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Zhou H, Yuan X, Hong H, Lai W, Long H. Protraction of Mandibular Second Molar for Substitution of Adjacent Missing First Molar With a Mini-Implant-Anchored Albert Loop Appliance. Cureus 2024; 16:e58397. [PMID: 38628379 PMCID: PMC11020604 DOI: 10.7759/cureus.58397] [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] [Accepted: 04/14/2024] [Indexed: 04/19/2024] Open
Abstract
Protraction of mandibular posterior teeth into edentulous regions is challenging in clinical practice. This case demonstrated a minor tooth movement of a mandibular second molar to substitute its adjacent missing first molar in a 15-year-old female. An efficient bodily movement of the mandibular second molar was achieved through a mini-implant-anchored protraction loop appliance. With this carefully designed biomechanical system, over 10-mm molar protraction was accomplished within 14 months without mesial or lingual tipping. The adjacent third molar erupted spontaneously during the protraction process and drafted mesially. Through brackets and segmented archwire after the protraction, the second and third molars were successfully protracted and good buccal interdigitation was achieved. The combination of the Albert protraction loop and mini-implant allows for more efficient protraction of the mandibular molars, avoiding mesial tipping and lingual rotation of the molars.
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Affiliation(s)
- Hong Zhou
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Xuechun Yuan
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Huiyi Hong
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Wenli Lai
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
| | - Hu Long
- Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, CHN
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Singh S, Sahoo N, Jena S, Mohanty P, Dash BP, Meher J. Effect of Surface Topography on the Primary Stability of Miniscrew Implants in Orthodontics-A Systematic Review and Meta-Analysis. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S78-S82. [PMID: 38595562 PMCID: PMC11000993 DOI: 10.4103/jpbs.jpbs_906_23] [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: 09/15/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 04/11/2024] Open
Abstract
This present study has the purpose of determining how surface topography of implants affects the initial stability of miniscrew implants (MSIs). Electronic databases like PubMed Central, Scopus, Web of Science, Embase, and Cochrane Library, as well as reference lists, were thoroughly searched up until September 2022. Clinical trials involving individuals who got anchorage through mini-implants, along with information on categories of mini-implants dimension, shape, thread design, and insertion site, were required as part of the eligibility criteria. Primary and secondary stability were also assessed. We carried out selection process for the study, extraction of data, quality assessment, and a meta-analysis. The qualitative synthesis included 10 papers: three randomized, four prospective, and four retrospective clinical investigations. The results of this meta-analysis demonstrate that the clinical state of MIs is controlled by their geometrical surface qualities, which are also influenced by their shape and thread design. According to the evidence this meta-analysis produced, this circumstance exists. The duration of the follow-up period and MI success rates did not correlate with one another.
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Affiliation(s)
- Shivani Singh
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Nivedita Sahoo
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Sanghamitra Jena
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Pritam Mohanty
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Bhagabati P. Dash
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
| | - Jasbir Meher
- Department of Orthodontics and Dentofacial Orthopaedics, Kalinga Institute of Dental Sciences, KIIT (Deemed to be University), Bhubaneswar, Odisha, India
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Hardan L, Bourgi R, Lukomska-Szymanska M, Hernández-Cabanillas JC, Zamarripa-Calderón JE, Jorquera G, Ghishan S, Cuevas-Suárez CE. Effect of scanning strategies on the accuracy of digital intraoral scanners: a meta-analysis of in vitro studies. J Adv Prosthodont 2023; 15:315-332. [PMID: 38205120 PMCID: PMC10774636 DOI: 10.4047/jap.2023.15.6.315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 11/28/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
PURPOSE This study aimed to investigate whether the accuracy of intraoral scanners is influenced by different scanning strategies in an in vitro setting, through a systematic review and meta-analysis. MATERIALS AND METHODS This review was conducted in accordance with the PRISMA 2020 standard. The following PICOS approach was used: population, tooth impressions; intervention, the use of intraoral scanners with scanning strategies different from the manufacturer's instructions; control, the use of intraoral scanners following the manufacturers' requirements; outcome, accuracy of intraoral scanners; type of studies, in vitro. A comprehensive literature search was conducted across various databases including Embase, SciELO, PubMed, Scopus, and Web of Science. The inclusion criteria were based on in vitro studies that reported the accuracy of digital impressions using intraoral scanners. Analysis was performed using Review Manager software (version 5.3.5; Cochrane Collaboration, Copenhagen, Denmark). Global comparisons were made using a standardized mean difference based on random-effect models, with a significance level of α = 0.05. RESULTS The meta-analysis included 15 articles. Digital impression accuracy significantly improved under dry conditions (P < 0.001). Moreover, trueness and precision were enhanced when artificial landmarks were used (P ≤ 0.02) and when an S-shaped pattern was followed (P ≤ 0.01). However, the type of light used did not have a significant impact on the accuracy of the digital intraoral scanners (P ≥ 0.16). CONCLUSION The accuracy of digital intraoral scanners can be enhanced by employing scanning processes using artificial landmarks and digital impressions under dry conditions.
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Affiliation(s)
- Louis Hardan
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut, Lebanon
| | - Rim Bourgi
- Department of Restorative Dentistry, School of Dentistry, Saint-Joseph University, Beirut, Lebanon
- Department of Biomaterials and Bioengineering, INSERM UMR_S 1121, University of Strasbourg, Strasbourg, France
| | | | - Juan Carlos Hernández-Cabanillas
- Health Sciences Faculty, Autonomous University of Baja California, Blvd Universitario 1000 Valle de Las Palmas, Tijuana, B.C. Mexico
| | - Juan Eliezer Zamarripa-Calderón
- Dental Materials Laboratory, Academic Area of Dentistry, Autonomous University of Hidalgo State, San Agustín Tlaxiaca, Mexico
| | - Gilbert Jorquera
- Department of Prosthodontics, Universidad de los Andes, Santiago, Chile
| | | | - Carlos Enrique Cuevas-Suárez
- Dental Materials Laboratory, Academic Area of Dentistry, Autonomous University of Hidalgo State, San Agustín Tlaxiaca, Mexico
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Alharbi MA, Alghamdi BA, Alswajy WA, Kattan SA, Austah O, Othman B, Baeshen HA. A Novel Approach for Orthodontic Extrusion Prior to Intentional Replantation: A Case Report. J Contemp Dent Pract 2023; 24:895-901. [PMID: 38238279 DOI: 10.5005/jp-journals-10024-3566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
AIM This case report aimed to present a novel surgical technique involving orthodontics luxation of the offended tooth using miniscrew prior to performing intentional replantation (IR) to remove an extruded separated instrument that injured the inferior alveolar nerve (IAN). BACKGROUND Intentional replantation is a dental procedure that involves extracting a tooth, managing the root canal, and then reinserting the tooth back into its socket. This procedure is typically used as a last resort when other treatment options have failed or are not possible. Intentional replantation can be successful in preserving the tooth and preventing tooth loss, but it is important to note that there are risks involved. Maintaining the viability of the periodontal ligament (PDL) is a pivotal step to achieve a favorable outcome. CASE DESCRIPTION A 15-year-old female patient came to the clinic complaining of electric-like pain in the left mandibular posterior area that radiated to the left ear and sometimes caused a headache. Upon clinical and radiographic evaluation, extruded endodontic file from the mesial root of the left first molar that penetrated the IAN canal was noticed. Nonsurgical root canal retreatment was performed, which failed to retrieve the separated file. Orthodontics luxation of the offended tooth was done 2 weeks before the surgical intervention using a miniscrew to induce PDL inflammation, which increased the tooth mobility and PDL volume, facilitating the atraumatic extraction and reduced the risk of complications, such as root resorption and ankylosis. Then, IR was performed, and the extruded file was successfully retrieved. Three months follow-up showed complete recovery of the endodontics-related IAN injury symptoms. Preapical radiographic evaluation and cone-beam computed tomography scan showed complete healing of the periapical radiolucency/area of low density and complete formation of the PDL space and lamina dura around the resected roots. CONCLUSION This novel approach using a miniscrew suggests a noninvasive technique that minimizes the damage to the offended tooth surrounding tissues as well as minimizing the morbidity of the adjacent teeth and the vital anatomical structures. CLINICAL SIGNIFICANCE Multidisciplinary comprehensive preplanning of complicated cases is essential to maximize treatment efficiency. The orthodontic extrusion facilitates the extraction process that helps in preserving the PDL, and ultimately increases the survivability of the teeth. How to cite this article: Alharbi MA, Alghamdi BA, Alswajy WA, et al. A Novel Approach for Orthodontic Extrusion Prior to Intentional Replantation: A Case Report. J Contemp Dent Pract 2023;24(11):895-901.
