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Sokmen T, Bagcı N, Balos Tuncer B. Buccolingual inclination of posterior dentition in maxillary impacted canine patients using quadrant analysis - A cone-beam computed tomographic study. BMC Oral Health 2024; 24:1012. [PMID: 39210316 PMCID: PMC11363395 DOI: 10.1186/s12903-024-04782-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND To examine the buccolingual inclination of maxillary posterior teeth, curve of Wilson, and transversal dimensions in palatally impacted maxillary canine patients, compared to controls by cone-beam computed tomography (CBCT). MATERIALS AND METHODS Pre-treatment images of 22 bilateral, 32 unilateral impacted maxillary canine patients and 30 controls were included. All patients had palatally impacted canines, with no posterior cross-bite. Data were reclassified in quadrants according to the presence of impaction, as the impaction quadrant (right and left quadrants of 22 bilateral impacted cases, and quadrants presenting impaction of 32 unilateral cases, n = 76), unaffected quadrant (quadrant without impaction in 32 unilateral cases, n = 32) and the control quadrant (right and left quadrants of 30 controls, n = 60) to evaluate the buccolingual inclination angle, transversal width, and arch perimeter. Additionally, comparisons were made regarding curve of Wilson and total arch perimeter among bilateral and unilateral impaction groups with the control group. Statistical analysis was performed by one-way ANOVA and Kruskal Wallis tests. Tukey or Dunn tests were used for comparisons between groups in pairs. RESULTS No significant difference was found for the buccolingual inclination of maxillary posterior teeth and curve of Wilson among groups. The buccolingual inclination of canines in the impaction quadrant was significantly lower than the other quadrants (p < 0.001). Basal bone width at the level of second premolars, and alveolar width at both premolars were significantly narrower in the impaction quadrant than in the unaffected quadrant (p < 0.05). Dental arch width at the level of first premolar was significantly decreased in the impaction quadrant compared to other quadrants (p < 0.05). Arch perimeter was significantly reduced in the impaction quadrant than in the unaffected quadrant (p < 0.05). CONCLUSION The presence of bilateral or unilateral palatally impacted maxillary canines did not effect the buccolingual inclination of posterior teeth, and curve of Wilson. Transverse discrepancy was evident in the impaction quadrant even in the absence of posterior cross-bite. Quadrant analysis was particularly useful in evaluating asymmetry for basal bone and alveolar bone widths in the premolar region in patients with unilateral palatally impacted maxillary canine patients.
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Affiliation(s)
- Tevhide Sokmen
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Biskek cad. 1.sokak no:4 Emek, Ankara, 06490, Turkey.
| | - Nuray Bagcı
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University, Ankara, Turkey
| | - Burcu Balos Tuncer
- Department of Orthodontics, Faculty of Dentistry, Gazi University, Biskek cad. 1.sokak no:4 Emek, Ankara, 06490, Turkey
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Le LN, Ma HN, Do TT, Le KVP. Root Resorption and Alveolar Bone Changes in the Maxillary Canine Retraction Using NiTi Closed-Coil Springs Versus Elastomeric Chains: A Split-Mouth Trial. J Int Soc Prev Community Dent 2024; 14:339-348. [PMID: 39380927 PMCID: PMC11458088 DOI: 10.4103/jispcd.jispcd_5_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 07/11/2024] [Accepted: 07/17/2024] [Indexed: 10/10/2024] Open
Abstract
Aim To compare apical root resorption and alveolar bone changes induced by the maxillary canine closure procedure performed on patients with Angle Class I malocclusion using NiTi closed-coil springs versus elastomeric chains. Materials and Methods Thirty-one adult patients who had been instructed to undergo bilateral maxillary first premolar extraction completed a randomized clinical trial split-mouth study with a double-blind design. Elastomeric chains will be used on the left side, and NiTi closed-coil springs will be used on the right side for patients with even numbers. Elastomeric chains will be used on the right side of patients with an odd number, whereas NiTi closed-coil springs will be used on the left side of patients. For each patient, cone-beam computed tomography of the maxillary canine and lateral cephalometric radiographs were carried out before and after treatment to evaluate apical root resorption and perform cephalometric measurements. Result The tooth root length decreased by 0.90 ± 0.60 mm in the NiTi closed-coil spring group. The alveolar bone level increased by 0.53 ± 0.66 mm on the buccal side and by 0.79 ± 0.72 mm on the lingual side. These changes were statistically significant (P < 0.001). In the elastomeric chain group, the tooth root length was decreased by 0.92 ± 0.69 mm, and the levels of vertical buccal and lingual alveolar bone increased significantly (P < 0.001). Compared to NiTi closed-coil springs and elastomeric chain groups, there was a 0.03 ± 0.878 mm difference in the tooth root length; however, this difference was not statistically significant (P = 0.878). Conclusion Elastomeric chains and NiTi closed-coil springs both generated tooth root resorption, but the results were comparable and the difference was not statistically significant. There was no statistically significant difference between the elastomeric chain and NiTi closed-coil spring groups regarding the changes in alveolar bone loss around the maxillary canines.
