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Wang Y, Zhou S, Zheng J, Yan L, Ngan P, Hua F, He H. Comparison of treatment effects between clear aligners and fixed appliances in patients treated with miniscrew-assisted molar distalization. Eur J Orthod 2024; 46:cjae021. [PMID: 38733349 DOI: 10.1093/ejo/cjae021] [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: 05/13/2024]
Abstract
OBJECTIVES The biomechanics in achieving molar distalization may differ between fixed appliances and clear aligners in the control of tooth movement. The objective of this study was to compare the treatment effects between clear aligners (CA) and fixed appliances (FA) in patients treated with miniscrew-assisted molar distalization. METHODS The sample consisted of 46 subjects with mild-to-moderate crowding. A total of 22 patients treated with clear aligners (age, 25.66 ± 6.11 years old) and 24 patients treated with fixed appliances (age, 24.04 ± 4.95 years old) for miniscrew-assisted molar distalization were included in this study. The dental and skeletal changes were evaluated by the pre- and post-treatment lateral cephalograms. RESULTS Significant changes were found with the vertical variables SN-OP angle (2.24 ± 3.22°, P < .05) and SN-MP angle (0.73 ± 1.15°, P < .05) for the FA group when compared with the CA group (SN-OP angle 0.41 ± 2.26° and SN-MP angle -0.21 ± 1.38°, P > .05). Both treatment groups achieved a 2-3 mm. molar distalization with significant intrusion of the upper molars. The CA group showed significantly less distal tipping of molars (U6^PP angle -2.29 ± 3.29° and L6^MP angle -2.92 ± 2.49°, P < .05) compared to the FA group (-5.24 ± 4.28° and -5.53 ± 5.03°, P < .05). In addition, significant retraction and lingual inclination of the upper and lower incisors were found in both groups. LIMITATIONS The changes of tooth position were evaluated by 2D lateral cephalograms, not 3D measurements. CONCLUSIONS Compared to fixed appliances, clear aligners seemed to have better control of vertical dimension and distal tipping of molars in patients treated with miniscrew-assisted molar distalization.
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Affiliation(s)
- Yunlei Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Shunquan Zhou
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jie Zheng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Lin Yan
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Peter Ngan
- Department of Orthodontics, West Virginia University, Morgantown, WV, United States
| | - Fang Hua
- Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom
| | - Hong He
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Center for Dentofacial Development & Sleep Medicine, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Orthodontics, School & Hospital of Stomatology, Wuhan University, Wuhan, China
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Schwertner A, de Almeida-Pedrin RR, Poleti TMFF, Oltramari P, de Castro Conti ACF, Cotrim-Ferreira FA, de Almeida G, Flores-Mir C, de Almeida MR. Biomechanical analysis of total arch maxillary distalization using infrazygomatic crest miniscrews: a finite element analysis study. Prog Orthod 2024; 25:10. [PMID: 38462550 PMCID: PMC10925583 DOI: 10.1186/s40510-024-00509-3] [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: 07/17/2023] [Accepted: 12/30/2023] [Indexed: 03/12/2024] Open
Abstract
AIM To evaluate the maxillary incisors and canine's immediate movement tendency using three different power arms (PA) height levels during total arch maxillary distalization supported on infrazygomatic crest (IZC) miniscrews according to finite element analysis (FEA). METHODS Three finite element models of the maxilla were developed based on CBCT imaging of a teenage male patient presenting a Class II Division 1 malocclusion in the early permanent dentition. Maxillary complex, periodontium, orthodontic accessories, IZC miniscrews and an orthodontic wire were digitally created. The PAs were placed between canines and lateral incisors and projected at 4, 7, and 10 mm height distances. After that, distalization forces were simulated between PA and IZC miniscrews. RESULTS The anterior teeth deformation produced in the FEA models was assessed according to a Von Mises equivalent. The stress was measured, revealing tendencies of initial maxillary teeth movement. No differences were found between the right and left sides. However, there was a significant difference among models in the under-stress areas, especially the apical and cervical root areas of the maxillary anterior teeth. More significant extrusion and lingual tipping of incisors were observed with the 4 mm power arm compared to the 7 mm and 10 mm ones. The 10 mm power arm did not show any tendency for extrusion of maxillary central incisors but a tendency for buccal tipping and intrusion of lateral incisors. CONCLUSION The maxillary incisors and canines have different immediate movement tendencies according to the height of the anterior point of the en-masse distalization force application. Based on the PA height increase, a change from lingual to buccal tipping and less extrusion tendency was observed for the incisors, while the lingual tipping and extrusion trend for canines increased.
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Affiliation(s)
- Alessandro Schwertner
- Post-Doctorate Student, Department of Orthodontics, University of North Paraná, UNOPAR, Londrina, PR, Brazil
| | | | | | - Paula Oltramari
- Department of Orthodontics, University of North Parana, UNOPAR, Londrina, PR, Brazil
| | | | | | - Guilherme de Almeida
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Uberlândia, Uberlândia, MG, Brazil
| | - Carlos Flores-Mir
- Division of Orthodontics, University of Alberta, Edmonton, AB, Canada
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Mohammed Bahaa El-Din A, Abd El Khaliq Hendy K, Elghetany Mohamed R, Abouelnour A, Mohamed Ali M, Akram El-Awady A, Ahmed Hussein F. Pain Intensity of Skeletally Anchored Maxillary Molar Distalization in Conjunction with Micro-osteoperforations: A Randomized Clinical Trial. Cureus 2024; 16:e53527. [PMID: 38445137 PMCID: PMC10912477 DOI: 10.7759/cureus.53527] [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: 02/03/2024] [Indexed: 03/07/2024] Open
Abstract
Objective To assess pain intensity levels during orthodontic therapy of Class II malocclusion patients undergoing skeletally anchored maxillary molar distalization assisted with different micro-osteoperforation (MOP) approaches. Methods Twenty-seven patients (12 males and 18 females) with a mean age of 16.1 ± 0.3 years were randomized into three equal groups (n=9): Group 1 comprised MOPs on buccal surface, Group 2 comprised MOPs on buccal and palatal surface, and Group 3 comprised the control or no-MOP group. The patients underwent maxillary molar distalization using skeletally anchored distal jet appliance assisted with or without MOPs. The MOPs were applied repeatedly on the buccal and buccal and palatal sides, or no MOP (control). Pain intensity was assessed using a 10 cm visual analog scale after each device activation at 24, 48, 72 hours, and at seven days. Data were analyzed using one-way ANOVA and repeated measures ANOVA for non-paired and paired means. Results Both approaches of buccal and buccal and palatal application of MOPs showed statistically significant (p< 0.01) higher levels of pain intensity after the first activation at 24 hours. Nevertheless, pain intensity levels decreased significantly in both MOP groups and between the two activations. Conclusion The repeated application of MOPs on either the buccal side only or on both buccal and palatal sides during maxillary molar distalization did not affect the levels of pain experienced; however, these levels were reported to be higher than that obtained in the control group. Moreover, it is observed that these pain levels tend to gradually reduce to mild levels over the subsequent days.