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Affiliation(s)
- Mohammed A Alharbi
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia, Phone: +966503653414, e-mail:
| | - Batool A Alghamdi
- Department of Endodontics, King Fahad Hospital, Ministry of Health, Almadinah, Saudi Arabia; Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Wafa A Alswajy
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Sereen A Kattan
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Obadah Austah
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Bader Othman
- Department of Periodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Hosam A Baeshen
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
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Murakami-Malaquias-Silva F, Perim Rosa E, Malavazzi TCS, Silva T, de Santana Sarmento DJ, Garcez AS, Fernandes MUR, Tortamano A, Ramalho KM, Motta LJ, Fernandes KPS, Bussadori SK, Mesquita-Ferrari RA, Horliana ACRT. Photobiomodulation increases uprighting tooth movement and modulates IL-1β expression during orthodontically bone remodeling. JOURNAL OF BIOPHOTONICS 2023; 16:e202300013. [PMID: 37162171 DOI: 10.1002/jbio.202300013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/11/2023] [Accepted: 04/14/2023] [Indexed: 05/11/2023]
Abstract
This study investigated the effects of photobiomodulation (PBM) in acceleration of orthodontic movement of inferior molar uprighting movement. Thirty-four individuals, with indication of molar uprighting movement for oral rehabilitation, were randomly divided in two groups: verticalization + PBM (808 nm, 100 mW, 1 J per point, 10 points and 25 J/cm2 ) or verticalization + PBM simulation. Elastomeric chain ligatures were changed every 30 days for 3 months. FBM was performed immediately, 24 h, 72 h, 1 and 2 months after activation. The primary outcome was the amount of uprighting movement. Secondary outcomes were pain, amount of medication, OHIP-14 questionnaire, and cytokine IL-1β. PBM group increase uprighting movement when compared to control after 3 months and modulate IL-1β expression. For pain control, the amount of medication and OHIP-14 no difference were found. This study suggests that PBM accelerates tooth movement during molar uprighting, due to modulation of IL-1β during bone remodeling.
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Affiliation(s)
| | - Ellen Perim Rosa
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | | | - Tamiris Silva
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | | | | | | | - Andre Tortamano
- Department of Orthodontics, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | | | - Lara Jansiski Motta
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | | | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
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Ramos de Faria F, de Sá Werneck C, Kuchenbecker Rösing C, Willer Farinazzo Vitral R, José da Silva Campos M. Lower incisor inclination and thickness of the alveolar process and mandibular symphysis in the development of gingival recession: A retrospective cohort study. Saudi Dent J 2023; 35:651-656. [PMID: 37817786 PMCID: PMC10562091 DOI: 10.1016/j.sdentj.2023.05.016] [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: 12/04/2022] [Revised: 05/17/2023] [Accepted: 05/18/2023] [Indexed: 10/12/2023] Open
Abstract
Introduction Retrospective studies have found conflicting results regarding the relationship between lower incisor inclination and the development of gingival recession (GR) after orthodontic treatment. Objective This study aimed to investigate the relationship between lower incisor inclination and alveolar process (AP) and mandibular symphysis (MS) thickness in the development of GR. Materials and Methods Frontal intraoral photography and cephalometric radiography were conducted before (T0) and after (T1) orthodontic treatment of 62 subjects. The presence of GR was considered when the cementoenamel junction was visible in the lower incisor on the frontal intraoral photograph. The circumstances for improvement, stability, and worsening of the gingival situation were based on the reduction, maintenance, and increase in the number of lower incisors with GR before and after treatment. To measure the incisor-mandibular plane angle (IMPA) and the thickness of the AP and the MS were used the cephalometric radiographs. Results Men had a significantly thicker MS than women at T0 and T1 (p < 0.0004). There was a significant reduction of approximately 10% in AP between T0 and T1 (p < 0.0001). Among subjects without GR at T0, 70.4% presented a stable gingival situation at T1. For subjects with 1 lower incisor with GR at T0, 50% showed improvement in the gingival situation at T1, 21.4% remained stable, and 28.6% experienced worsening. Sixteen lateral incisors presented a worsening gingival situation, representing an increase of 129% compared to the central incisors. Conclusion No relationship was found between lower incisor inclination and the thickness of the AP and MS in the development of GR.
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Affiliation(s)
| | - Carolina de Sá Werneck
- Department of Orthodontics – Federal University of Juiz de Fora, Juiz de Fora, MG, Brazil
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Gupta S, Singh VK, Pandey S, Singh S, Jaiswal A, Hawaldar C. 3D assessment of alveolar bone alterations in orthodontic movement among Indians. Bioinformation 2023; 19:764-769. [PMID: 37885780 PMCID: PMC10598358 DOI: 10.6026/97320630019764] [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: 06/01/2023] [Revised: 06/30/2023] [Accepted: 06/30/2023] [Indexed: 10/28/2023] Open
Abstract
Apical root resorption, which is characterised as a biological or abnormal phenomenon that shortens the length of the root apex, is additional typical iatrogenic impact of orthodontic tooth movement that may jeopardise the effectiveness of treatment and tooth lifespan. The main goals of the current retrospective investigation were to assess the dimensions of alveolar bone alterations that come along with orthodontic movement and to look into the frequency and extent of resorption of root in maxillary incisors across categories that were similarly managed with clear aligners (OCA) and fixed appliances (OFA) using CBCT. The study included 50 subjects who were divided into two categories with 25 study subjects in each category. Category OFA: Subjects receiving OFA (n=25). A CBCT scan was used to get three-dimensional pictures at the beginning of therapy as well as at the end of therapy. The overall resorption of root at apical region in OFA group was 0.63±0.21 mm. The overall resorption of root at apical region in OCA group was 0.32 ±0.36 mm. The difference in observation was statistically significant (p= 0.000) with reduced resorption of root at apical region in clear aligners. It was concluded that the decrease in thickness of alveolar bone was greater in orthodontic fixed appliances group as compared to clear aligners. The resorption of root at apical region was lesser in clear aligners group as compared to fixed appliances.