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Affiliation(s)
- Lam Nguyen Le
- Department of Pediatrics Dentistry and Orthodontics, Faculty Odonto-Stomatology, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
| | - Hanh Ngoc Ma
- Faculty Odonto-Stomatology, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
| | - Thao Thi Do
- Department of Oral Pathology and Periodontology, Faculty Odonto-Stomatology, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
| | - Khanh Vu Phuong Le
- Faculty Odonto-Stomatology, Can Tho University of Medicine and Pharmacy, Can Tho City, Vietnam
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Sadvandi G, Kianfar AE, Becker K, Heinzel A, Wolf M, Said‐Yekta Michael S. Systematic review on effects of experimental orthodontic tooth displacement on brain activation assessed by fMRI. Clin Exp Dent Res 2024; 10:e879. [PMID: 38558512 PMCID: PMC10982672 DOI: 10.1002/cre2.879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/04/2024] [Accepted: 03/09/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Orthodontic treatment is often accompanied by discomfort and pain in patients, which are believed to be a result of orthodontic tooth displacement caused by the mechanical forces exerted by the orthodontic appliances on the periodontal tissues. These lead to change blood oxygen level dependent response in related brain regions. OBJECTIVE This systematic review aims to assess the impact of experimental orthodontic tooth displacement on alterations in central nervous system activation assessed by tasked based and resting state fMRI. MATERIALS AND METHODS A literature search was conducted using online databases, following PRISMA guidelines and the PICO framework. Selected studies utilized magnetic resonance imaging to examine the brain activity changes in healthy participants after the insertion of orthodontic appliances. RESULTS The initial database screening resulted in 791 studies. Of these, 234 were duplicates and 547 were deemed irrelevant considering the inclusion and exclusion criteria. Of the ten remaining potential relevant studies, two were excluded during full-text screening. Eight prospective articles were eligible for further analysis. The included studies provided evidence of the intricate interplay between orthodontic treatment, pain perception, and brain function. All of the participants in the included studies employed orthodontic separators in short-term experiments to induce tooth displacement during the early stage of orthodontic treatment. Alterations in brain activation were observed in brain regions, functional connectivity and brain networks, predominantly affecting regions implicated in nociception (thalamus, insula), emotion (insula, frontal areas), and cognition (frontal areas, cerebellum, default mode network). CONCLUSIONS The results suggest that orthodontic treatment influences beyond the pain matrix and affects other brain regions including the limbic system. Furthermore, understanding the orthodontically induced brain activation can aid in development of targeted pain management strategies that do not adversely affect orthodontic tooth movement. Due to the moderate to serious risk of bias and the heterogeneity among the included studies, further clinical trials on this subject are recommended.
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Affiliation(s)
- Gelareh Sadvandi
- Department of OrthodonticsRWTH Aachen University HospitalGermany
| | | | - Kathrin Becker
- Department of Dentofacial Orthopedics and OrthodonticsCharité Universitätsmedizin BerlinBerlinCC03Germany
| | - Alexander Heinzel
- Department of Nuclear MedicineMartin‐Luther‐University Halle‐WittenbergHalleGermany
| | - Michael Wolf
- Department of OrthodonticsRWTH Aachen University HospitalGermany
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Bernisha R, Mishra G, Pradeep Raj G, Chitra P. Incisor torque expression characteristics in two passive self-ligating brackets placed at different heights. A finite element investigation. J Oral Biol Craniofac Res 2024; 14:98-106. [PMID: 38293569 PMCID: PMC10827546 DOI: 10.1016/j.jobcr.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Accepted: 01/06/2024] [Indexed: 02/01/2024] Open
Abstract
Objective This study investigated torque expression in maxillary incisors using two passive self-ligating bracket types (Damon Q and Pitts 21) placed at different heights using the Finite element method. Materials and methods Two passive self-ligating brackets, Damon Q (Ormco, USA) and Pitts 21 (OC Orthodontics, USA) were 3D modeled using micro-computed tomography. Damon Q (0.022ˮ x 0.028″ slot size) and Pitts 21 (0.021ˮ x 0.021″ slot size) brackets were placed on a maxillary central incisor at predetermined vertical heights. Arch wires of size 0.019ˮ x 0.025″ stainless steel (Damon Q) and 0.020ˮ x 0.020" Titanium Molybdenum (Pitts 21) were placed in the bracket slots. Results Pitts 21 brackets showed higher torquing moments at all bonding heights as compared to Damon Q brackets. The minimum torquing moment was 9.03Nmm at 5 mm for Damon Q and the maximum torquing moment was 14.92Nmm for Pitts 21 at a bracket bonding height of 8 mm. Total deformation for Pitts 21 at a height of 5 mm from the incisal edge was 0.61 × 10-6mm as compared to that of Damon Q which was 0.41 × 10-6mm. Lowest Von Mises stress values were at 27.07 MPa in Damon Q brackets at a bracket height of 5 mm from the incisal edge. Highest Von Mises stress values were 36.80 MPa for Pitts 21 brackets at a bracket height of 8 mm from the incisal edge. Conclusion Pitts 21 brackets exhibited superior torquing characteristics compared to Damon Q. Total deformation in Pitts 21 was higher than Damon Q at all tested bracket bonding heights.
