, Fuzhou, China
- School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
- Research Center of Dental and Craniofacial Implants, Fujian Medical University, Fuzhou, China
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Londoño A, Assis M, Fornai C, Greven M. Premolar Extraction Affects Mandibular Kinematics. Eur J Dent 2023; 17:756-764. [PMID: 36167318 PMCID: PMC10569881 DOI: 10.1055/s-0042-1755629] [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: 10/14/2022] Open
Abstract
OBJECTIVES The practice of premolar extraction in orthodontics is controversial for its potential detrimental effects on the stomatognathic system. However, the ways in which premolar extraction affects mandibular function are still poorly understood. The purpose of this study was to assess the influence of premolar extraction on mandibular kinematics by evaluating axiographic tracings. MATERIALS AND METHODS Forty-five orthodontically treated patients with premolar teeth extraction were compared with 45 paired untreated controls, selected for the absence of malocclusions. Systematic three-dimensional axiographic recordings of the mandibular movements were performed for protrusive-retrusive movements and speech. The transversal deviations and length of the movements were recorded for both sides along with the rotation angle during speech. STATISTICAL ANALYSIS Differences between the axiographic variables were analyzed via the permutation test and Wilcoxon rank-sum test. Linear regression was performed to test whether axiographic parameters were predictive of group affiliation. Dot plots were used to explore the distribution of each of the axiographic outcomes, and isometric principal component analysis to assess the differences between the cumulative effects of premolar extraction on jaw motion. RESULTS The mandibular lateral translation in protrusion-retrusion and speech, the amount of rotation as well as the length of mandibular movements during speech were significantly higher in the treated subjects than in the controls, while retral stability did not differ. The linear regression yielded significant results for the mandibular lateral translation in protrusion-retrusion. The isometric principal component analysis showed higher values of the axiographic variables for 11 out of 45 individuals in the study sample compared with the control group. CONCLUSIONS Premolar extraction altered mandibular kinematics in at least 25% of the cases within our sample, and the transversal discrepancy between protrusive and retrusive tracings was even predictive of group affiliation. These results support the notion that the routine practice of premolar extraction as part of the orthodontic treatment should be discouraged. It is compelling to perform further studies to assess whether a disrupted kinematics of the mandible is associated to temporomandibular disorders.
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Affiliation(s)
- Alejandra Londoño
- Department of Research in Occlusion Medicine, Vienna School of Interdisciplinary Dentistry — VieSID, Klosterneuburg, Austria
- Clinical Division of Prosthodontics, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria
| | - Miguel Assis
- Department of Research in Occlusion Medicine, Vienna School of Interdisciplinary Dentistry — VieSID, Klosterneuburg, Austria
- Clinical Division of Prosthodontics, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria
| | - Cinzia Fornai
- Department of Research in Occlusion Medicine, Vienna School of Interdisciplinary Dentistry — VieSID, Klosterneuburg, Austria
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Department of Evolutionary Anthropology & Human Evolution and Archaeological Sciences (HEAS), University of Vienna, Vienna, Austria
- Center of Clinical Research, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria
| | - Markus Greven
- Clinical Division of Prosthodontics, University Clinic of Dentistry Vienna, Medical University of Vienna, Vienna, Austria
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Roganović J, Radenković M, Miličić B. Responsible Use of Artificial Intelligence in Dentistry: Survey on Dentists' and Final-Year Undergraduates' Perspectives. Healthcare (Basel) 2023; 11:healthcare11101480. [PMID: 37239766 DOI: 10.3390/healthcare11101480] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/26/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023] Open
Abstract
The introduction of artificial intelligence (AI)-based dental applications into clinical practice could play a significant role in improving diagnostic accuracy and reforming dental care, but its implementation relies on the readiness of dentists, as well as the health system, to adopt it in everyday practice. A cross-sectional anonymous online survey was conducted among experienced dentists and final-year undergraduate students from the School of Dental Medicine at the University of Belgrade (n = 281) in order to investigate their current perspectives and readiness to accept AI into practice. Responders (n = 193) in the present survey, especially final-year undergraduates (n = 76), showed a lack of knowledge about AI (only 7.9% of them were familiar with AI use) and were skeptical (only 34% of them believed that AI should be used), and the underlying reasons, as shown by logistic regression analyses, were a lack of knowledge about the AI technology associated with a fear of being replaced by AI, as well as a lack of regulatory policy. Female dentists perceived ethical issues more significantly than men regarding AI implementation in the practice. The present results encourage an ethical debate on education/training and regulatory policies for AI as a prerequisite for regular AI use in dental practice.