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Affiliation(s)
- Sweta Gupta
- Department of Orthodontics and Dentofacial Orthopaedics, Patna Dental College and Hospital, Patna, Bihar, India
| | - Vinit Kumar Singh
- Department of Orthodontic and Dentofacial Orthopedic, Vananchal Dental College, Garhwa, Jharkhand, India
| | - Shreya Pandey
- Department of Orthodontic and Dentofacial Orthopedic, Dental College Azamgarh, Azamgarh, UP, India
| | - Sandeep Singh
- Department of Orthodontic and Dentofacial Orthopedic, Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
| | - Avinash Jaiswal
- Department of Orthodontic and Dentofacial Orthopedic, Dental College Azamgarh, Azamgarh, UP, India
| | - Chinmaya Hawaldar
- Department of Orthodontic and Dentofacial Orthopedic, Terna Dental College and Hospital, Navi Mumbai, Maharashtra, India
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Adly MS, Adly AS, Younes R, El Helou M, Panayotov I, Cuisinier F, Carayon D, Estephan E. Prevention and repair of orthodontically induced root resorption using ultrasound: a scoping review. Expert Rev Med Devices 2023. [PMID: 37294872 DOI: 10.1080/17434440.2023.2223965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/06/2023] [Indexed: 06/11/2023]
Abstract
INTRODUCTION This review summarizes the available recent literature on different mechanisms and parameters of pulsed ultrasound (US) that have been used during orthodontic treatments to prevent and repair root resorption. AREAS COVERED A literature search was conducted between January (2002) and September (2022) in the following databases: PubMed, Google-Scholar, Embase and The-Cochrane-Library. After exclusions, a total of 19 papers were included in the present review. The most used US parameters with positive outcomes were frequency of 1.5 MHz, pulse repetition frequency of 1000 Hz, output intensity of 30 mW/cm2, duration of application of 20 mins and total number sessions were 14 with a repetition interval of 1day. The suggested mechanisms induced by US were alteration of cementoblasts, osteoblasts, osteoclasts, alkaline-phosphatase (ALP), runt-related-gene-2 (Runx2), osteoprotegerin (OPG), type-I-collagen (Col-I), C-telopeptide-type-I-collagen (CTX-I), hepatocyte-growth-factor (HGF), bone morphogenetic protein-2 (BMP-2), cyclooxygenase-2 (Cox-2), calcium (Ca2+), receptor activator of nuclear factor-kappa-B ligand (RANKL), and receptor activator of nuclear factor-kappa-B (RANK). EXPERT OPINION Understanding mechanisms and deciding which parameters of US that can be used during orthodontic treatment to prevent and repair root resorption is a great challenge. This work summarizes all the available data that can aid this process and suggest that US is an effective noninvasive method not only in prevention and repairing of orthodontic induced root resorption but also in accelerating teeth movement.
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Affiliation(s)
| | | | - Richard Younes
- Institute for Neurosciences of Montpellier (INM), Univ Montpellier, Inserm, Montpellier, France
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Marwan El Helou
- LBN, Univ Montpellier, Montpellier, France
- CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
| | - Ivan Panayotov
- LBN, Univ Montpellier, Montpellier, France
- CSERD, CHU Montpellier, Montpellier, France
- UFR Odontologie, Univ. Montpellier, Montpellier, France
| | - Frederic Cuisinier
- LBN, Univ Montpellier, Montpellier, France
- CSERD, CHU Montpellier, Montpellier, France
- UFR Odontologie, Univ. Montpellier, Montpellier, France
| | - Delphine Carayon
- LBN, Univ Montpellier, Montpellier, France
- CSERD, CHU Montpellier, Montpellier, France
- UFR Odontologie, Univ. Montpellier, Montpellier, France
| | - Elias Estephan
- LBN, Univ Montpellier, Montpellier, France
- Neuroscience Research Center, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
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Hong H, Zhou J, Fan Q, Jiao R, Kuang Q, Zhou H, Hua C, Yang Z, Lai W, Long H. Characteristics of Spatial Changes in Molars and Alveolar Bone Resorption among Patients with Loss of Mandibular First Molars: A CBCT-Based Morphometric Study. J Clin Med 2023; 12:jcm12051932. [PMID: 36902721 PMCID: PMC10004128 DOI: 10.3390/jcm12051932] [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: 01/17/2023] [Revised: 02/19/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023] Open
Abstract
OBJECTIVES To investigate the characteristics of spatial changes in molars and alveolar bone resorption among patients with loss of mandibular first molars. METHODS A total of 42 CBCT scans of patients with missing mandibular first molars (3 males, 33 females) and 42 CBCT scans of control subjects without loss of mandibular first molars (9 males, 27 females) were evaluated in this cross-sectional study. All images were standardized using the mandibular posterior tooth plane with Invivo software. The following indices regarding alveolar bone morphology were measured, including alveolar bone height, bone width, mesiodistal and buccolingual angulation of molars, overeruption of maxillary first molars, bone defects, and the capability of molar mesialization. RESULTS The vertical alveolar bone height in the missing group was reduced by 1.42 ± 0.70 mm, 1.31 ± 0.68, and 1.46 ± 0.85 mm on the buccal, middle, and lingual side, respectively (no differences among the three sides; p > 0.05). Alveolar bone width was reduced the greatest at the buccal CEJ level and the least at the lingual apex level. Mandibular second molar mesial tipping (with mean of the mesiodistal angulation = 57.47 ± 10.34°) and lingual tipping (with mean of the buccolingual angulation = 71.75 ± 8.34°) were observed. The mesial and distal cusps of maxillary first molars were extruded by 1.37 mm and 0.85 mm, respectively. Buccal and lingual defects of alveolar bone occurred at the CEJ, mid-root, and apex levels. Through 3D simulation, the second molar cannot be successfully mesialized into the missing tooth position, and the difference between the available and required distances for mesialization was the greatest at the CEJ level. The duration of tooth loss was significantly correlated with the mesio-distal angulation (R = -0.726, p < 0.001), buccal-lingual angulation (R = -0.528, p < 0.001) and the extrusion of the maxillary first molar (R = -0.334, p < 0.05). CONCLUSION Both vertical and horizontal resorption of alveolar bone occurred. Mandibular second molars exhibit mesial and lingual tipping. Lingual root torque and uprighting of the second molars are needed for the success of molar protraction. Bone augmentation is indicated for severely resorbed alveolar bone.