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Affiliation(s)
| | | | | | - Ahmed Abouelnour
- Department of Orthodontics, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo, EGY
| | - Mohamed Mohamed Ali
- Department of Orthodontics, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo, EGY
| | - Ahmed Akram El-Awady
- Department of Orthodontics, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo, EGY
| | - Farouk Ahmed Hussein
- Department of Orthodontics, Faculty of Dental Medicine (Boys), Al-Azhar University, Cairo, EGY
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Cheng L, Feng Z, Hao Z, Si M, Yuan R, Feng Z. Molar distalization in orthodontics: a bibliometric analysis. Clin Oral Investig 2024; 28:123. [PMID: 38286861 PMCID: PMC10824817 DOI: 10.1007/s00784-024-05520-w] [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: 09/26/2023] [Accepted: 01/17/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVES The study endeavors to undertake a bibliometric analysis on molar distalization, with the objective of illuminating its evolutionary trajectory, current status, and prognosticating future research hotspots and trends. MATERIAL AND METHODS A comprehensive exploration of the literature on molar distalization was carried out by conducting a search in the Web of Science (WOS) core database of the University of Hong Kong Electronic Library. The search for topic terms employed included "molar distalization," "molar distalisation," "move molar distally," "molar distal movement," and "molar backwards." The search results were subsequently subjected to meticulous analysis using CiteSpace software. This analysis encompassed various facets such as the citation count; the geographical distribution of the countries, institutions, and journals responsible for publishing the articles; the distribution of the authors; the utilization of keywords within the articles; and the analysis of references. RESULTS A total of 516 articles were included in the analysis. The top 5 countries in terms of the number of published papers were the United States (USA), South Korea, Turkey, Italy, and Germany, and the top 5 institutions in terms of the number of published papers were Kyung Hee University, A.T. Still University of Health Sciences, Catholic University of Korea, Seoul St. Mary's Hospital, and Universidade de Sao Paulo. The top 5 authors in terms of the number of published papers were Park, Kook, Bayome, Janson, and Lee. There was little cooperation overall. The top 3 journals in terms of the most published related articles were all orthodontic-related journals. After molar distalization and anchorage, the most frequently used keywords were distalization, movement, and pendulum appliance. Kinzinger GSM is the most frequently cited author in references, and one of his articles also has the highest centrality score in references. CONCLUSIONS As the tides of time shift and scholars display an ever-growing dedication to unraveling the intricacies of this therapeutic modality, the realm of molar distalization has undergone notable advancements in technology. Initially, the traditional appliance suffered from aesthetic drawbacks and discomfort. However, contemporary iterations of the appliance have transcended these limitations, boasting enhanced elegance and convenience while concurrently elevating their efficacy. Nevertheless, limitations of current appliances, including their durability and propensity for recurrence post-treatment, continue to necessitate further advancement. Hence, the ongoing scientific inquiry aims to delve deeper into refining treatment modalities and fabricating cutting-edge appliances within this realm. CLINICAL RELEVANCE This study holds the potential to significantly enhance the ability of orthodontists to devise treatment protocols and offer state-of-the-art clinical recommendations, thereby empowering them to deliver advanced and refined orthodontic interventions.
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Affiliation(s)
- Lin Cheng
- Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Zezhou Feng
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Zhaonan Hao
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Minmin Si
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Rui Yuan
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, School and Hospital of Stomatology, Shanxi Medical University, Taiyuan, China
| | - Zhiyuan Feng
- Department of Orthodontics, Shanxi Provincial People's Hospital, The Fifth Clinical Medical College of Shanxi Medical University, Taiyuan, China.
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Ceratti C, Serafin M, Del Fabbro M, Caprioglio A. Effectiveness of miniscrew-supported maxillary molar distalization according to temporary anchorage device features and appliance design: systematic review and meta-analysis. Angle Orthod 2024; 94:107-121. [PMID: 37870251 DOI: 10.2319/052223-364.1] [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: 05/01/2023] [Accepted: 08/01/2023] [Indexed: 10/24/2023] Open
Abstract
OBJECTIVES To evaluate the effectiveness of distalizing maxillary first molars (U6) by temporary anchorage devices (TADs) according to their location (palatal, buccal, and zygomatic), their number, and appliance design. MATERIALS AND METHODS An electronic search of maxillary molar distalization with TADs was done through April 2023. After study selection, data extraction, and risk-of-bias assessment, meta-analyses were performed for the extent of distalization, distal tipping, and vertical movement of U6 using the generic inverse variance and random-effects model. The significance level was set at 0.05. RESULTS Forty studies met the inclusion criteria: 4 randomized controlled trials (RCTs), 13 prospective studies, and 23 retrospective studies (total of 1182 patients). Distalization of the U6 was not significantly greater (P = .64) by palatal (3.74 mm) and zygomatic (3.68 mm) than by buccal (3.23 mm) TADs. Distal tipping was significantly higher (P < .001) in nonrigid (9.84°) than in rigid (1.97°) appliances. Vertical movement was mostly intrusive and higher but not significantly different (P = .28) in zygomatic anchorage (-1.16 mm). CONCLUSIONS Distalization of U6 with TADs can be an effective and stable treatment procedure, especially when performed with rigid palatal appliances. However, further RCTs or prospective cohort studies are strongly recommended to provide more clinical evidence.