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Affiliation(s)
- Jelena Roganović
- Department of Pharmacology in Dentistry, School of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Miroslav Radenković
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Biljana Miličić
- Department of Medical Statistics and Informatics, School of Dental Medicine, University of Belgrade, 11000 Belgrade, Serbia
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Sadry S, Giray B. Evaluation of occlusion parameters using T-scan III in patients receiving fixed orthodontic treatment. APOS TRENDS IN ORTHODONTICS 2023. [DOI: 10.25259/apos_203_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Objectives:
The aim of this study is to examine the relationship between occlusal factors and temporomandibular joint diseases (TMD).
Material and Methods:
In our study, 43 individuals who had fixed orthodontic treatment and 20 individuals who did not need treatment at Istanbul Aydin University Faculty of Dentistry Department of Orthodontics were included in the study. Evaluations were made at the beginning of treatment (T0) and at 6 months (T1). T-Scan® computerized Occlusion Analyzer was used to evaluate the number of contact points, occlusal force parameters during centric occlusion and lateral movements, and occlusion and disclusion times. Differences between groups were evaluated with Mann–Whitney or independent t-test, and within-group differences were evaluated with Wilcoxon sign test or paired t-test, depending on whether the data showed normal distribution or not.
Results:
There was no statistically significant distinction between the gender-based parameters and right and left joint of Joint Vibration Analysis record in all three groups (P > 0.05). At the beginning of orthodontic treatment, there was no statistical difference in the variables within the group and between the groups. As a result of the comparison between the beginning of treatment (T0) and the 6th month (T1), no significant difference was found between the parameters of the anterior/posterior occlusal force distribution of the right-left quadrant and the force distribution of the working and non-working sides in lateral movements, and the occlusion and disclusion time parameters. Maximum intercuspal position left/right (MxlntlTSCANT1) was found to be statistically significant at 6 months in individuals who received fixed orthodontic treatment with extraction compared to the none xtraction treatment group (P < 0.05).
Conclusion:
According to our research, T-scan is one of the best devices for the early detection of TMD, especially for people undergoing orthodontic treatment. T-scan offers fast, non-invasive, and repeatable occlusion recording.