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Affiliation(s)
- R.P Bernisha
- Department of Orthodontics and Dentofacial Orthopaedics, Army College of Dental Sciences, Secunderabad, Telangana, 500087, India
| | - Gyanda Mishra
- Department of Orthodontics and Dentofacial Orthopaedics, Army College of Dental Sciences, Secunderabad, Telangana, 500087, India
| | - G. Pradeep Raj
- Department of Orthodontics and Dentofacial Orthopaedics, Army College of Dental Sciences, Secunderabad, Telangana, 500087, India
| | - Prasad Chitra
- Department of Orthodontics and Dentofacial Orthopaedics, Army College of Dental Sciences, Secunderabad, Telangana, 500087, India
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Chen SM, Ho CT, Huang TH, Kao CT. An in vitro evaluation of aligner force decay in artificial saliva. J Dent Sci 2023; 18:1347-1353. [PMID: 37404637 PMCID: PMC10316483 DOI: 10.1016/j.jds.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/18/2023] [Indexed: 07/06/2023] Open
Abstract
Background/purpose The present study aimed to compare the force decay of invisible aligners for maxillary anterior teeth with 0.1 mm (D1), 0.2 mm (D2), and 0.3 mm (D3) labial movement within a simulated oral environment over 7 days. Materials and methods The prepared invisible aligners were immersed in saliva (S) and subjected to applied force (F) for 7 days. The aligners were set and placed on the maxillary right central incisor with 0.1 mm (D1), 0.2 mm (D2), and 0.3 mm (D3) labial movement. Thin-film pressure sensors were used to measure the aligner force changes. The data were collected and analyzed by statistical methods. Results Significant differences were observed in the initial and first-day force between the D2 and D3 groups under simulated oral environment force (SF) (P < 0.05). There was a significant difference in force decay between Day 1 and Day 7 for all groups (P < 0.05). The SFD1 group showed a significant decrease in force on Day 5 (P < 0.05), while the SFD2 and SFD3 groups showed significant force decay on Day 4 (P < 0.05). The force decay ratio on Day 7 was higher in the SFD3 group than in the SFD1 and SFD2 groups, but no significant difference was observed. Conclusion Larger labial movement of the aligners resulted in higher force decay under artificial saliva environments, and the force decay of invisible aligners was increased by immersion time in artificial saliva.
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Affiliation(s)
- Shou-Min Chen
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan
- Orthodontic Department, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chun-Te Ho
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan
- Orthodontic Department, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Tsui-Hsein Huang
- School of Dentistry, College of Oral Medicine, Chung Shan Medical University, Taichung, Taiwan
- Dental Department, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chia-Tze Kao
- Orthodontic Department, Chung Shan Medical University Hospital, Taichung, Taiwan
- Dental Department, Chung Shan Medical University Hospital, Taichung, Taiwan
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Awni KM, Dewachi Z, Al-Hyani OH. Effect of Injectable platelet-rich fibrin (i-PRF) on new bone formation in surgical expansion with mini-screw assisted rapid palatal expander: A dog model study. J Orthod Sci 2023; 12:12. [PMID: 37351391 PMCID: PMC10282521 DOI: 10.4103/jos.jos_56_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/06/2022] [Accepted: 08/19/2022] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVES The objective of the study is to test whether the local injection of i-PRF may affect osteoblast, blood vessels and new bone formation in surgically expanded mid palatal suture using maxillary skeletal expander. MATERIALS AND METHODS Eighteen adult male local breed dogs were divided randomly into three groups: group I (control), includes the expansion with maxillary skeletal expander that was done without corticotomy and i-PRF. Group II, involves the expansion that was done with mid palatal corticotomy but without i-PRF injection. Group III, has the expansion that was done with mid palatal corticotomy and has injection with 2 ml of i-PRF. Each group consisted of 6 dogs which were subdivided into 3 dogs. Three dogs were sacrificed after 15 days and the other 3 dogs were sacrificed after 45 days. The number of osteoblast, blood vessels and new bone formation percentage were statistically analyzed using Sigma plot platform. Mean and standard error, ANOVA and Duncan were performed among the different groups. Values of P ≤ 0.05 were considered significant. RESULTS After expansion, the i-PRF group demonstrated a considerable increase in the amount of new bone in the mid-palatal suture at 15 and 45 days compared with other 2 groups which were indicated by highest percentages of new bone formation (29.30% of 15 days and 76.55% at 45 days) if compared to control group which were (7.72% at 15 days and 22.30% at 45 days). The corticotomy groups were in between, 15.33% and 46.84% respectively. Moreover the number of osteoblasts was higher in corticotomy with i-PRF group on 15 days and decreased on 45 days than the other two groups, while the blood vessels were highest in this group than the other two groups both on 15 and 45 days. CONCLUSION I-PRF enhanced the production of osteoblast, blood vessels, and new bone in the surgically expanded mid palatal suture.