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Huh J, Liu J, Yu JH, Choi YJ, Ahn HK, Chung CJ, Cha JY, Kim KH. Three-dimensional evaluation of a virtual setup considering the roots and alveolar bone in molar distalization cases. Sci Rep 2023; 13:14955. [PMID: 37696835 PMCID: PMC10495328 DOI: 10.1038/s41598-023-41480-z] [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: 05/23/2023] [Accepted: 08/27/2023] [Indexed: 09/13/2023] Open
Abstract
We aimed to evaluate root parallelism and the dehiscence or fenestrations of virtual teeth setup using roots isolated from cone beam computed tomography (CBCT) images. Sixteen patients undergoing non-extraction orthodontic treatment with molar distalization were selected. Composite teeth were created by merging CBCT-isolated roots with intraoral scan-derived crowns. Three setups were performed sequentially: crown setup considering only the crowns, root setup-1 considering root alignment, and root setup-2 considering the roots and surrounding alveolar bone. We evaluated the parallelism and exposure of the roots and compared the American Board of Orthodontics Objective Grading System (ABO-OGS) scores using three-dimensionally printed models among the setups. The mean angulation differences between adjacent teeth in root setups-1 and -2 were significantly smaller than in the crown setup, except for some posterior teeth (p < 0.05). The amount of root exposure was significantly smaller in root setup-2 compared to crown setup and root setup-1 except when the mean exposure was less than 0.6 mm (p < 0.05). There was no significant difference in ABO-OGS scores among the setups. Thus, virtual setup considering the roots and alveolar bone can improve root parallelism and reduce the risk of root exposure without compromising occlusion quality.
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Affiliation(s)
- Jaewook Huh
- Department of Orthodontics, Yonsei University College of Dentistry, Seoul, Korea
| | - Jing Liu
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - Jae-Hun Yu
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - Yoon Jeong Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea
| | - Hee-Kap Ahn
- Graduate School of Artificial Intelligence, Department of Computer Science and Engineering, Pohang University of Science and Technology, Pohang, Korea
- Institute for Convergence Research and Education in Advanced Technology, Yonsei University, Seoul, Korea
| | - Chooryung J Chung
- Department of Orthodontics, Institute of Craniofacial Deformity, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea
| | - Jung-Yul Cha
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Institute for Innovation in Digital Healthcare, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
| | - Kyung-Ho Kim
- Department of Orthodontics, Institute of Craniofacial Deformity, Gangnam Severance Dental Hospital, College of Dentistry, Yonsei University, Seoul, Korea.
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Okawa K, Matsunaga S, Kasahara N, Kasahara M, Tachiki C, Nakano T, Abe S, Nishii Y. Alveolar Bone Microstructure Surrounding Orthodontic Anchor Screws with Plasma Surface Treatment in Rats. J Funct Biomater 2023; 14:356. [PMID: 37504851 PMCID: PMC10381738 DOI: 10.3390/jfb14070356] [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: 06/18/2023] [Revised: 07/04/2023] [Accepted: 07/05/2023] [Indexed: 07/29/2023] Open
Abstract
A lateral load was applied to anchor screws that had undergone surface treatment, and the structure, cellular dynamics, and quality of the bone surrounding anchor screws were analyzed to investigate the effect of this surface treatment on the peri-implant jawbone. In addition, bone microstructural characteristics were quantitatively evaluated for each site of loading on the bone around the anchor screw. Rats were euthanized after observation on days 3, 5, or 7, and bone quality analyses were performed. Bone-implant contact rate increased more rapidly at an early stage in the treated surface group than in the untreated surface group. Bone lacuna morphometry showed that the measured values adjacent to the screw at the screw neck on the compressed side (A) and at the screw tip on the uncompressed side (D) were significantly lower than those at the screw tip on the compressed side (B) and at the screw neck on the uncompressed side (C). Collagen fiber bundle diameter showed that the measured values adjacent to regions A and D were significantly higher than those at regions B and C. Anchor screw surface activation facilitates initial bone contact of the screw, suggesting that early loading may be possible in clinical practice.
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Affiliation(s)
- Keisuke Okawa
- Department of Orthodontics, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Satoru Matsunaga
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Norio Kasahara
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- Department of Histology and Developmental Biology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Masaaki Kasahara
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- Department of Dental Materials Science, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Chie Tachiki
- Department of Orthodontics, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Takayoshi Nakano
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1, Yamadaoka, Suita 565-0871, Japan
| | - Shinichi Abe
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
| | - Yasushi Nishii
- Department of Orthodontics, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
- Oral Health Science Center, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
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Ji L, Li B, Wu X. Evaluation of biomechanics using different traction devices in distalization of maxillary molar with clear aligners: a finite element study. Comput Methods Biomech Biomed Engin 2023; 26:559-567. [PMID: 35543236 DOI: 10.1080/10255842.2022.2073789] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The study aimed to mechanically evaluate the tooth displacement of molar distalization by clear aligners combined with micro-implant through different traction devices using finite element analysis. A three-dimensional finite element model of complete maxillary dentition was constructed. Simultaneously move the maxillary first and second molars 0.2 mm distally at the height of 4 mm and 6 mm of micro-implant, and 150 g force was applied to button, precision cut and angelbutton respectively. Initial tooth movement in six different conditions of anterior tooth and molars was analyzed and calculated with ANSYS software. All the upper anterior tooth exhibited uncontrolled labial tipping and intrusion upon the six conditions, and the central incisor showed the largest tendency of crown labial inclination. Among the absolute values of crown-root displacement difference of the anterior tooth in sagittal direction, the angelbutton was the smallest, which means the torque control ability was superior to others. However, button played a more accurate role in the sagittal and vertical control of canine. With the increase of micro-implant height, the torque control ability of anterior tooth was decreased, but the intrusion trend increased. The controlled distal inclination with extrusion of the first molar and uncontrolled distal inclination with intrusion of the second molar were observed, and the angelbutton had more effective horizontal and vertical control on molars, which was close to bodily movement than others. As a new type of traction device, angelbutton has excellent anchorage control effect in clear aligners therapy of molar distalization, which further realizes the accurate expression of orthodontic force.