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Affiliation(s)
- Sanaz Sadry
- Department of Orthodontics, Faculty of Dentistry, Istanbul Aydin University, Istanbul, Turkey,
| | - Bilgin Giray
- Department of Orthodontics, Faculty of Dentistry, Kocaeli Health and Technology University, Kocaeli, Turkey,
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Perkovic V, Alexander M, Greer P, Kamenar E, Anic-Milosevic S. Association between arch width changes and long-term stability 20 years after orthodontic treatment with and without extractions. Angle Orthod 2023; 93:490511. [PMID: 36744873 PMCID: PMC10117210 DOI: 10.2319/080822-557.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 12/01/2022] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVES To investigate long-term stability 20 years after orthodontic treatment and the association with arch width changes during treatment. MATERIALS AND METHODS This retrospective study investigated 103 patients with Class I and II malocclusions treated with fixed appliances with and without extractions. The sample was treated by one experienced orthodontist and collected from a private orthodontic office. Dental casts were obtained pretreatment (T1), posttreatment (T2), and long-term postretention (T3); they were scanned and converted to STL files. Measurements were evaluated in for the upper and lower arch: intercanine width (IC), intermolar (IM) width, Little's irregularity index (LII). RESULTS There were 73 female and 30 male patients. Class I was present in 74 patients and Class II in 29. Average postretention time was 17.2 (±6.5) years after an average active retention time of 3.4 (±1.17) years. Extraction was performed in 55 patients while 48 received nonextraction treatment. Bonferroni Post Hoc test showed that LII in the upper and lower arches at T1 was significantly higher in the extraction group (P < .001). Upper and lower arch LII at T3 was slightly higher in extraction cases but remained under 2.05 mm. LII at T3 in the upper and lower arches showed negative correlation with IM T3 in the upper arch (Pearson, N = 103, P = .047), while IC in the upper and lower arches at T3 correlated with IM T3 in the upper and lower (N = 103, P < .001). CONCLUSIONS Clinically relevant long-term stability in both arches was found in extraction and nonextraction cases. Intermolar width and its change during orthodontic treatment was an influential factor on long-term stability in extraction cases.
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Gözler S, Sadry S. Examination of chewing performance with extraction and non-extraction fixed orthodontic treatment – A prospective clinical 1-year study. APOS TRENDS IN ORTHODONTICS 2022. [DOI: 10.25259/apos_19_2022] [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
Objectives:
It shows that patients receiving orthodontic treatment may have a risk of developing temporomandibular disorder symptoms. The aim of this study is to examine the changes in the chewing system of occlusal contact parameters related to joint vibrations, chewing patterns, and measured excursive movements in fixed and non-extractive orthodontic treatments.
Material and Methods:
A total of 43 individuals with premolar extraction (n = 23) and without extraction (n = 20) who applied to the Department of Orthodontics, Dentistry Faculty of Istanbul Aydin University and needed orthodontic treatment were included in the study. In this study, 43 active fixed orthodontic treatment patients were conducted at the beginning (T0) and 6th month (T1) and 12th month (T2) on the parameter recorded during chewing. For occlusion analysis, T-Scan® computerized occlusion analysis recording and examination of the chewing pattern were used for JVA and JT temporomandibular joint parameters. Depending on whether the data showed normal distribution or not, differences between groups were evaluated using the Mann–Whitney or independent t-test, and intragroup differences were evaluated using the Wilcoxon sign test or paired t-test.
Results:
At the beginning, 6th month and 12th month of orthodontic treatment, it was observed that the opening, closing, and occlusion times and joint vibration frequencies in the chewing pattern in cases with and without tooth extraction, the integral value differences of total integral, and frequencies below 300 Hz and above 300 Hz were statistically significant (P < 0.001). In digital occlusion analysis values, the right-left differences were not found statistically significant in the measurements made in cases with and without extraction (P > 0.05), while there were statistically significant differences in disclusion values at the beginning, 6th and 12th months (P < 0.05).
Conclusion:
At the beginning of the orthodontic treatments with or without extraction, it was observed that the values at the joint level changed significantly in the 6th month. However, the changes in the joints during the treatment, when they return to their ideal values at the end of the 12th month, are more than the change in occlusion.