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Affiliation(s)
- Huiyi Hong
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Jing Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Pediatric Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Qi Fan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ruijie Jiao
- West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Qianyun Kuang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Hong Zhou
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Orthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Chengge Hua
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of General Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zheng Yang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of General Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, 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 University, Chengdu 610041, 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 University, Chengdu 610041, China
- Correspondence:
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Comparison of the Accuracy of Two Transfer Caps in Positional Transmission of Palatal Temporary Anchorage Devices: An In Vitro Study. Dent J (Basel) 2023; 11:dj11020051. [PMID: 36826196 PMCID: PMC9954813 DOI: 10.3390/dj11020051] [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: 12/15/2022] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
The aim of this study was to compare the positional information transfer accuracy of palatal temporary anchorage devices (TADs) of two different brands of transfer caps: PSM and Leone. Thirty plaster casts of maxillary dental arches were chosen for master models. A couple of Leone TADs were inserted in each master model. For each master model, two analysis models were created: using two transfer caps, Leone and PSM, the impressions were taken, the analogues were connected on the transfer caps, and the casts were poured. Using digital methods and equipment, such as a 3D scanner, a 3D analysis and a comparison of the accuracy of the two transfer caps in transferring the positional information of the TADs was then made. The data obtained were analyzed using the Mann-Whitney U-test at a significance level of α = 0.05. PSM transfer caps showed higher error frequency in almost all measurements. Only two measurements had a larger error in the analysis models made with Leone transfer caps. The Mann-Whitney U-test found a significant difference between the error levels of TADs found in the analysis models created with PSM transfer caps. Leone transfer caps showed greater reliability in TADs positional information transmission.
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Karkazi F, Karvelas N, Alexiou A, Gizani S, Tsolakis AI. Comparison between orthodontic and surgical uprighting of mandibular molars: a systematic review. Angle Orthod 2023; 93:104-110. [PMID: 36240427 DOI: 10.2319/041822-298.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 08/01/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To evaluate and compare the efficiency of orthodontic treatment and surgical uprighting of first and second mandibular molars. MATERIALS AND METHODS An electronic literature search in PubMed, Science Direct, Embase, Scopus, Web of Science, Cochrane Library, LILACS, and Google Scholar, as well as a hand search was conducted by two independent researchers to identify relevant articles up to January 2022. In addition, a manual search was done that included article reference lists, grey literature, and dissertations. The risk of bias of the included prospective and retrospective studies was assessed with the Risk Of Bias Tool In Non-randomized Studies of Interventions (ROBINS-I) assessment tool. RESULTS A total of six nonrandomized clinical trials (non-RCT) evaluating the efficiency of mandibular molar orthodontic and/or surgical uprighting were included. The quality analysis showed certain defects of the Non-RCTs included and, according to the criteria used, the majority of the articles were judged to be of moderate quality. CONCLUSIONS Based on the evidence, orthodontic and surgical uprighting appear to be effective treatment methods for mandibular molars. Surgical uprighting may be associated with more complications than orthodontic uprighting. However, the existing literature on the subject is limited, heterogeneous, and methodologically limited. Therefore, the outcomes should be interpreted carefully.
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Prosthetically Guided Orthodontics (PGO): A Personalized Clinical Approach for Aesthetic Solutions Using Digital Technology. J Pers Med 2022; 12:jpm12101716. [PMID: 36294855 PMCID: PMC9605514 DOI: 10.3390/jpm12101716] [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: 09/19/2022] [Revised: 10/08/2022] [Accepted: 10/09/2022] [Indexed: 11/07/2022] Open
Abstract
Conformative rehabilitation generally involves the treatment of partial dentate or the application of veneers. In this regard, conformative rehabilitation aims to generate an aesthetic prosthetic solution minimizing the amount of tissue removal without generating occlusal input interfering with the equilibrium of neuro-muscular function. In fact, pre-prosthetic orthodontics aims to re-establishing the correct position/inclination of the neighboring or antagonist teeth, providing appropriate space for the prosthetic crown. Clear aligners therapy (CAT) represents a valuable tool in the management of prosthetic cases with a conformative approach, as it allows clinicians to plan orthodontic movements that are guided by the prosthetic outcomes. In the present manuscript, we argue the concept of prosthetic guided orthodontics (PGO) by presenting and discussing three cases treated with the Invisalign GO system, which has been developed for the clinical management of multidisciplinary orthodontic-prosthetic cases with a conformative approach. In this regard, the rationale of this paper is to address the effectiveness and predictability of the digital set-up and CAT for aesthetic conformative rehabilitations.
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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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Cardoso PC, Mecenas P, Normando D. The impact of the loss of first permanent molars on the duration of treatment in patients treated with orthodontic space closure and without skeletal anchorage. Prog Orthod 2022; 23:32. [PMID: 36089601 PMCID: PMC9464666 DOI: 10.1186/s40510-022-00427-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background This study aims to evaluate the impact of the loss of permanent molars on the duration of orthodontic treatment for space closure and without skeletal anchorage. Methods Records at the beginning (T0) and the end (T1) of orthodontic treatment were selected retrospectively. Patients were divided into two groups: loss of molar (n = 19) and control, without loss (n = 24). The impact of loss on treatment time was assessed using multiple linear regression adjusted for the number of absences, bonding failures, age, sex, PAR index at T0 and T1 at p<0.05. Treatment time was also evaluated by the number of losses and which arches were involved (upper, lower). The systematic and random errors for the PAR index were verified using the intraclass correlation coefficient (ICC) and the Dahlberg formula, respectively.
Results A small random error (1.51) and excellent replicability (ICC = 99.6) were observed. Overall average treatment time was 22.5 months (± 7.95) for the group without loss and 44.7 months (± 17.3) with a loss. Treatment time was longer in cases where there was a higher number of missing molars and when both arches were involved. In addition to the loss (β = 4.25, p < 0.001), the number of missed appointments (β = 2.88, p < 0.001) had a significant effect and increased treatment time. Bonding failures, gender, age, and PAR index at T0 and T1 were not significantly associated with treatment time in the multivariate model (p > 0.05). Conclusion Loss of the first permanent molar has a negative impact on orthodontic treatment time in cases of space closure. The treatment time is longer when there are more tooth losses and arches involved. Treatment time also increases with greater numbers of missed clinical appointments.