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Affiliation(s)
- Lili Ji
- Dental Hospital of Shanxi Medical University, Taiyuan, P. R. China
| | - Bing Li
- Dental Hospital of Shanxi Medical University, Taiyuan, P. R. China
| | - Xiuping Wu
- Dental Hospital of Shanxi Medical University, Taiyuan, P. R. China
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Kovuru V, Aileni KR, Mallepally JP, Kumar KS, Sursala S, Pramod V. Factorial analysis of variables affecting bone stress adjacent to mini-implants used for molar distalization by direct anchorage-A finite element study. J Orthod Sci 2023; 12:18. [PMID: 37351414 PMCID: PMC10282530 DOI: 10.4103/jos.jos_77_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: 08/25/2022] [Revised: 10/25/2022] [Accepted: 11/10/2022] [Indexed: 06/24/2023] Open
Abstract
OBJECTIVE The aim of this study was to investigate the stresses on mini-implant, cortical bone, and cancellous bone for maxillary molar distalization using an orthodontic implant in a finite element model for different angulations and depths of insertion. METHODS A three-dimensional finite element method was used to simulate overall orthodontic tooth movements by using ANSYS software. The maxillary bone and the molars were reproduced using CT scan images and conversion of the same into STL file was done. Finite element model was generated and the effect of forces was studied on the model for different depths and angulations of mini-implant insertions. The distalization force was exerted by an open-coil spring and the direct skeletal anchorage was provided by a mini-implant. Mini-implants were placed in depths of 5 mm, 7 mm, and 9 mm inside the bone and insertion angles of 30°, 60°, and 90°. Stresses on mini-implant and extent of stress on the surrounding bone were assessed by the software. RESULTS 1. Least stress was found when the mini-implant was inserted at an angle of 30°, as it is nearer to the stronger cortical bone. 2. As the length of the mini-implant increases, accompanied by the increase in the depth of insertion, a decrease in stress in the mini-implant, cortical bone, and cancellous bone was noticed. CONCLUSION An increase in the insertion angle from 30° to 90° increases the stresses on both the implant and the cortical bone. A higher depth of thread in the bone helps in reducing the stress on the implant, cortical bone, and cancellous bone. This helps in improving the primary stability of the mini-implant and its life.
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Affiliation(s)
- Veena Kovuru
- Department of Orthodontics and Dentofacial Orthopedics, SVS Institute of Dental Sciences, Appanapally, Yenugonda, Mahabubnagar, Telangana, India
| | - Kaladhar R. Aileni
- Department of Orthodontics and Dentofacial Orthopedics, SVS Institute of Dental Sciences, Appanapally, Yenugonda, Mahabubnagar, Telangana, India
| | - Jaya P. Mallepally
- Department of Orthodontics and Dentofacial Orthopedics, SVS Institute of Dental Sciences, Appanapally, Yenugonda, Mahabubnagar, Telangana, India
| | - K. Siva Kumar
- Department of Orthodontics and Dentofacial Orthopedics, SVS Institute of Dental Sciences, Appanapally, Yenugonda, Mahabubnagar, Telangana, India
| | | | - Vattipalli Pramod
- Department of Orthodontics and Dentofacial Orthopedics, SVS Institute of Dental Sciences, Appanapally, Yenugonda, Mahabubnagar, Telangana, India
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Zheng DH, Hou FC, Zang YJ, Li B. Effects of low-level laser therapy on orthodontic miniscrew stability: a systematic review. Eur J Med Res 2023; 28:50. [PMID: 36707888 PMCID: PMC9881366 DOI: 10.1186/s40001-023-01010-z] [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: 10/03/2021] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Miniscrews as auxiliary anchorage devices in orthodontic treatment have definite advantages and efficacy. The aim of the present study was to investigate the scientific evidence including randomized controlled trials (RCTs) or controlled clinical trials (CCTs) to support the application of low-level laser therapy to improve miniscrews stability in orthodontic treatment. METHODS An extensive literature research was conducted with the Cochrane Library, PubMed, EMBASE, Web of Science and ScienceDirect without language limitations. All searches were inclusive until June 2020. The Cochrane Risk of Bias Tool was used to assess the risk of bias (RoB) in the included RCTs. RESULTS Through the electronic searches, 428 titles and abstracts were identified. From these, 4 articles were retrieved for review, and 3 of these met the inclusion criteria. Two RCTs reported increased miniscrews stability with low-intensity laser therapy, but the other one reported no difference. Except one study assessed as "high risk of bias" the other two were rated as "low risk of bias". CONCLUSION There is insufficient evidence to support or refute the effectiveness of LLLT for improvement of miniscrew stability. Further studies with a better study design, reliable evaluation method, comprehensive evaluation intervals and appropriate loading protocol are required to provide more reliable evidence for the clinical application of LLLT.
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Affiliation(s)
- De-Hua Zheng
- grid.410645.20000 0001 0455 0905Department of Orthodontics, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, Shandong People’s Republic of China
| | - Feng-Chun Hou
- grid.410645.20000 0001 0455 0905Department of Orthodontics, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, Shandong People’s Republic of China
| | - Yan-Jun Zang
- grid.410645.20000 0001 0455 0905Department of Orthodontics, Qingdao Stomatological Hospital Affiliated to Qingdao University, Qingdao, Shandong People’s Republic of China
| | - Bing Li
- grid.410645.20000 0001 0455 0905Department of Genetics and Cell Biology, Basic Medical College, Qingdao University, Qingdao, China ,grid.412521.10000 0004 1769 1119Department of Hematology, The Affiliated Hospital of Qingdao University, Qingdao, China ,No. 306, Ningxia Road, Shinan District, Qingdao, 266000 Shandong China
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Rosa WGN, de Almeida-Pedrin RR, Oltramari PVP, de Castro Conti ACF, Poleti TMFF, Shroff B, de Almeida MR. Total arch maxillary distalization using infrazygomatic crest miniscrews in the treatment of Class II malocclusion: a prospective study. Angle Orthod 2023; 93:41-48. [PMID: 36126679 DOI: 10.2319/050122-326.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/01/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To evaluate treatment effects in Class II patients using infrazygomatic crest (IZC) miniscrews (MS). MATERIALS AND METHODS A prospective sample of 25 adolescents (14 females and 11 males; mean age: 13.6 ± 1.5 years) who underwent maxillary dentition distalization treatment with IZC MSs were recruited. Lateral cephalograms and digital models at the beginning of treatment (T1) and after Class II molar correction (T2) were obtained. To compare cephalometric and digital model changes, paired t-test and Wilcoxon test were used. A significance level of 5% was used. RESULTS All patients achieved Class II molar correction over a mean period of 7.7 ± 2.5 months. The IZC MS therapy provided 4 mm of distalization; there was 1.2 mm of intrusion of the first molar with 11.2° distal tipping. The maxillary incisors were retracted 4.7 mm and tipped lingually 13.4°. Overjet and overbite showed a reduction of 3.6 mm and 2.4 mm, respectively. The occlusal plane rotated clockwise 2.8°. The upper lip was retracted by 1 mm and the nasolabial angle increased 5.1°. There was an increase in the interpremolar and intermolar distances. CONCLUSIONS Total arch distalization of the maxillary dentition using IZC MS was effective in the treatment of Class II malocclusions.