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Affiliation(s)
- Serdar Gözler
- Department of Prosthetic, Faculty of Dentistry, Istanbul Aydin University, Istanbul, Turkey,
| | - Sanaz Sadry
- Department of Orthodontics, Faculty of Dentistry, Istanbul Aydin University, Istanbul, Turkey,
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Orthodontic Retention-Protocols and Materials-A Questionnaire Pilot Study among Polish Practitioners. MATERIALS 2022; 15:ma15020666. [PMID: 35057382 PMCID: PMC8779968 DOI: 10.3390/ma15020666] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 01/09/2022] [Accepted: 01/14/2022] [Indexed: 02/04/2023]
Abstract
The aim of the study was to analyze retention protocols and materials for fixed retainers used by clinicians providing orthodontic treatment in Poland. The survey was carried out from February to April 2021. The questionnaire was designed using the Google Forms tool. After validation, the questionnaire was delivered to verified active orthodontists gathered in a closed social media group of 615 members. Finally, 104 answers were received. Answers to individual questions were provided in percentages and tabularized. A chi-squared test of proportion was used to compare: the proportion of clinicians using retainers of different characteristics and the proportions of clinicians indicating the superiority of a given clinical solution. Rectangular steel braided wire was rated as most reliable. However, doctors who declared to use gold chain were mostly solely using this type of wire. Multistranded round wire was rated the worst. Fiber-reinforced composite was mainly used in periodontal patients. The protocols used by Polish orthodontic practitioners relied on double long-term retention with regular follow-up. The most popular material was stainless steel braided rectangular wire bonded with a flowable composite. Most clinicians believed they could maintain the treatment results, but they declared that patients’ cooperation was a challenge.
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The rationale for orthodontic retention: piecing together the jigsaw. Br Dent J 2021; 230:739-749. [PMID: 34117429 DOI: 10.1038/s41415-021-3012-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/08/2021] [Indexed: 12/12/2022]
Abstract
Retaining teeth in their corrected positions following orthodontic treatment is one of the most challenging aspects of orthodontic practice. Despite much research, the rationale for retention is not entirely clear. Teeth tend to revert to their pre-treatment positions due to periodontal and gingival, soft tissue, occlusal and growth factors. Changes may also follow normal dentofacial ageing and are unpredictable with great variability. In this overview, each of these factors are discussed with their implications for retention, along with adjunctive procedures to minimise relapse. The state of current knowledge, methods used to assess relapse, factors regarded as predictive of or associated with stability as well as overcorrection are outlined. Potential areas requiring further investigation are suggested. The way in which the clinician may manage current retention practice, with a need for individualised retention plans and selective retainer wear, is also considered.
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Alfawaz F, Park JH, Lee NK, Bayome M, Tai K, Ku JH, Kim Y, Kook YA. Comparison of treatment effects from total arch distalization using modified C-palatal plates versus maxillary premolar extraction in Class II patients with severe overjet. Orthod Craniofac Res 2021; 25:119-127. [PMID: 34087028 DOI: 10.1111/ocr.12507] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/26/2021] [Accepted: 05/30/2021] [Indexed: 12/17/2022]
Abstract
INTRODUCTION This study aimed to compare the skeletodental and soft tissue changes with total arch distalization using a modified C-palatal plate (MCPP) and maxillary first premolar extraction treatment in Class II malocclusion patients with severe overjet. SETTING AND SAMPLE POPULATION The sample consisted of 46 adult patients who had Class II Division 1 malocclusion with severe overjet; 25 of them received non-extraction treatment with MCPPs (age, 22.5 ± 7.2 years), and 21 received maxillary first premolar extraction treatment (age 23.4 ± 6.5 years). METHOD A total of 26 variables were measured on pre- and post-treatment lateral cephalograms. To evaluate the differences between pretreatment and post-treatment in each group, t tests and Wilcoxon rank-sum tests were used. To compare the amount of change between the two groups, MANOVA test was used. RESULTS The overjet was significantly reduced in the MCPP and extraction groups by 4.8 mm and 5.4 mm, respectively. However, the two groups had no significant difference in the sagittal, vertical and angular changes of the maxillary incisors. In addition, regarding soft tissue changes, the MCPP and extraction groups showed an increased nasolabial angle of 7.5° and 9.4°, decreased upper lip to the true vertical line of 1.8 mm and 2.2 mm, respectively (P < .001). CONCLUSIONS There was no significant difference in the skeletal changes between the MCPP and extraction groups, and the reduction in overjet was similar in the groups. These results suggest that MCPP might be a viable treatment option for total arch distalization in Class II malocclusion patients with severe overjet.