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Torqued and conventional cantilever for uprighting mesially impacted molars: A 3-dimensional finite element analysis. Am J Orthod Dentofacial Orthop 2022; 162:e203-e215. [PMID: 35999156 DOI: 10.1016/j.ajodo.2022.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 07/01/2022] [Accepted: 07/01/2022] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The objective of this study was to evaluate the effects of the torqued cantilever (TC) and conventional tip-back cantilever (CC) made of stainless steel (SS) and titanium-molybdenum alloy (TMA) on the uprighting of mesially impacted mandibular molars using three-dimensional finite element analysis. METHODS The 3-dimensional mandibular model included part of the mandible with mesially tipped and impacted mandibular second molar, periodontal ligament (PDL), molar tube, mini-implant, and cantilevers. Four finite element method models (TC-SS, TC-TMA, CC-SS, and CC-TMA) were created to simulate different skeletally anchored uprighting mechanics. CC mechanics involved a known 0.019 × 0.025-in helical cantilever acting on a buccal molar tube. TC mechanics included a 0.019 × 0.025-in cantilever capable of producing mesial root torque by acting on a tube positioned on the molar disto-occlusal surface with the slot in a buccolingual direction. Three-dimensional molar displacement and stress distribution on the molar PDL were recorded. RESULTS The SS cantilever produced almost twice as much molar displacement as the TMA. TC mechanics showed more evident mesial displacement of the molar root apexes. CC mechanics had greater molar rotation. TC uprighting moment produced greater molar mesial extrusion and greater intrusion of the distal root apex. The dual deflection system of the TC mechanics induced the lowest stress on the PDL, regardless of the metallic alloy. CONCLUSIONS TC delivered a more efficient uprighting moment to the molar with less unwanted tooth movement and stress on the PDL and a more accessible site for bonding the molar tube.
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Venkatesh P, Harish P, Madakkuni A, Reddy S. Orthodontic Management of Severe Dentoalveolar Collapse with Miniscrew-Assisted TMA Cantilever Springs and Bite Blocks. JOURNAL OF INDIAN ORTHODONTIC SOCIETY 2022. [DOI: 10.1177/03015742221086348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Management of mutilated cases is challenging, and adult patients often require orthodontic correction of occlusion before prosthetic replacement of missing teeth. Objective: To highlight the novel, simple, hygienic, and efficient miniscrew-supported Beta titanium molybdenum alloy (TMA) cantilever spring for uprighting severe mesially tipped molars for interdisciplinary treatment. Diagnosis and Treatment: A 23-year-old male patient presented with skeletal Class I relation, average growth pattern, Class II Div 1 malocclusion with dentoalveolar collapse, crowding, multiple missing, supraerupted teeth, and severe mesially tipped mandibular third molars. MBT appliance with 0.022˝ slot was used to achieve the objectives. 38 and 48 were uprighted and protracted with miniscrew implant-supported TMA cantilever springs to substitute 37 and 47. Mild intrusion of maxillary posterior teeth was done with acrylic bite blocks and transpalatal arch (TPA), followed by prosthetic replacement of missing teeth. Results: The patient had a consonant smile arc and a pleasing soft tissue profile. Mandibular third molars were uprighted and protracted with good vertical control, and the mesial pockets were eliminated. The supraerupted maxillary molars were intruded, and group function occlusion was established. Class I canine relationship, normal overjet, and overbite were achieved. Conclusion: Miniscrew supported TMA cantilevers are efficient for uprighting of severely tipped third molars without extrusion, unlike the conventional mechanics. The third molars with good root forms can be protracted and substituted as second molars to minimize prosthetic rehabilitation.
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Affiliation(s)
| | - Pooja Harish
- Department of Orthodontics and Dentofacial Orthopedics, Yenepoya Dental College, Yenepoya (Deemed to be) University, Mangaluru, Karnataka, India
| | - Anjuna Madakkuni
- Impact Oasis Apartment, Chikkabanaswadi, Bangaluru, Karnataka, India
| | - Sumitra Reddy
- Department of Orthodontics and Dentofacial Orthopedics, KLE Society’s Institute of Dental Sciences, Bengaluru, Karnataka, India
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Sobouti F, Chiniforush N, Saravani HJ, Noroozian M, Cronshaw M, Navaei RA, Rakhshan V, Dadgar S. Efficacy of compound topical anesthesia combined with photobiomodulation therapy in pain control for placement of orthodontic miniscrew: a double-blind, randomized clinical trial. Lasers Med Sci 2022; 37:589-594. [PMID: 33796965 DOI: 10.1007/s10103-021-03307-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 03/28/2021] [Indexed: 02/05/2023]
Abstract
This study aims to investigate the effect of compound topical anesthetic (CTA) application combined with photobiomodulation therapy (PBMT) on the level of pain perceived during placement of miniscrews and 24 h post the procedure in the buccal side of the maxillary bone. This randomized, prospective, single-center, split-mouth, double-blinded study included 25 subjects (12 males and 13 females, aged 16 to 35). Two anesthetic techniques before implantation were performed including Profound gel +PBM with 980 nm diode laser and local anesthesia with 2% lidocaine hydrochloride. Then, the miniscrews with the size of 1.6 mm in diameter and 8 mm in length were placed with a hand driver in the buccal side of the maxillary bone. The pain immediately after miniscrew placement (T1), also 12 h (T2), and 24 h (T3) post the procedure were collected by visual analog scale (VAS). Data were analyzed by SPSS version 22. There were no statistically significant differences in mean VAS scores within or between CTA combined with PBMT or injection applications, immediately after miniscrew placement (P = 0.75), 12 h after miniscrew placement (P = 0.4), and 24 h after miniscrew placement (P = 1.0). Compound topical anesthetic combined with PBMT provided adequate local anesthesia for the placement of miniscrews in the buccal side of the maxillary bone.
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Affiliation(s)
- Farhad Sobouti
- Dental Sciences Research Center, Department of Orthodontics, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Nasim Chiniforush
- Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Qouds Ave, Tehran, 1441987566, Iran.
| | - Hamid Jaahed Saravani
- Student Research Committee, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Noroozian
- Department of Orthodontics, Student Research Committee, School of dentistry, Ilam University of Medical Sciences, Ilam, Iran
| | - Mark Cronshaw
- School of Dentistry, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- Leicester School of Pharmacy, De Montfort University, Leicester, UK
| | - Reza Alizadeh Navaei
- Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Sepideh Dadgar
- Dental Sciences Research Center, Department of Orthodontics, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran.
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Selvido DI, Wongsirichat N, Arirachakaran P, Rokaya D, Wongsirichat N. Surgical Management of Impacted Lower Second Molars: A Comprehensive Review. Eur J Dent 2022; 16:465-477. [PMID: 35016240 PMCID: PMC9507580 DOI: 10.1055/s-0041-1739443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Impacted lower second molars (ILM2) are rarely reported in the literature, but various studies have been done for its treatment. Apart from solely orthodontic approaches, different surgical management techniques were reported to have successful outcomes. Surgical intervention of ILM2 can help expose the tooth for further orthodontic purposes, simplifying complex treatment methods, and reducing treatment time. This review illustrates the comprehensive evaluation and updated methods of surgical uprighting, repositioning, and transplantation of ILM2 with future directions for better understanding and treatment planning in the clinical setting. The successful outcome of surgical intervention depends on case selection, root development of ILM2, careful surgical manipulation, and adherence to sound biological principles.