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Booij JW, Fontana M, Serafin M, Fastuca R, Kuijpers-Jagtman AM, Caprioglio A. Treatment outcome of class II malocclusion therapy including extraction of maxillary first molars: a cephalometric comparison between normodivergent and hyperdivergent facial types. PeerJ 2022; 10:e14537. [PMID: 36530416 PMCID: PMC9753754 DOI: 10.7717/peerj.14537] [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: 08/15/2022] [Accepted: 11/17/2022] [Indexed: 12/14/2022] Open
Abstract
Background The dentoalveolar component of a Class II division 1 malocclusion can be orthodontically treated either with extractions or by distalization of the molars. This study aimed to compare skeletal, dentoalveolar and profile changes in normodivergent and hyperdivergent Class II Division I growing patients orthodontically treated with fixed appliances including maxillary first molar extraction. Methods Sixty-four patients treated orthodontically with full fixed appliances including maxillary first molar extractions were retrospectively analyzed. Patients were divided into a normodivergent group (Group N; 30° ≤ SN^GoGn < 36°) consisting of 38 patients (17M, 21F; mean age 13.2 ± 1.3 years) and a hyperdivergent (Group H; SN^GoGn ≥ 36°) including 26 patients (12M, 14F; mean age 13.7 ± 1.1 years). Lateral cephalograms were available before (T0) and after treatment (T1) and cephalometric changes were calculated for 10 linear and 13 angular variables. The Shapiro-Wilk test confirmed a normal distribution of data, hence parametric tests were employed. The Student t-test was used to compare groups at baseline. The paired t-test was used to analyze intragroup changes between timepoints, and the Student t-test for intergroup comparisons. The level of significance was set at 0.05. Results The Class II division 1 malocclusion was successfully corrected, and the facial profile improved both in normodivergent and hyperdivergent patients. Divergency increased by 0.76 ± 1.99° in Group N (p = 0.02) while it decreased -0.23 ± 2.25° (p = 0.60); These changes were not significant between groups after treatment (p = 0.680). Most dentoskeletal measurements changed significantly within groups but none of them showed statistically significant differences between groups after treatment. Dental and soft tissue changes were in accordance with the biomechanics used for this Class II orthodontic therapy. Discussion The effect of orthodontic treatment of Class II division 1 malocclusion including extraction of the maxillary first molars in growing patients can be considered clinically equivalent in normodivergent and hyperdivergent patients. For this reason, this orthodontic treatment can be considered a viable option in the armamentarium of the Class II Division I therapy for both facial types.
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Affiliation(s)
| | | | - Marco Serafin
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | | | - Anne Marie Kuijpers-Jagtman
- Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia,Department of Orthodontics and Dentofacial Orthopedics, University of Berne, Berne, Switzerland,Department of Orthodontics, University of Groningen, Groningen, Netherlands
| | - Alberto Caprioglio
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy,Fondazione IRCCS Cà Granda, Milan, Italy
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Greco M, Rossini G, Rombolà A. G-Block: Posterior anchorage device tads-supported after molar distalization with aligners: An adult case report. Int Orthod 2022; 20:100687. [PMID: 36153240 DOI: 10.1016/j.ortho.2022.100687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/14/2022] [Accepted: 08/15/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Temporary anchorage devices represent a fundamental tool to reliably manage orthodontic anchorage in several conditions. One of the most recent application is represented by the combination of aligners with TADs to simplify specific movements such as posterior intrusion, anterior intrusion, molars distalization. The objective of this case report is to show a novel technique called "G-block" to manage posterior anchorage with a hybrid approach combining aligners and TADs. MATERIALS AND METHODS This case report shows a Class II malocclusions (end to end relationship) with increased overjet and incisors proclination treated with aligners and maxillary distalization approach. To manage the posterior anchorage after second molar distalization and to avoid the use of Class II elastics, TADs (Spider Pin 1.3mm×10mm) were inserted into the interradicular space between the maxillary first and second molars following second molar distalization. The mini screws were used to provide both direct and indirect anchorage. The second molars were connected to the TAD by means of a 0.18 SS wire embedded in the attachment and blocked to the head of the mini-screw for indirect anchorage, while an elastic chain connecting the TADs to the buttons bonded to the first molars and premolars provided direct anchorage during first molar and premolar distalization. RESULTS A solid bilateral Class I occlusion was achieved with a normal overjet and overbite. The dental arches were well aligned and leveled with good intra-arch symmetry and regular arch forms. Final cephalometric analysis showed a significant change in upper incisor proclination (15̊ reduction) while maintaining correct torque control and a significant change in molar relationship. The aesthetic analysis showed an improvement in lip competence and incisor exposure. CONCLUSION The use of TADs for posterior anchorage after maxillary molar distalization with aligners, could represent an effective solution to easily manage the posterior anchorage reducing the need for patient's compliance in using elastics and in particular simplifying the posterior teeth movements by coupling the force expressed from the aligners with the force expressed by the auxiliary system.
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Affiliation(s)
- Mario Greco
- Department of Paediatric Dentistry, University of L'Aquila, L'Aquila, Italy; Private Practice, Rome, Italy.
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Tunçer Nİ, Arman-Özçırpıcı A. Clinical effectiveness of buccally and palatally anchored maxillary molar distalization: The miniscrew-supported 3-dimensional maxillary bimetric distalizing arch vs the Beneslider. Am J Orthod Dentofacial Orthop 2022; 162:e337-e348. [DOI: 10.1016/j.ajodo.2022.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 09/01/2022] [Accepted: 09/01/2022] [Indexed: 11/26/2022]
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Lim HJ, Kim Y, Park JH, Lee NK, Kim KB, Kook YA. Cephalometric and model evaluations after molar distalization using modified C-palatal plates in patients with severe arch length discrepancy. Am J Orthod Dentofacial Orthop 2022; 162:870-880. [PMID: 36117031 DOI: 10.1016/j.ajodo.2021.07.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This study aimed to evaluate the dentoskeletal and soft-tissue changes after molar distalization using modified C-palatal plates in patients with severe maxillomandibular arch length discrepancies. METHODS Twenty-four patients with Class I and II malocclusion (19.0 ± 7.3 years; 17 females and 8 males), who had severe maxillary crowding of >10 mm, and moderate mandibular crowding of >6 mm, underwent molar distalization using modified C-palatal plates and buccal miniscrews with approximately 300 g of force per side. Models were made, and cephalograms were taken before and after treatment. Cephalometric variables and arch dimensions were measured. Paired t test and Wilcoxon rank sum test were used for statistical analysis. RESULTS In the maxillary dentition, an average of 12.4 mm of crowding was resolved by molar distalization of 4.4 mm, interproximal stripping of 0.7 mm, and arch expansion. In the mandibular dentition, crowding of 6.7 mm was alleviated by molar distalization of 2.4 mm, an interproximal of 1.5 mm, and additional arch expansion. The incisor positions were maintained (SN-U1, 101.3°; IMPA, 88.8°), and soft-tissue profiles were improved (LL/E-line -1.1 mm; P < 0.001) after treatment. CONCLUSIONS Maxillary and mandibular tooth-size arch length discrepancy of 12.4 mm and 6.7 mm, respectively, were resolved by molar distalization, interproximal reduction, and arch expansion, whereas incisor positions were maintained, and soft-tissue profiles were improved. This could be a viable treatment option in patients with moderate-to-severe crowding.