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Affiliation(s)
- Fawaz Alfawaz
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, AZ, US.,International Scholar, Graduate School of Dentistry, Kyung Hee University, Seoul, Korea
| | - Nam-Ki Lee
- Department of Orthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Mohamed Bayome
- Department of Preventive Dentistry, College of Dentistry, King Faisal University, Alhufuf, Saudi Arabia.,Department of Postgraduate Studies, Universidad Autonóma del Paraguay, Asunción, Paraguay
| | - Kiyoshi Tai
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, Mesa, AZ, US.,Private practice of orthodontics, Okayama, Japan
| | - Ja Hyeong Ku
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoonji Kim
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoon-Ah Kook
- Department of Orthodontics, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Yabe A, Ikoma M, Arai K. Evaluations of the facial attractiveness of young women with severe maxillary anterior crowding by orthodontists and laypeople with and without orthodontic treatment experience in Japan. Am J Orthod Dentofacial Orthop 2021; 159:750-757. [PMID: 33888377 DOI: 10.1016/j.ajodo.2020.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 01/01/2020] [Accepted: 02/01/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Maxillary anterior crowding (MxAC) has been considered to be an esthetically favorable characteristic of young women in Japan. It has been hypothesized that laypeople and orthodontists have different esthetic preferences; however, to date, this has not been investigated in detail. Therefore, the present study compared the facial attractiveness of women with MxAC and the interpretation of MxAC among orthodontists and laypeople with and without orthodontic treatment experience in Japan. METHODS Thirty-eight orthodontists, 42 laypeople with orthodontics (patients), and 43 laypeople without orthodontics (laypeople) evaluated the attractiveness of resting and smiling frontal images of 12 women with MxAC (MxAC models; mean age, 21.7 ± 2.6 years) and 12 women with normal occlusion (normal models; mean age, 20.1 ± 0.7 years) using a visual analog scale. In addition, they responded to a questionnaire that asked them to select the terms most closely associated with MxAC. All evaluators and models were Japanese. RESULTS For all evaluator groups, the facial attractiveness of the MxAC models was significantly lower than that of the normal models for both the resting and smiling images. For MxAC models, orthodontists evaluated resting images more attractive than smiling images, whereas laypeople evaluated smiling images more attractive than resting images. Significantly more patients and laypeople than orthodontists selected "cute" as the term most closely associated with MxAC (P <0.05). CONCLUSIONS The orthodontists, patients, and laypeople showed a different tendency in their facial attractiveness preferences. Regardless of their orthodontic experience, the laypeople showed more positive interpretations of MxAC than orthodontists. This finding seems to be influenced by Japanese culture, which values irregularity in nature as one form of beauty.
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Affiliation(s)
- Aiko Yabe
- Department of Orthodontics, School of Life Dentistry at Tokyo, The Nippon Dental University, Chiyoda-ku, Tokyo, Japan
| | - Misa Ikoma
- Department of Orthodontics, School of Life Dentistry at Tokyo, The Nippon Dental University, Chiyoda-ku, Tokyo, Japan
| | - Kazuhito Arai
- Department of Orthodontics, School of Life Dentistry at Tokyo, The Nippon Dental University, Chiyoda-ku, Tokyo, Japan.
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14
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Lower incisor extraction therapy in a complex case with an ankylosed tooth in an adult patient: A case report. Int Orthod 2020; 18:850-862. [PMID: 32948482 DOI: 10.1016/j.ortho.2020.08.006] [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: 08/02/2020] [Revised: 08/28/2020] [Accepted: 08/29/2020] [Indexed: 11/23/2022]
Abstract
This case report describes a successful orthodontic therapy of an adult female treated by mandibular central incisor extraction and vestibular fixed appliances. The patient presented a skeletal Class I with normodivergent facial pattern, Class II subdivision dental relationship, extremely deep Curve of Spee and severe overbite. Moreover, during the treatment, the upper left first molar does not respond to orthodontic forces due to tooth ankylosis, augmenting the difficulty of this case. Despite this, a good occlusal relationship on both sites and an optimal extraoral outcome have been achieved after a 26-months therapy. To our knowledge no case report with such entity of Curve of Spee with contemporary tooth ankylosis has been presented.