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Affiliation(s)
- Khawla M. Awni
- Department of Orthodontics, College of Dentistry, College of Veterinary Medicine, University of Mosul, Iraq
| | - Zaid Dewachi
- Department of Orthodontics, College of Dentistry, College of Veterinary Medicine, University of Mosul, Iraq
| | - Osama Hazim Al-Hyani
- Department of Surgery and Obstetrics, College of Veterinary Medicine, University of Mosul, Iraq
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Jin Y, Li F, Yang H, Long H, Gong Q, Lai W. Altered spontaneous neural activity in experimental odontogenic pain: a resting-state functional MRI study. Am J Transl Res 2022; 14:8398-8406. [PMID: 36505321 PMCID: PMC9730070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 11/07/2022] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study aimed to evaluate the intrinsic cerebral activity alternations in experimental odontogenic pain with resting-state functional magnetic resonance imaging (fMRI). MATERIALS AND METHODS Forty-nine participants in an odontogenic pain group and 49 participants in control group underwent imaging using fMRI in this prospective study. Odontogenic pain was induced by experimental tooth movement. We calculated the fractional amplitude of low-frequency fluctuation (fALFF) value to evaluate regional cerebral function and compared it between the two groups utilizing a voxel-based two-sample t-test. RESULTS In comparison with the healthy controls, the participants in odontogenic pain group showed increased fALFF value in the left cerebellum, right posterior cingulate gyrus, and bilateral inferior temporal gyrus, as well as decreased fALFF in the medial prefrontal cortex, the left anterior cingulate cortex, bilateral angular gyrus, left inferior parietal cortex, middle temporal gyrus, and miscellaneous cerebral regions (P < 0.001 familywise error-corrected VOXEL > 100). CONCLUSION The present study showed abnormal cerebral activity in odontogenic pain, and reveled that the aberrant regional functional activities were mainly located within the default mode network. The finding could provide insight into the underlying neural mechanism of odontogenic pain. Registry of clinical trials (Trial number ChiCTR1800018589) - http://www.chictr.org.cn/showproj.aspx?proj=31424.
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Affiliation(s)
- Yu Jin
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan UniversityChengdu, Sichuan, P. R. China
| | - Fei Li
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan UniversityChengdu, Sichuan, P. R. China,Unit of Psychoradiology, Chinese Academy of Medical SciencesChengdu 610041, Sichuan, P. R. China
| | - Hong Yang
- School of Stomatology, Southern Medical UniversityGuangzhou, Guangdong, P. R. China
| | - Hu Long
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan UniversityChengdu, Sichuan, P. R. China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan UniversityChengdu, Sichuan, P. R. China,Unit of Psychoradiology, Chinese Academy of Medical SciencesChengdu 610041, Sichuan, P. R. China
| | - Wenli Lai
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Orthodontics, West China Hospital of Stomatology, Sichuan UniversityChengdu, Sichuan, P. R. China
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Sharhan HM, Almashraqi AA, Al-fakeh H, Alhashimi N, Abdulghani EA, Chen W, Al-Sosowa AA, Cao B, Alhammadi MS. Qualitative and quantitative three-dimensional evaluation of maxillary basal and dentoalveolar dimensions in patients with and without maxillary impacted canines. Prog Orthod 2022; 23:38. [PMID: 36274114 PMCID: PMC9588850 DOI: 10.1186/s40510-022-00434-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/03/2022] [Indexed: 11/25/2022] Open
Abstract
Background This study aimed to three-dimensionally evaluate the qualitative and quantitative maxillary basal, dentoalveolar, and dental dimensions in patients with unilateral or bilateral maxillary impacted canines relative to their normal peers.