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Affiliation(s)
- Hee Jin Lim
- Department of Orthodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Yoonji Kim
- Department of Orthodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Ariz Graduate School of Dentistry, Kyung Hee University, Seoul, South Korea
| | - Nam-Ki Lee
- Department of Orthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ki Beom Kim
- Department of Orthodontics, Saint Louis University, St Louis, Mo
| | - Yoon-Ah Kook
- Department of Orthodontics, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
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Raghis TR, Alsulaiman TMA, Mahmoud G, Youssef M. Efficiency of maxillary total arch distalization using temporary anchorage devices (TADs) for treatment of Class II-malocclusions: A systematic review and meta-analysis. Int Orthod 2022; 20:100666. [PMID: 35871982 DOI: 10.1016/j.ortho.2022.100666] [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: 02/05/2022] [Revised: 06/20/2022] [Accepted: 07/01/2022] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To evaluate the treatment effects and post-treatment stability of the maxillary total arch distalization using TADs during the non-extraction treatment of class II malocclusions. MATERIALS AND METHODS Study involved an electronic search followed by hand searching for randomized and non-randomized clinical studies about maxillary total arch distalization using TADs. After data extraction and risk of bias assessment, meta-analysis was performed for dental, skeletal and soft tissue changes using the Generic-inverse variance approach by use of the mean difference and random-effect model. RESULTS In total, 1788 articles were identified, 88 full texts were screened and 22 studies were found eligible; 17 of them were included in the quantitative analysis. The means of distalization/distal tipping of the maxillary first molar were 4mm/3.17° in adults, 3.95mm/1.61° in adolescents after treatment with the Modified C-Palatal plate (MCPP), while they were 2.44mm/2.91° with the inter-radicular mini-screws. Both MCPP's treatment in adults and inter-radicular mini-screws resulted in significant intrusion of U6 (1.64 and 0.75mm, respectively), while insignificant extrusion of U6 was resulted in adolescents treated by MCPP. MCPP appliances resulted in palatal inclination/extrusion of maxillary incisors U1 (6.77°/2mm in adults, 7.46°/3.14mm in adolescents). In contrast, inter-radicular mini-screws resulted in less palatal less amount of palatal inclination/insignificant intrusion of U1 (2.42°/0.14mm). MCPP treatment also resulted in significant changes in the skeletal measurements (SNA, ANB, occlusal and mandibular planes). Insignificant differences were found between subgroups in the retraction amount of maxillary incisors, as well as the upper and lower lips. In the follow-up of adolescents treated with MCPP, a significant amount of mesial movement, mesial tipping, and extrusion (2.94mm, 2.84°, and 3.94mm, respectively) was found. However, skeletal and occlusal corrections of the Class II relationship were maintained. CONCLUSIONS Maxillary total arch distalization using TADs can be an effective and stable treatment procedure. However, RCTs or prospective cohort studies are highly recommended to establish a clinical evidence regarding their efficiency.
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Affiliation(s)
- Tuqa Rashad Raghis
- Department of Orthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria.
| | | | - Ghiath Mahmoud
- Department of Orthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Mohamed Youssef
- Department of Orthodontics, Faculty of Dentistry, Damascus University, Damascus, Syria
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Wang Y, Sun J, Shi Y, Li X, Wang Z. Buccal bone thickness of posterior mandible for microscrews implantation in molar distalization. Ann Anat 2022; 244:151993. [PMID: 36041697 DOI: 10.1016/j.aanat.2022.151993] [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: 01/21/2022] [Revised: 06/04/2022] [Accepted: 08/16/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND This study explored the inter-radicular space and buccal bone thickness of the posterior mandibular region to provide an appropriate miniscrew insertion site for lower dentition distalization. METHODS The cone-beam computed tomographic (CBCT) records of 63 subjects were collected. Buccal bone thickness (BBT) was measured at four sections: (I) the root of the second premolar(P1); (II) the mesial root of the first molar(P2); (III) the distal root of the first molar(P3); (IV) the mesial root of the second molar(P4). The narrowest inter-radicular space of the four sections was also detected. Both BBT and inter-radicular space were measured at 4 height levels, 2, 4, 6 and 8mm from the alveolar ridge. RESULTS The largest BBT was observed at the mesial root of the second molar at 6 and 8mm, demonstrating a thickness of 6.77±2.50mm and 7.46±1.94mm, respectively. It provided sufficient coverage for mini-implants inserted 10°-30° oblique to the root. Therefore, during distalization of the mandibular dentition, roots have sufficient space to bypass the inclined mini-implants on the lingual side, avoiding miniscrew-root contact. The width between the mesiodistal roots of the first molar was the smallest, showing 1.53±0.69mm and 2.13±0.65mm at 4 and 6mm. Miniscrews implanted in this region had an increased risk of root proximity. CONCLUSIONS The most appropriate insertion site at the mandibular buccal shelf was the mesial point of the second molar at 6-8mm from the alveolar ridge, and an insertion angle of 10°-30° was recommended to avoid miniscrew-root contact. CBCT analysis is recommended before implantation due to individual differences.
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Affiliation(s)
- Yaqi Wang
- Department of Orthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Jing Sun
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Yanli Shi
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Xin Li
- Department of Stomatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China.
| | - Zhiqiang Wang
- Department of Orthodontics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 324 Jingwu Road, Jinan, Shandong, China; Department of Orthodontics,Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, 324 Jingwu Road, Jinan, Shandong, China.