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Carruitero MJ, Aliaga-Del Castillo A, Garib D, Janson G. Stability of maxillary interincisor diastema closure after extraction orthodontic treatment. Angle Orthod 2020; 90:627-633. [PMID: 33378481 DOI: 10.2319/080619-516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 03/01/2020] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate the stability of maxillary interincisor diastema closure and the relationship between space relapse and interincisor diastema width, overjet, overbite, angulations between adjacent maxillary anterior teeth and presence of intermaxillary osseous cleft after orthodontic treatment with extractions. MATERIALS AND METHODS Twenty-four individuals with a maxillary interincisor diastema pretreatment, treated with maxillary first premolar extractions were evaluated. Dental casts and panoramic radiographs taken at pretreatment (T1), posttreatment (T2), and posttreatment follow-up (T3) were assessed. Periapical radiographs at T1 and T2 were also evaluated. Diastema relapse was assumed when T3-T2 interincisor space change was greater than zero. Diastema relapse was considered clinically significant when it was at least 0.50 mm. Data were analyzed using repeated-measures analysis of variance followed by post hoc Tukey tests or Friedman followed by Wilcoxon tests. T-test or Mann-Whitney U-test, Pearson correlation coefficient, and multiple linear regression analyses were also performed. RESULTS No statistically significant relapse of maxillary interincisor diastemas was found. The percentage of clinically significant relapse of the maxillary interincisor diastemas was 27.78%. Specifically, for the interincisor midline diastema, it was 8.33%. CONCLUSIONS Maxillary interincisor diastema closure showed no statistically significant relapse after orthodontic treatment with premolar extractions. Clinically significant stability for maxillary interincisor diastema closure was 72.22% and, specifically, for interincisor midline diastema closure, it was 91.67%.
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Naveda R, Janson G, Natsumeda GM, de Freitas MR, Capelozza-Filho L, Garib D. Pretreatment dentoskeletal comparison between individuals treated with extractions in the 1970s and in the new millennium. Clin Oral Investig 2020; 25:1997-2005. [PMID: 32780295 DOI: 10.1007/s00784-020-03508-w] [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: 05/13/2020] [Accepted: 08/05/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This retrospective study aimed to compare the occlusal and dentoskeletal initial features of patients treated with four first premolar extractions in the 1970s and after 2000. MATERIALS AND METHODS Group 70' was composed by 30 subjects with Class I malocclusion (mean age of 12.8 years, 10 male, 20 female) treated in the 1970s with four first premolar extractions and comprehensive orthodontic treatment. Group NM comprised 30 subjects with Class I malocclusion (mean age of 13.4 years, 13 male, 17 female) treated in the new millennium, similarly to Group 70'. Initial dental models and lateral cephalograms were digitized and measured using OrthoAnalyzerTM 3D software and Dolphin Imaging 11.0 software, respectively. Initial occlusal and dentoskeletal features were analyzed and compared. Intergroup comparison was performed using t tests (p < 0.05). Holm-Bonferroni correction for multiple comparison was applied. RESULTS Group NM showed significantly greater maxillary and mandibular effective lengths and greater maxillary and mandibular incisor protrusion in comparison with Group 70'. Group NM presented a significantly greater lower anterior facial height. Group NM also showed significantly smaller nasolabial angle and protruded inferior lip. CONCLUSION Patients with Class I malocclusion treated with four first premolar extractions in the new millennium present a greater degree of dental and labial protrusion, increased lower anterior facial height, and more acute nasolabial angle compared with patients treated similarly in the 1970s. Greater dental and labial protrusion determines first premolar extractions in the new millennium. CLINICAL RELEVANCE Despite the decrease of tooth extraction frequency, four first premolar extractions may be justified in cases with severe dental and skeletal protrusions.