Materials and methods This is a retrospective comparative study. Cone-beam computed tomography images of one hundred and fifty adult patients were divided into three equal groups: unilateral, bilateral, and control groups. Each had 50 patients that were three-dimensionally analysed. The quantitative measurements involved three basal (molar basal width, premolar basal width, and arch depth), seven dentoalveolar (molar alveolar width, premolar alveolar width, inter-molar width, inter-premolar width, inter-canine width, arch length, and arch perimeter), and two dental (canine length and width) measurements. The qualitative measurements included four bone density areas (buccal, lingual, mesial, and distal) around the maxillary impacted canines. Result Differences between the three groups were statistically different for the quantitative measurements involving the two basal variables (molar basal width and premolar basal width) and all measured dentoalveolar variables; these were smaller in the unilateral and bilateral groups compared with the control group (p < 0.001). Unilateral and bilateral impacted canine groups showed significantly wider and shorter canines than the control group (p < 0.001). The qualitative measurements (the four bone density areas) around unilateral and bilateral impacted canine groups showed significantly greater density than the control group (p < 0.001). There was no significant qualitative or quantitative difference between the unilateral and bilateral impacted canines. The three groups had no significant variations in terms of arch depth. Conclusion Maxillary unilateral and bilateral canine impactions are associated with reduced basal and dentoalveolar dimensions as well as wider and shorter maxillary canines compared to normal peers. The quality of bone around unilateral and bilateral impacted maxillary canines is higher than in non-impacted cases. Unilateral and bilateral canine impactions have quite similar qualitative and quantitative parameters.
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Yassaei S, Safi Y, Valian F, Mohammadi A. Evaluation of maxillary arch width and palatal volume and depth in patients with maxillary impacted canine by CBCT. Heliyon 2022; 8:e10854. [PMID: 36247115 PMCID: PMC9561739 DOI: 10.1016/j.heliyon.2022.e10854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/27/2022] [Accepted: 09/26/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Canines are the second most common tooth in terms of impaction. Impacted teeth can be associated with some different indices of dental arch and dentoalveolar structures. The aim of this study was to evaluate maxillary arch width as well as volume and depth of palate in patients with maxillary impacted canine by cone beam computed tomography (CBCT). Methods In this cross-sectional study, 45 CBCT images of patients with unilateral maxillary impacted canines were examined. All patients had palatally impacted canines. Three parameters of maxillary arch width, palatal volume and palatal depth were assessed using axial and sagittal incisions on the CBCT images. Then all the measurements on the impacted side were compared with the non-impacted side. Data were entered into SPSS software and paired sample t-test and Student's t-test were used to comparison. The significance level of 0.05 was considered. Results The maxillary arch width on the impacted side was significantly less than the normal side (P < 0.001). The mean depth of the palate was 14.86 ± 3.53 mm. There was a significant correlation between canine impaction and Palatal volume (R = 0.728 and P-value< 0.001), but no significant correlation between canine impaction and Maxillary arch width was shown (R = 0.15 and p-value = 0.326). Conclusion The impacted canine was significantly associated with a reduction in the width of the maxillary arch on the affected side, and it made no difference if the impacted side was left or right. Also, impacted canine teeth were significantly associated with volume reduction on the affected side.
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Affiliation(s)
- Soghra Yassaei
- Full Professor, Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran,Corresponding author.
| | - Yaser Safi
- Associate Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faeze Valian
- Dentist, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Asma Mohammadi
- Postgraduate Student, Department of Orthodontics, Faculty of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd Iran
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Tang Z, Zhou J, Long H, Gao Y, Wang Q, Li X, Wang Y, Lai W, Jian F. Molecular mechanism in trigeminal nerve and treatment methods related to orthodontic pain. J Oral Rehabil 2021; 49:125-137. [PMID: 34586644 DOI: 10.1111/joor.13263] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 09/02/2021] [Accepted: 09/23/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Orthodontic treatment is the main treatment approach for malocclusion. Orthodontic pain is an inevitable undesirable adverse reaction during orthodontic treatment. It is reported orthodontic pain has become one of the most common reason that patients withdraw from orthodontic treatment. Therefore, understanding the underlying mechanism and finding treatment of orthodontic pain are in urgent need. AIMS This article aims to sort out the mechanisms and treatments of orthodontic pain, hoping to provide some ideas for future orthodontic pain relief. MATERIALS Tooth movement will cause local inflammation. Certain inflammatory factors and cytokines stimulating the trigeminal nerve and further generating pain perception, as well as drugs and molecular targeted therapy blocking nerve conduction pathways, will be reviewed in this article. METHOD We review and summaries current studies related to molecular mechanisms and treatment approaches in orthodontic pain control. RESULTS Orthodontics pain related influencing factors and molecular mechanisms has been introduced. Commonly used clinical methods in orthodontic pain control has been evaluated. DISCUSSION With the clarification of more molecular mechanisms, the direction of orthodontic pain treatment will shift to targeted drugs.