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Affiliation(s)
- Diane Isabel Selvido
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Nattharin Wongsirichat
- Department of Preventive Dentistry, Division of Orthodontics, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Pratanporn Arirachakaran
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Dinesh Rokaya
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
| | - Natthamet Wongsirichat
- Clinical Science Department, International College of Dentistry, Walailak University, Bangkok, Thailand
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Shibasaki WMM, Martins RP. Loads of continuous mechanics for uprighting the second molar on the second molar and premolar. Am J Orthod Dentofacial Orthop 2021; 161:679-686. [PMID: 34952778 DOI: 10.1016/j.ajodo.2020.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This paper aims to evaluate the effect of tube height on uprighting a mandibular second molar with a continuous arch, specifically the main effects on the molar tube and the side effects on the second premolar bracket. METHODS Slot brackets (0.18-in) and tubes were passively bonded from the left second molar to the right second premolar of the patient's cast and fixed to an orthodontic force tester. A mesially tipped second molar along with its tube was positioned at 5 different heights in relation to the bracket slots of the remaining appliance: 2 mm below (group -2), 1 mm below (group -1), leveled (group 0), 1 mm above (group 1) and 2 mm above (group 2). Each group had 10 different 0.016 × 0.022-in superelastic nickel-titanium wires tied one at a time to the appliance to register the vertical forces (Fz) and tipping moments (Mx) produced at the molar tube and the premolar bracket, statistically. Analysis of variance was used to identify differences of load among the groups for wire response to the position of the tube in relation to the other brackets' slots. RESULTS As the molar tube was positioned more occlusally, Fz and Mx decreased at the molar tube from 1.31 N to 0.75 N and 13.98 N.mm to 11.84 N.mm, respectively, whereas at the premolar bracket, Fz and Mx decreased from 1.52 N to 0.88 N and 8.77 N.mm to 1.05 N.mm, respectively. CONCLUSIONS In all groups, the load system at the molar tube (the main effects) registered a distal tipping moment and an extrusive force, whereas at the premolar bracket, the load system (side effects) included a distal tipping moment and an intrusive force. As the tube moved occlusally, the extrusive force and the uprighting moment decreased, along with the side effects at the premolar bracket. Attempting to bond the molar tube more occlusally (within reasonable intraoral dimensions) when trying to upright a molar does not appear to be sufficient to keep a molar from extruding.
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Affiliation(s)
- Wendel Minoro Muniz Shibasaki
- Department of Orthodontics, Faculdade de Odontologia de Araraquara, Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Renato Parsekian Martins
- Department of Orthodontics, Faculdade de Odontologia de Araraquara, Universidade Estadual Paulista, Araraquara, São Paulo, Brazil; Private practice, Araraquara, São Paulo, Brazil.
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Patni VJ, Kolge NE, Pednekar MJ. ‘N-Angle’: Clinical Indicator for Predictable Insertion of Ramal Bone Screws. JOURNAL OF INDIAN ORTHODONTIC SOCIETY 2021. [DOI: 10.1177/0301574221991947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: The primary concern in the placement of ramal bone screws is the blind nature of the procedure, as there is a thick, mobile layer of soft tissue over the bone; also, the ramus is not a uniplanar structure but is swerving like a propeller blade. The purpose of this study was to evaluate the possibility of establishing clinical guidelines based on visible dental and soft-tissue landmarks for safe, reliable, and accurate insertion of ramal bone screws. Aims and Objectives: Our primary objective was to evaluate the angle formed between the appropriate direction of ramal-implant placement and the line tangential to the buccal surfaces of the first and second permanent molars. Our secondary objective was to evaluate the average distance of the neurovascular bundle from the tip of the bone screw. Materials and Methods: We obtained 80 cone beam computed tomography (CBCT) samples, marked reference lines and points on selected axial and coronal sections, and evaluated the following parameters using the software’s linear- and angular-measurement device: the angle between the appropriate direction of ramal bone screw placement and the line tangential to the buccal surfaces of the first and second permanent molars; and the proximity of the bone screw to the neurovascular bundle. Results: The angle between the constructed line of insertion and the occlusal line, as evaluated from our study, was 19.04 (SD ± 6.89) degrees. The proximity of the neurovascular bundle from the screw is 7.1773 (SD ± 1.73988) mm. Conclusion: We can conclude that ramal bone screws can be placed with a comfortable margin of safety.
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Affiliation(s)
- Vivek J Patni
- Department of Orthodontics & Dentofacial Orthopaedics, MGM Dental College & Hospital, Navi Mumbai, Maharashtra, India
| | - Neeraj E Kolge
- Department of Orthodontics & Dentofacial Orthopaedics, MGM Dental College & Hospital, Navi Mumbai, Maharashtra, India
| | - Madhura J Pednekar
- Department of Orthodontics & Dentofacial Orthopaedics, MGM Dental College & Hospital, Navi Mumbai, Maharashtra, India
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Biomechanical effect of selective osteotomy and corticotomy on orthodontic molar uprighting. Am J Orthod Dentofacial Orthop 2021; 160:292-301. [PMID: 34099344 DOI: 10.1016/j.ajodo.2020.06.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 05/01/2020] [Accepted: 06/01/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Uprighting mesially tipped molars is often a necessary step before implant placement. However, the orthodontic treatment can be lengthy and discourage patients from choosing implant prostheses. Periodontally accelerated osteogenic orthodontics is reported to facilitate molar movements. This study aimed to evaluate the biomechanical effects of various corticotomy and osteotomy approaches on the uprighting of a mesially tipped mandibular second molar in a 3-dimensional finite element analysis model. METHODS The initial tooth displacement and periodontal ligament (PDL) strain in 9 finite element analysis models with various corticotomy and osteotomy simulations were compared under 3 intended tooth movement scenarios: distal crown tipping, mesial root movement with restraints, and mesial root movement without restraints. RESULTS Corticotomy or osteotomy approaches altered the tooth displacement and the PDL strain in all 3 intended molar uprighting scenarios. The 2 most extensive surgical approaches, the combined mesial and distal osteotomy with horizontal corticotomy and the circumferential corticotomy at root apex level, resulted in increased tooth movement but had a distinct impact on PDL strain. CONCLUSIONS It was revealed that different combinations of corticotomy and osteotomy had a biomechanical impact on orthodontic molar uprighting movements.
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Choi JY, Kim MJ, Kim SH, Chung KR, Nelson G. Effect of Different Head Hole Position on the Rotational Resistance and Stability of Orthodontic Miniscrews: A Three-Dimensional Finite Element Study. SENSORS 2021; 21:s21113798. [PMID: 34070904 PMCID: PMC8198358 DOI: 10.3390/s21113798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/26/2021] [Accepted: 05/27/2021] [Indexed: 12/26/2022]
Abstract
The orthodontic miniscrew is driven into bone in a clockwise direction. Counter-clockwise rotational force applied to the implanted miniscrew can degrade the stability. The purpose of this three-dimensional finite element study was to figure out the effect of shifting the miniscrew head hole position from the long axis. Two miniscrew models were developed, one with the head hole at the long axis and the other with an eccentric hole position. One degree of counter-clockwise rotation was applied to both groups, and the maximum Von-Mises stress and moment was measured under various wire insertion angles from −60° to +60°. All Von-Mises stress and moments increased with an increase in rotational angle or wire insertion angle. The increasing slope of moment in the eccentric hole group was significantly higher than that in the centric hole group. Although the maximum Von-Mises stress was higher in the eccentric hole group, the distribution of stress was not very different from the centric hole group. As the positive wire insertion angles generated a higher moment under a counter-clockwise rotational force, it is recommended to place the head hole considering the implanting direction of the miniscrew. Clinically, multidirectional and higher forces can be applied to the miniscrew with an eccentric head hole position.