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Affiliation(s)
- Rodrigo Naveda
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP CODE 17012-901, Vila Nova Cidade Universitária, Bauru, São Paulo, Brazil.
| | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP CODE 17012-901, Vila Nova Cidade Universitária, Bauru, São Paulo, Brazil
| | - Gabriela Manami Natsumeda
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP CODE 17012-901, Vila Nova Cidade Universitária, Bauru, São Paulo, Brazil
| | - Marcos Roberto de Freitas
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP CODE 17012-901, Vila Nova Cidade Universitária, Bauru, São Paulo, Brazil
| | - Leopoldino Capelozza-Filho
- Department of Orthodontics, Bauru dental School, Hospital for Rehabilitation of Craniofacial Anomalies, University of São Paulo, Rua Sílvio Marchione, 3-20, ZIP CODE 17012-900, Vila Nova Cidade Universitária, Bauru, São Paulo, Brazil
| | - Daniela Garib
- Department of Orthodontics, Bauru Dental School and Hospital for Rehabilitation of Dentofacial Anomalies, University of São Paulo, Alameda Octávio Pinheiro Brisolla 9-75, ZIP CODE 17012-901, Vila Nova Cidade Universitária, Bauru, São Paulo, Brazil
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Heuck Henriksson C, Andersson MEM, Møystad A. Hypodontia and retention of third molars in Norwegian medieval skeletons: dental radiography in osteoarchaeology. Acta Odontol Scand 2019; 77:310-314. [PMID: 30616446 DOI: 10.1080/00016357.2018.1549749] [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: 10/27/2022]
Abstract
OBJECTIVES The objective of the present study is to compare the prevalence of third molar hypodontia in matched medieval and modern Norwegian sample with the aim to examine whether there are secular changes in dental anomalies. A second objective is to determine the level of primary retention of third molar in the medieval sample. MATERIAL AND METHODS The medieval material consisted of 130 adult skulls, hypodontia of third molars was determined using radiography and compared to findings with panoramic film images of 400 15-year-old individuals from a contemporary Norwegian epidemiological study. RESULTS Among 130 medieval skulls, hypodontia of third molar was found in 36 skulls (27.7%), and in the contemporary sample, hypodontia of third molar was found in 69 individuals (17.2%). Female predominance, although not statistically significant, was observed both in the medieval and in the contemporary group. The third molars showed absence in the mandible (21.5%) more often than the maxilla in the medieval sample, and in both jaws (11.2%) in the contemporary material. In the medieval sample, only 7.7% of the individuals had at least one retained third molar. CONCLUSION No increase in the frequency of third molar hypodontia was found from the medieval period until today. The frequency of retained third molars seems to have increased from the medieval period to modern times. The use of radiographic examination in addition to macroscopic inspection can give us a better understanding of the aetiology on a number of conditions in human skeletal remains.