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Affiliation(s)
- Ziwei Tang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jiawei Zhou
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Hu Long
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yanzi Gao
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qingxuan Wang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaolong Li
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yan Wang
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wenli Lai
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Fan Jian
- State Key Laboratory of Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Jin Y, Yang H, Zhang F, Wang J, Liu H, Yang X, Long H, Li F, Gong Q, Lai W. The Medial Thalamus Plays an Important Role in the Cognitive and Emotional Modulation of Orofacial Pain: A Functional Magnetic Resonance Imaging-Based Study. Front Neurol 2021; 11:589125. [PMID: 33551953 PMCID: PMC7859266 DOI: 10.3389/fneur.2020.589125] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 12/23/2020] [Indexed: 02/05/2023] Open
Abstract
The thalamus plays a critical role in the perception of orofacial pain. We investigated the neural mechanisms of orofacial pain by exploring the intrinsic functional alterations of the thalamus and assessing the changes in functional connectivity (FC) between the thalamic subregions with significant functional alterations and other brain regions in orofacial pain using the seed-based FC approach. There were 49 participants in the orofacial pain group and 49 controls. Orofacial pain was caused by orthodontic separators. The resting-state functional magnetic resonance imaging data of the two groups were analyzed to obtain the fractional amplitude of low-frequency fluctuations (fALFF) of the thalamus; the thalamic subregions with significant fALFF abnormalities were used as seeds for FC analysis. Student's t-tests were used for comparisons. Pearson's correlation analysis was performed using SPM software. Forty-four participants with orofacial pain (mean age, 21.0 ± 0.9 years; 24 women) and 49 age- and sex-matched controls (mean age, 21.0 ± 2.6 years; 27 women) were finally included. Compared with the control group, the orofacial pain group demonstrated the following: (1) increased function in the dorsal area of the thalamus and decreased function in the medial thalamus; (2) decreased FC between the medial thalamus and 12 brain regions (p < 0.05, family-wise error corrected, voxel > 100); and (3) potential positive and negative correlations between the medial thalamus-seeded FC and visual analog scale score changes (p < 0.05, AlphaSim corrected). The findings show that the medial and dorsal thalami play important roles in orofacial pain perception, and that the medial thalamus likely plays an important role in the cognitive and emotional modulation of orofacial pain.
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Affiliation(s)
- Yu Jin
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Hong Yang
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Feifei Zhang
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Jue Wang
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - He Liu
- Department of Orthodontics, China-Japan Friendship Hospital, Beijing, China
| | - Xin Yang
- Department of Stomatology, Shanghai Jiao Tong University School of Medicine Xinhua Hospital, Shanghai, China
| | - Hu Long
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, China
| | - Fei Li
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China
| | - Qiyong Gong
- Department of Radiology, Huaxi MR Research Center (HMRRC), West China Hospital of Sichuan University, Chengdu, China.,Psychoradiology Research Unit of the Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu, China
| | - Wenli Lai
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, China
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12
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Effects of ibuprofen and low-level laser therapy on orthodontic pain by means of the analysis of interleukin 1-beta and substance P levels in the gingival crevicular fluid. J Orofac Orthop 2020; 82:143-152. [PMID: 33097977 DOI: 10.1007/s00056-020-00254-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 08/02/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The goal of this study was to compare the effects of ibuprofen and low-level laser therapy in alleviating orthodontic pain observed after elastomeric separator placement (ESP) by means of the analysis of interleukin 1‑beta (IL-1β) and substance P (SP) levels in gingival crevicular fluid (GCF) and visual analog scale (VAS). MATERIALS AND METHODS A total of 60 subjects requiring ESP for the banding of maxillary first molars were randomly assigned to the ibuprofen, laser, and control groups. The ibuprofen and control groups received, respectively, 400 mg ibuprofen and placebo lactose tablets orally 1 h before ESP; the laser group received a single low-level laser irradiation session immediately after ESP. GCF samples were collected immediately after ESP (day 0) and on days 1, 3, and 7. Pain intensity was evaluated using the VAS immediately after ESP (baseline) and at hours 2 and 6, as well as on days 1, 3, and 7. RESULTS Although IL-1β levels increased significantly on days 1, 3, and 7 compared to day 0, intergroup comparison results revealed insignificant differences. SP levels indicated insignificant within-group differences. Only the SP levels of the ibuprofen group showed a significant decrease on days 0 and 1 compared to the laser and control groups. In all groups, VAS scores increased from baseline to a peak level on day 1, followed by a significant decrease on days 3 and 7. Intergroup comparison results of VAS scores indicated less pain intensity in the ibuprofen group compared to the control group at baseline. CONCLUSIONS Only the ibuprofen group exhibited significant decreases in SP levels on days 0 and 1, as well as in VAS scores at baseline.