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Affiliation(s)
- Jin-Young Choi
- Department of Orthodontics, Kyung Hee University Dental Hospital, Seoul 02447, Korea;
| | - Min-Jung Kim
- Department of Convergence Medicine, Asan Medical Center, Asan Medical Institute of Convergence Science and 8 Technology, Seoul 02447, Korea;
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School of Dentistry, Kyung Hee University, Seoul 02447, Korea;
- Correspondence:
| | - Kyu-Rhim Chung
- Department of Orthodontics, Graduate School of Dentistry, Kyung Hee University, Seoul 02447, Korea;
| | - Gerald Nelson
- Division of Orthodontics, Department of Orofacial Science, University of California, San Francisco, CA 94143, USA;
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Park JH, Choo H, Choi JY, Chung KR, Kim SH. Evaluation of strategic uprighting of the mandibular molars using an orthodontic miniplate and a nickel-titanium reverse curve arch wire: Preliminary cephalometric study. Korean J Orthod 2021; 51:179-188. [PMID: 33984225 PMCID: PMC8133900 DOI: 10.4041/kjod.2021.51.3.179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/09/2020] [Accepted: 10/28/2020] [Indexed: 01/20/2023] Open
Abstract
Objective To evaluate the overall treatment effects in terms of the amount of uprighting with changes in the sagittal and vertical positions of mandibular molars after applying an orthodontic miniplate with a nickel-titanium (NiTi) reverse curve arch wire (biocreative reverse curve [BRC] system). Methods A total of 30 female patients (mean age, 25.99 ± 8.96 years) were treated with the BRC system (mean BRC time, 10.3 ± 4.07 months). An I-shaped C-tube miniplate (Jin Biomed) was placed at the labial aspect for the alveolar bone of the mandibular incisors. A 0.017 × 0.025-inch NiTi reverse curve arch wire was engaged at the C-tube mini-plate anteriorly and the first and second premolars and molars posteriorly in the mandibular arch. Pre- and post-BRC lateral cephalograms were analyzed. A paired t-test was used to analyze the treatment effects of BRC. Results The mandibular second molars were intrusively uprighted successfully by the BRC system. Distal uprighting with a controlled vertical dimension was noted on the first molars when they remained engaged in the BRC and the distal ends of the arch wire were laid on the second molars. The mandibular first and second premolars showed a slight extrusion. The changes in the mandibular incisors were unremarkable, while the mandibular molar angulation improved significantly. The lower occlusal plane rotated counterclockwise (MP-LOP 1.13° ± 2.60°). Conclusions The BRC system can provide very effective molar uprighting without compromising the position of the mandibular anterior teeth.
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Affiliation(s)
- Jae-Hyun Park
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - HyeRan Choo
- Department of Plastic Surgery, Stanford University School of Medicine, Lucile Packard Children's Hospital, Palo Alto, CA, USA
| | - Jin-Young Choi
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Kyu-Rhim Chung
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
| | - Seong-Hun Kim
- Department of Orthodontics, Graduate School, Kyung Hee University, Seoul, Korea
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Lorente C, Perez-Vela M, Lorente P, Lorente T. Miniscrew-supported pole technique: Surgical-orthodontic approach for impacted or retained second molars in adolescents. Int Orthod 2021; 19:147-158. [PMID: 33454236 DOI: 10.1016/j.ortho.2020.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/26/2020] [Accepted: 10/27/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Several treatment options have been proposed for the treatment of eruption disturbances of permanent molars. Despite being an infrequent condition, these disturbances should be solved as they can lead to important complications and play a relevant role in completing the occlusion. FINDINGS The presented cases involved maxillary and mandibular included second molars (M2s) respectively. Both teeth erupted successfully after the application of the miniscrew-supported pole technique, and a functional occlusion was established. CONCLUSIONS This technique is a surgically assisted orthodontic procedure performed to force the eruption of impacted/retained M2s. This device uses one mesial miniscrew which allows the application of relevant force to achieve the eruption of complicated retained/impacted M2s within a short period of time.
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Affiliation(s)
- Carmen Lorente
- University of Zaragoza, Department of Human Anatomy and Histology, Zaragoza, Spain; Private practice in Lorente Orthodontic Clinic, Zaragoza, Spain.
| | | | - Pedro Lorente
- Private practice in Lorente Orthodontic Clinic, Zaragoza, Spain
| | - Teresa Lorente
- University of Zaragoza, Department of Human Anatomy and Histology, Zaragoza, Spain; Private practice in Lorente Orthodontic Clinic, Zaragoza, Spain
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Tamer İ, Öztaş E, Marşan G. Up-to-Date Approach in the Treatment of Impacted Mandibular Molars: A Literature Review. Turk J Orthod 2020; 33:183-191. [PMID: 32974065 DOI: 10.5152/turkjorthod.2020.19059] [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: 10/16/2019] [Accepted: 11/10/2019] [Indexed: 11/22/2022]
Abstract
Eruption problems in the mandibular molars are rare, but they have to be diagnosed and treated early. Treatment of impacted molars is challenging due to a limited access and complexity of the mechanics that needs to be applied. Methods for managing impacted or tilted mandibular molars include orthodontic repositioning, surgical uprighting, and extraction with or without transplantation of the third molar into the extraction site. This review highlights the methods and clinical procedures of surgical and orthodontic uprighting procedures of mandibular molars with different degrees and levels of impaction. It further discusses the use of the ramus screw as a temporary anchorage device in the uprighting of horizontally impacted mandibular molars.