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Affiliation(s)
| | | | - Anne Møystad
- Department of Maxillofacial Radiology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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18
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Fleming PS, Cunningham SJ, Benson PE, Jauhar P, Millett D. Extraction of premolars for orthodontic reasons on the decline? A cross-sectional survey of BOS members. J Orthod 2018; 45:1-6. [PMID: 30192715 DOI: 10.1080/14653125.2018.1517470] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 08/24/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To obtain the opinion of British Orthodontic Society (BOS) members in relation to possible patterns of prescription of orthodontic extractions over the past 5-10 years and to relate any changes identified to treatment objectives, facial and smile aesthetics, and treatment strategies and adjuncts. DESIGN Cross-sectional questionnaire. SETTING On-line survey of BOS members. METHODS A 14-item on-line questionnaire was sent to orthodontic practitioners for completion. The questionnaire covered demographics, possible changes in frequency of prescribed extractions with specific information concerning the effect of patient age, and the influence of other factors including alternative approaches to space creation, evolving treatment mechanics, smile and facial aesthetics, and retention protocols. RESULTS Two hundred and eight responses were obtained with 95.6% (n = 199) reporting reduced extraction prescription over the last 5-10 years. Overall, 29.9% and 35.5% felt that their threshold for extractions had increased by more than 2 mm in adolescents and adults, respectively. Facial (n = 145; 69.7%) and smile (n = 127; 61.1%) aesthetics, and increased use of inter-proximal reduction (n = 102; 49%) were the factors most frequently reported as having either a moderate or major influence on this trend. Based on ordinal logistical regression analyses, no significant relationship was found between threshold for extractions and work setting (P = 0.675; O.R. 0.51; 95% CI: 0.39, 1.85) or level of orthodontic experience (P = 0.15; O.R. 1.02; 95% CI: 0.15, 1.05), although a higher threshold for extractions was more likely among users of conventional than self-ligating brackets (P = 0.001; O.R. 4.74; 95% CI: 1.95, 11.5). CONCLUSIONS A reduced tendency to prescribe orthodontic extractions over the past 5-10 years among British Orthodontic Society members was identified. Comparative clinical research exploring the relative merits of extraction and non-extraction approaches could be timely.
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Affiliation(s)
- Padhraig S Fleming
- a Barts and The London School of Medicine and Dentistry, Queen Mary University of London , London , UK
| | | | | | - Preeti Jauhar
- a Barts and The London School of Medicine and Dentistry, Queen Mary University of London , London , UK
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Stasinopoulos D, Papageorgiou SN, Kirsch F, Daratsianos N, Jäger A, Bourauel C. Failure patterns of different bracket systems and their influence on treatment duration: A retrospective cohort study. Angle Orthod 2018; 88:338-347. [PMID: 29394090 PMCID: PMC8288329 DOI: 10.2319/081817-559.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Accepted: 12/01/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To compare the failure pattern of four different bracket types and to assess its effect on treatment duration. MATERIALS AND METHODS A total of 78 white patients (28 male, 50 female) with a mean age of 12.6 years were included in this retrospective cohort study and treated for a mean period of 30.6 months. The patients were treated in a private practice with stainless steel conventionally ligated brackets, ceramic conventionally ligated brackets, stainless steel self-ligating brackets, or nickel-free self-ligating brackets. The loss of at least one bracket during the course of treatment was analyzed with Cox proportional hazards survival analyses and generalized linear regression. RESULTS The overall bracket failure rate at the tooth level was 14.1% (217 brackets), with significant differences according to tooth type (between 8.0%-23.4%) and bracket type (between 11.2%-20.0%). After taking confounders into account, patients treated with ceramic brackets lost more brackets (hazard ratio = 1.62; 95% confidence interval = 1.14-2.29; P = .007) than patients with stainless steel brackets. On average, treatment time increased by 0.6 months (95% confidence interval = 0.21-1.05; P = .004) for each additional failed bracket. CONCLUSIONS Bracket failure was more often observed with ceramic brackets and was associated with increased treatment duration.
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Vaden JL, Riolo CS, Riolo ML. An orthodontic registry: Producing evidence from existing resources. Am J Orthod Dentofacial Orthop 2017; 152:289-291. [PMID: 28863899 DOI: 10.1016/j.ajodo.2017.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 06/06/2017] [Accepted: 06/08/2017] [Indexed: 11/16/2022]
Affiliation(s)
| | - Christopher S Riolo
- Department of Orthodontics, School of Dentistry, University of Washington, Seattle, Wash
| | - Michael L Riolo
- Department of Orthodontics, School of Dentistry, University of Detroit Mercy, Detroit, Mich
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