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13
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Padminee K, Hemalatha R, Shankar P, Senthil D, Trophimus GJ. Topical anesthesia for stainless steel crown tooth preparation in primary molars: a pilot study. J Dent Anesth Pain Med 2020; 20:241-250. [PMID: 32934990 PMCID: PMC7470992 DOI: 10.17245/jdapm.2020.20.4.241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/27/2020] [Accepted: 07/09/2020] [Indexed: 11/15/2022] Open
Abstract
Background Placement of full-coverage restorations such as stainless steel crowns (SSCs) for pulpectomy treated primary molars is essential for successful outcomes. The tooth preparation process for SSCs can cause discomfort to gingival tissues since the crown should be seated 1 mm subgingivally. The purpose of this prospective trial was to compare the effectiveness of subgingival and transmucosal application of topical anesthetics on dental pain during SSC tooth preparation among 6- to 8-year-old children. Methods A consecutive sample of 27 children, aged 6-8 years, who required an SSC after pulp therapy in primary molars were randomly divided into three groups. Group A received infiltration anesthesia before tooth preparation for SSC placement, whereas in Group B and C, only topical anesthesia was applied subgingivally and transmucosally. Wong-Bakers Faces pain rating scale (WBFPS) scores were recorded after tooth preparation. Faces, Legs, Activity, Cry and Consolability (FLACC) scores were evaluated by two blinded and calibrated investigators through video recordings of the patient during tooth preparation. Data were tabulated, and inter-group comparisons were performed using the Kruskal-Wallis and analysis of variance tests. Results Out of the 27 participants, 48% were boys and 52% were girls, with an overall mean age of 6.83 years. Group A showed the least pain scores according to both the scales, followed by Group B and Group C. The pain intensity was statistically significant on both the pain scales with P = 0.003 for FLACC and P < 0.001 for WBFPS. Conclusion Subgingival application of topical anesthesia reduced pain to a certain extent but not as effectively as infiltration anesthesia during SSC tooth preparation in primary molars. Transmucosal application of topical anesthesia did not reduce discomfort when compared to the other two interventions.
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Affiliation(s)
- Krishnan Padminee
- Department of Pedodontics, SRM Dental College and Hospital, Ramapuram, Chennai, India
| | - R Hemalatha
- Department of Pedodontics, SRM Dental College and Hospital, Ramapuram, Chennai, India
| | - P Shankar
- Department of Pedodontics, SRM Dental College and Hospital, Ramapuram, Chennai, India
| | - D Senthil
- Department of Pedodontics, SRM Dental College and Hospital, Ramapuram, Chennai, India
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Monk AB, Harrison JE, Worthington HV, Teague A. Pharmacological interventions for pain relief during orthodontic treatment. Cochrane Database Syst Rev 2017; 11:CD003976. [PMID: 29182798 PMCID: PMC6486038 DOI: 10.1002/14651858.cd003976.pub2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pain is a common side effect of orthodontic treatment. It increases in proportion to the amount of force applied to the teeth, and the type of orthodontic appliance used can affect the intensity of the pain. Pain during orthodontic treatment has been shown to be the most common reason for people wanting to discontinue treatment, and has been ranked as the worst aspect of treatment. Although pharmacological methods of pain relief have been investigated, there remains some uncertainty among orthodontists about which painkillers are most suitable and whether pre-emptive analgesia is beneficial. We conducted this Cochrane Review to assess and summarize the international evidence relating to the effectiveness of analgesics for preventing this unwanted side effect associated with orthodontic treatment. OBJECTIVES The objectives of this review are to determine:- the effectiveness of drug interventions for pain relief during orthodontic treatment; and- whether there is a difference in the analgesic effect provided by different types, forms and doses of analgesia taken during orthodontic treatment. SEARCH METHODS Cochrane Oral Health's Information Specialist searched the following databases: the Cochrane Oral Health Trials Register (to 19 June 2017), the Cochrane Central Register of Controlled Trials (CENTRAL;the Cochrane Library 2016, Issue 7), MEDLINE Ovid (1946 to 19 June 2017), Embase Ovid (1980 to 19 June 2017) and CINAHL EBSCO (Cumulative Index to Nursing and Allied Health Literature; 1937 to 19 June 2017). The US National Institutes of Health Ongoing Trials Register (ClinicalTrials.gov) and the World Health Organization International Clinical Trials Registry Platform were searched on the 19 June 2017 for ongoing studies. We placed no restrictions on language or date of publication when searching the electronic databases. SELECTION CRITERIA We included randomized controlled trials (RCTs) relating to pain control during orthodontic treatment. Pain could be measured on a visual analogue scale (VAS), numerical rating scale (NRS) or categorical scale. DATA COLLECTION