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Verma P, George AM. Efficacy of clear aligners in producing molar distalization: Systematic review. APOS TRENDS IN ORTHODONTICS 2022. [DOI: 10.25259/apos_37_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives:
The aim of this review is to systematically analyze the efficacy of molar distalization using clear aligners in non-growing Class II patients.
Materials and Methods:
A complete search across the electronic database through PubMed, Cochrane, Google scholar, LILACS, and manual search of orthodontic journals were done till 2019. Studies were selected on the basis of PRISMA guidelines.
Results:
A total of four articles were included in this review. The amount of molar distalization reported was 2–3 mm.
Conclusion:
Out of the four studies included. In all the studies a significant amount of distalization was reported. Three retrospective studies concluded that distalization with aligners is the most effective of all tooth movements. One study concluded that aligners effectively achieved distalization with an efficacy of 87%, other two studies concluded that aligners effectively distalized the molars with good control over vertical dimension and mesiodistal tipping.
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Affiliation(s)
- Purva Verma
- Department of Orthodontics, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India,
| | - Ashwin Mathew George
- Department of Orthodontics, Saveetha Dental College and Hospital, Chennai, Tamil Nadu, India,
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The effect of third molars on maxillary molar distalisation using a miniscrew-supported 3D® maxillary bimetric distalising arch. AUSTRALASIAN ORTHODONTIC JOURNAL 2022. [DOI: 10.2478/aoj-2022-033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Objectives: The aim of the present study was to investigate the effect of third molars on the efficiency and biomechanics of a novel miniscrew-supported 3D® Maxillary Bimetric Distalising Arch (3D-MBDA).
Methods: Twenty-three patients, whose third molars were either extracted at the beginning of treatment (Group 1, n =11) or retained (Group 2, n =12), were included in the study. Lateral cephalometric films and dental casts, taken at the beginning (T0) and at the end of upper molar distalisation (T1), were analysed to study the differences between groups.
Results: Crown distalisation of the first molars was similar between the groups; however, root distalisation, both at the trifurcation and apex levels, intrusion at the mesiobuccal cusp tip, and the distalisation rate were significantly higher in Group 1. The resultant tipping of the first molars in both groups was mesially-directed, unlike the usual distal tipping. The second molars distalised more, displaced less vestibularly and rotated mesiobuccally in Group 1, whereas they demonstrated a significantly higher vestibular displacement and distobuccal rotation in Group 2. The mean distalisation time was significantly shorter in Group 1 when compared to Group 2. The miniscrew success rate was 95.5% for Group 1 and 91.7% for Group 2.
Conclusion: The miniscrew-supported 3D-MBDA was found to have greater effects on root distalisation and the final inclination of the molars. The third molars were associated with limited root movement, unfavourable displacement of the second molars, as well as a slower distalisation rate. Therefore, the extraction of third molars prior to distalisation is recommended, especially when the miniscrew-supported 3D-MBDA is the appliance choice.
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Matsumoto T, Matsunaga S, Kasahara M, Kasahara N, Nakano T, Ishimoto T, Nishii Y. Evaluation of the Microstructural Characteristics of Bone Surrounding Anchor Screws Placed under a Horizontal Load by Exploring the Orientation of Biological Apatite Crystals and Collagen Fiber Anisotropy. J HARD TISSUE BIOL 2022. [DOI: 10.2485/jhtb.31.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | | | - Norio Kasahara
- Department of Histology and Developmental Biology, Tokyo Dental College
| | - Takayoshi Nakano
- Division of Materials & Manufacturing Science, Graduate School of Engineering, Osaka University
| | - Takuya Ishimoto
- Division of Materials & Manufacturing Science, Graduate School of Engineering, Osaka University
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Matsumoto K, Tanna N. Maxillary protraction and vertical control utilizing skeletal anchorage for midfacial-maxillary deficiency. Dental Press J Orthod 2021; 26:e2120114. [PMID: 34932708 PMCID: PMC8690863 DOI: 10.1590/2177-6709.26.6.e2120114.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 09/24/2020] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION The efficacy and efficiency of early treatment of skeletal Class III patients with facemask therapy are well-documented; however, very few cases for adolescents or adults were reported. OBJECTIVE The aim of this case report was to demonstrate skeletal and dental correction of a post-pubertal-growth-spurt patient whose malocclusion consisted of a skeletal Class III with slight transverse deficiency, a high mandibular plane angle, and a retrusive maxillary complex. CASE REPORT A 13-year-5-months old Hispanic female was diagnosed as a retrognathic maxilla and mandible, a high mandibular plane angle, open bite pattern, a bilateral Angle Class I molar relationship with an anterior crossbite on the maxillary lateral incisors. A TAD-supported Haas rapid palatal expander was utilized for maxillary protraction combined with a facemask, vertical control, and maxillary molar distalization with fixed appliance. RESULTS The total treatment time was 26 months. An improved facial profile with maxillary lip support and more prominent cheeks was established. Adequate vertical control prevented a change in the mandibular plane angle even though facemask treatment can increase the vertical dimension. After the 18-month retention, excellent stability of the treatment results was shown. CONCLUSION With skeletal anchorage and facemask treatment, orthodontists have the ability of expanding and protracting the maxilla without tipping maxillary molars buccally and without the risk of unfavorable periodontal consequences. A TAD-supported Haas rapid palatal expander allowed to control the vertical dimension and distalize molars, while minimizing undesired consequences.
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Affiliation(s)
- Kensuke Matsumoto
- University of Pennsylvania, School of Dental Medicine, Department of Periodontics and Orthodontics (Philadelphia/PA, USA)
| | - Nipul Tanna
- University of Pennsylvania, School of Dental Medicine, Department of Orthodontics (Philadelphia/PA, USA)
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22
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Liaw JJL, Park JH, Chang CC, Wang SH, Tsai BMY. An interdisciplinary approach to orthodontic treatment of a mutilated Class III malocclusion with mini-implants, dental implants, and an autotransplant. J ESTHET RESTOR DENT 2021; 34:281-296. [PMID: 34617363 DOI: 10.1111/jerd.12819] [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: 07/21/2021] [Revised: 09/02/2021] [Accepted: 09/13/2021] [Indexed: 11/28/2022]
Abstract
This case report demonstrates the interdisciplinary treatment of a 24-year-old female. Her skeletal discrepancy, anterior crossbite, mutilated dentition, and midline deviation made it challenging to achieve satisfactory treatment results, especially without major orthognathic surgery. This article thoroughly discusses the decision-making process associated with various treatment alternatives, the biomechanical considerations with temporary skeletal anchorage devices, and the detailed operational process of dental implant restoration and autotransplantation. CLINICAL SIGNIFICANCE: Orthodontic treatment aims to obtain better facial and dental esthetics, achieve functional occlusion, and improve oral health. Treatment of patients with a mutilated dentition requires interdisciplinary teamwork from a group of professionals with various types of expertise. Orthodontists should be the navigator that generates the tooth movement and space redistribution, thus facilitating the subsequent functional rehabilitation under a well-organized occlusal architecture. Autotransplantation offers an economical and biologically-friendly opportunity to replace a missing tooth.