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Affiliation(s)
- İpek Tamer
- Department of Orthodontics, İstanbul University İstanbul School of Dentistry, İstanbul, Turkey
| | - Evren Öztaş
- Department of Orthodontics, İstanbul University İstanbul School of Dentistry, İstanbul, Turkey
| | - Gülnaz Marşan
- Department of Orthodontics, İstanbul University İstanbul School of Dentistry, İstanbul, Turkey
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Morita Y, Koga Y, Nguyen TA, Yoshida N. Biomechanical considerations for uprighting impacted mandibular molars. Korean J Orthod 2020; 50:268-277. [PMID: 32632046 PMCID: PMC7369381 DOI: 10.4041/kjod.2020.50.4.268] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/03/2019] [Accepted: 03/08/2019] [Indexed: 11/10/2022] Open
Abstract
This case report demonstrates two different uprighting mechanics separately applied to mesially tipped mandibular first and second molars. The biomechanical considerations for application of these mechanisms are also discussed. For repositioning of the first molar, which was severely tipped and deeply impacted, a novel cantilever mechanics was used. The molar tube was bonded in the buccolingual direction to facilitate insertion of a cantilever from the buccal side. By twisting the distal end of the cantilever, sufficient uprighting moment was generated. The mesial end of the cantilever was hooked over the miniscrew placed between the canine and first premolar, which could prevent exertion of an intrusive force to the anterior portion of the dentition as a side effect. For repositioning of the second molar, an uprighting mechanics using a compression force with two step bends incorporated into a nickel-titanium archwire was employed. This generated an uprighting moment as well as a distal force acting on the tipped second molar to regain the lost space for the first molar and bring it into its normal position. This epoch-making uprighting mechanics could also minimize the extrusion of the molar, thereby preventing occlusal interference by increasing interocclusal clearance between the inferiorly placed two step bends and the antagonist tooth. Consequently, the two step bends could help prevent occlusal interference. After 2 years and 11 months of active treatment, a desirable Class I occlusion was successfully achieved without permanent tooth extraction.
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Affiliation(s)
- Yukiko Morita
- Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yoshiyuki Koga
- Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tuan Anh Nguyen
- Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Noriaki Yoshida
- Department of Orthodontics and Dentofacial Orthopedics, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Okihara H, Ono T. Correction of bilateral heavily impacted second molar with improved super-elastic nickel-titanium alloy wires. Am J Orthod Dentofacial Orthop 2020; 158:114-125. [PMID: 32600748 DOI: 10.1016/j.ajodo.2019.03.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/08/2019] [Accepted: 03/23/2019] [Indexed: 11/16/2022]
Abstract
Impaction and an abnormal eruption of a second molar occur because of a lack of retromolar space, premature eruption of the mandibular third molar, and ankyloses. The prognosis must be carefully considered when extracting a damaged permanent tooth. In addition to extraction for orthodontics, this enables the establishment of an effective force system to align the impacted tooth. A 21-year-old woman exhibited maxillary anterior crowding, deviation of the maxillary midline, and deeply impacted mandibular second molars bilaterally. The molar relationship was Class II. The cephalometric analysis demonstrated a skeletal Class I relationship (ANB angle, 1.4°); maxillary and mandibular incisors were lingually inclined. Cone-beam computed tomography images indicated that root resorption, caries, and periodontitis were absent in all mandibular molar. Mandibular second premolars were extracted to relieve crowding and achieve Class I molar relationships. The second molars moved mesially on both sides, and there were no signs of ankylosis. We used improved super-elastic nickel-titanium alloy wire (ISW) to upright the mesioangular second molars. We heat-treated the anterior portion of the ISW, including the first molar area, to increase wire stiffness; the posterior portion of the ISW, including the impacted second molar area, remained untreated to ensure that its super-elasticity was preserved. We alleviated crowding, corrected the maxillary midline, and created ideal occlusion with Class I relationship. This case shows that the alignment of a deeply impacted tooth with a heat-treated ISW, combined with voluntary adjustment of wire stiffness, can be a simple and useful treatment option for adult patients.
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Affiliation(s)
- Hidemasa Okihara
- Department of Orthodontic Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
| | - Takashi Ono
- Department of Orthodontic Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Baik UB, Choi HB, Kim YJ, Lee DY, Sugawara J, Nanda R. Change in alveolar bone level of mandibular second and third molars after second molar protraction into missing first molar or second premolar space. Eur J Orthod 2019; 41:513-518. [PMID: 30715310 PMCID: PMC6754516 DOI: 10.1093/ejo/cjz001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective To investigate the factors associated with the change in alveolar bone level of mandibular second and third molars after second molar protraction into the space of the missing first molar (L6) or second premolar (LE). Methods Fifty-one patients in whom space of the missing L6 or LE was treated with second molar protraction (13 males, 38 females, mean age 19.6 ± 4.7 years) from 2003 to 2015 were included. The alveolar bone level and position and angulation of the mandibular second and third molars were measured in panoramic radiographs at pre-treatment (T1), and after the alignment of the third molars following second molar protraction (T2). Factors associated with alveolar bone loss on the distal aspect of the mandibular second molars were assessed using linear regression analysis. Results Age at T1 (P < 0.001) and third molar angulation at T1 (P = 0.002) were significant factors for the prediction of alveolar bone level distal to the second molars. Limitation This study used two-dimensional panoramic radiographs, and we could observe only the interproximal bone level. Conclusions After second molar protraction into the missing first molar or second premolar space, mandibular second molars may exhibit alveolar bone resorption in the distal root in older patients and in those with mesially tilted third molars before treatment.
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Affiliation(s)
| | | | - Yoon-Ji Kim
- Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University, Seoul, Korea
| | - Dong-Yul Lee
- Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University, Seoul, Korea
| | - Junji Sugawara
- SAS Orthodontic Center, Ichiban-Cho Dental Clinic, Sendai, Japan
| | - Ravindra Nanda
- Division of Orthodontics, School of Dental Medicine, University of Connecticut, Farmington, CT, USA
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First and second permanent molars with failed or delayed eruption: Clinical and statistical analyses. Am J Orthod Dentofacial Orthop 2019; 156:355-364. [PMID: 31474265 DOI: 10.1016/j.ajodo.2018.09.020] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 09/01/2018] [Accepted: 09/01/2018] [Indexed: 11/23/2022]
Abstract
INTRODUCTION The aim of this work was to analyze data of patients with failed or delayed eruption of first and second permanent molars, to assess the effectiveness of the treatment methods used. METHODS Epidemiologic and clinical data of 125 patients (mean age 14.08 ± 4.04 years) with 197 affected molars (30 first and 167 second molars) were retrospectively analyzed. The treatment outcome was known in 161 molars after patient drop-out (20 patients with 36 molars). The cases were categorized into 8 groups according to the choice of treatment: orthodontic uprighting, surgical-orthodontic uprighting, surgical uprighting, surgical repositioning, surgical exposure, first or second molar extraction, third molar extraction, or removal of pathologic conditions. RESULTS The overall treatment outcome was positive in 141 molars (87.6%). It was positive in all cases treated with orthodontic uprighting (7 molars), surgical exposure (10 molars), surgical uprighting (38 molars), and surgical repositioning (8 molars), but it was significantly lower for surgical-orthodontic uprighting (34/48 molars, 70.8%). The positive outcome was significantly lower for inclusion (52/68 molars, 76.5%) than for early-diagnosed condition (11/11 molars, 100%) and retention (78/82 molars, 95.1%), and for total bone crown coverage (21/28 molars, 75.0%) than for osteomucosal or mucosal crown coverage (120/133 molars, 90.2%). CONCLUSIONS This study demonstrates that an early diagnosis results in a better outcome regardless of the treatment used, with the number of cases with a positive outcome being higher in younger patients.
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