AND ANALYSIS Two review authors independently screened the search results, agreed the studies to be included and extracted information from the included studies regarding methods, participants, interventions, outcomes, harms and results. We planned to resolve any discrepancies or disagreements through discussion. We used the Cochrane 'Risk of bias' tool to assess the risk of bias in the studies. MAIN RESULTS We identified 32 relevant RCTs, which included 3110 participants aged 9 to 34 years, 2348 of whom we were able to include in our analyses. Seventeen of the studies had more than two arms. We were able to use data from 12 trials in meta-analyses that compared analgesics versus control (no treatment or a placebo); nine that compared non-steroidal anti-inflammatories (NSAIDs) versus paracetamol; and two that compared pre-emptive versus post-treatment ibuprofen for pain control following orthodontic treatment. One study provided data for the comparison of NSAIDs versus local anaesthetic.We found moderate-quality evidence that analgesics effectively reduced pain following orthodontic treatment when compared to no treatment or a placebo at 2 hours (mean difference (MD) -11.66 mm on a 0 to 100 mm VAS, 95% confidence interval (CI) -16.15 to -7.17; 10 studies, 685 participants), 6 hours (MD -24.27 mm on a VAS, 95% CI -31.44 to -17.11; 9 studies, 535 participants) and 24 hours (MD -21.19 mm on a VAS, 95% CI -28.31 to -14.06; 12 studies, 1012 participants).We did not find any evidence of a difference in efficacy between NSAID and paracetamol at 2, 6 or 24 hours (at 24 hours: MD -0.51, 95% CI -8.93 to 7.92; 9 studies, 734 participants; low-quality evidence).Very low-quality evidence suggested pre-emptive ibuprofen gave better pain relief at 2 hours than ibuprofen taken post treatment (MD -11.30, 95% CI -16.27 to -6.33; one study, 41 participants), however, the difference was no longer significant at 6 or 24 hours.A single study of 48 participants compared topical NSAIDs versus local anaesthetic and showed no evidence of a difference in the effectiveness of the interventions (very low-quality evidence).Use of rescue analgesia was poorly reported. The very low-quality evidence did not show evidence of a difference between participants taking ibuprofen and participants taking paracetamol (relative risk (RR) 1.5, 95% CI 0.6 to 3.6). Nor did we find evidence of a difference between groups in likelihood of requiring rescue analgesia when ibuprofen was taken pre-emptively compared to after treatment (RR 0.8, 95% CI 0.3 to 1.9).Adverse effects were identified in one study, with one participant developing a rash that required treatment with antihistamines. This was provisionally diagnosed as a hypersensitivity to paracetamol. AUTHORS' CONCLUSIONS Analgesics are more effective at reducing pain following orthodontic treatment than placebo or no treatment. Low-quality evidence did not show a difference in effectiveness between systemic NSAIDs compared with paracetamol, or topical NSAIDs compared with local anaesthetic. More high-quality research is needed to investigate these comparisons, and to evaluate pre-emptive versus post-treatment administration of analgesics.
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Affiliation(s)
- Aoife B Monk
- Liverpool University Dental HospitalOrthodontic DepartmentPembroke PlaceLiverpoolUKL3 5PS
| | - Jayne E Harrison
- Liverpool University Dental HospitalOrthodontic DepartmentPembroke PlaceLiverpoolUKL3 5PS
| | - Helen V Worthington
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of ManchesterCochrane Oral HealthJR Moore BuildingOxford RoadManchesterUKM13 9PL
| | - Annabel Teague
- University Hospital WaterfordOrthodontic DepartmentDunmore RoadWaterfordIrelandX91 ER8E
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Hussain AS, Al Toubity MJ, Elias WY. Methodologies in Orthodontic Pain Management: A Review. Open Dent J 2017; 11:492-497. [PMID: 28979577 PMCID: PMC5611706 DOI: 10.2174/1874210601711010492] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 05/18/2017] [Accepted: 08/12/2017] [Indexed: 02/05/2023] Open
Abstract
Introduction: Patients experience pain and discomfort during active orthodontic treatment with fixed appliances. Pain is considered a subjective response to noxious stimuli. It can vary from person to person and is influenced by certain factors such as age, gender, previous pain experiences, stress or anxiety, and type of appliance. Objective: The objective of this literature review was to discuss conventional versus recently introduced treatment modalities used in pain management for orthodontic patients. Discussion: According to the reviewed articles, both pharmacological and non-pharmacological methods were introduced in orthodontic pain management. However, orthodontists must use their best professional judgment to assess each case individually and select an appropriate treatment modality based on pain threshold level of an individual. Conclusion: Nevertheless, further investigations are required in this field.
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Affiliation(s)
| | | | - Wael Y Elias
- Oral Diagnostic Science Department, King Abdul-Aziz University, Faculty of Dentistry, Jeddah, KSA
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