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Affiliation(s)
- Johnny Joung-Lin Liaw
- Department of Orthodontics, National Taiwan University Hospital, Taipei, Taiwan.,Beauty Forever Dental Clinic, Taipei, Taiwan
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, Mesa, Arizona, USA.,Graduate School of Dentistry, Kyung Hee University, Seoul, South Korea
| | | | | | - Betty Meng-Yun Tsai
- Department of Orthodontics, National Taiwan University Hospital, Taipei, Taiwan.,Beauty Forever Dental Clinic, Taipei, Taiwan
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Aliaga-Del Castillo A, Soldevilla L, Valerio MV, Bellini-Pereira SA, Vilanova L, Arriola-Guillén LE, Janson G. Class II malocclusion treatment with a customized dual force distalizer. Am J Orthod Dentofacial Orthop 2021; 160:743-756. [PMID: 34332795 DOI: 10.1016/j.ajodo.2020.06.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 06/01/2020] [Accepted: 06/01/2020] [Indexed: 10/20/2022]
Abstract
Intraoral distalizers associated with skeletal anchorage provide the major benefit of promoting molar distalization with minimum anchorage loss and patient cooperation. This case report presents the treatment of a 17-year-old female with Class II Division 2 malocclusion, maxillary dentoalveolar protrusion, mild mandibular retrusion, increased overjet, deepbite, and lip incompetence. The treatment plan involved initial maxillary molar distalization with a customized version of the skeletally anchored dual force distalizer (DFD). The customized DFD used smaller mini-implants and included a fixed anterior biteplane. The device applied simultaneous forces from the buccal and palatal sides directly to the molars using nickel-titanium coil springs and allowed orthodontic mechanics in the mandibular teeth. An overcorrected Class I molar relationship was obtained after 6 months. After the distalization phase, retraction mechanics began with retraction loops and using a modified transpalatal bar reinforced with the mini-implants as anchorage. Moreover, the finishing phase was performed with multiloop edgewise archwires and intermaxillary elastics to enable an individualized control of each tooth. Total treatment time comprised 2 years 4 months, and significant improvements regarding the facial and occlusal perspectives were noticed. Similarly, these favorable changes remained stable during the 2-year follow-up period. The customized version of the skeletally anchored DFD followed by fixed appliances showed effectiveness and stability in Class II malocclusion treatment.
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Affiliation(s)
- Aron Aliaga-Del Castillo
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil; Department of Orthodontics, Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru.
| | - Luciano Soldevilla
- Department of Orthodontics, Faculty of Dentistry, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Marcelo Vinicius Valerio
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | | | - Lorena Vilanova
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
| | - Luis Ernesto Arriola-Guillén
- Divisions of Orthodontics and Oral and Maxillofacial Radiology, School of Dentistry, Universidad Científica del Sur, Lima, Peru
| | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
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Beyling F, Klang E, Niehoff E, Schwestka-Polly R, Helms HJ, Wiechmann D. Class II correction by maxillary en masse distalization using a completely customized lingual appliance and a novel mini-screw anchorage concept - preliminary results. Head Face Med 2021; 17:23. [PMID: 34187487 PMCID: PMC8240392 DOI: 10.1186/s13005-021-00273-3] [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: 05/11/2021] [Accepted: 06/17/2021] [Indexed: 02/05/2023] Open
Abstract
Background The aim of the study was to evaluate the efficacy of a novel en masse distalization method in the maxillary arch in combination with a completely customized lingual appliance (CCLA; WIN, DW Lingual Systems, Germany). Therefore, we tested the null-hypothesis of a significant deviation from an Angle-Class I canine relationship and a normal overjet defined by an individual target set-up after dentoalveolar compensation in Angle Class II subjects. Methods This retrospective study included 23 patients, (m/f 3/20, mean age 29.6 years (min/max, 13.6/50.9 years)), with inclusion criteria of an Angle Class II occlusion of more than half a cusp prior to en masse distalization and treatment completed consecutively with a CCLA in combination with a mini-screw (MS) anchorage for uni- or bilateral maxillary distalization (12 bilateral situations, totalling 35). Plaster casts taken prior to (T0) and following CCLA treatment (T3) were compared with the treatment plan / set-up (TxP, with a Class I canine relationship and a normal overjet as the treatment objective). MSs were placed following levelling and aligning (T1) and removed at the end of en masse distalization at T2. Statistical analysis was carried out using Schuirmann’s TOST [two one-sided tests] equivalence test, based on a one-sample t-test with α = 0.025 on each side (total α = 0.05). Results Ninety-seven percent of planned correction of the canine relationship was achieved (mean 3.6 of 3.7 mm) and also 97 % of the planned overjet correction (mean 3.1 of 3.2 mm), with a statistically significant equivalence (p < 0.0001) for canine relationship and overjet between the individual treatment plan (set-up) and the final outcome. Adverse effects were limited to the loss of n = 2 of 35 mini-screws. However, in each instance, the treatment was completed, as scheduled, without replacing them. Accordingly, the null-hypothesis was rejected. Conclusions The technique presented allows for a predictable correction of an Angle-Class II malocclusion via dentoalveolar compensation with maxillary en masse distalization.
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Affiliation(s)
- Frauke Beyling
- Private Practice, Kieferorthopädische Fachpraxis, Lindenstraße 44, 49152, Bad Essen, Germany.
| | - Elisabeth Klang
- Private Practice, Kieferorthopädische Fachpraxis, Lindenstraße 44, 49152, Bad Essen, Germany
| | - Eva Niehoff
- Private Practice, Kieferorthopädische Fachpraxis, Lindenstraße 44, 49152, Bad Essen, Germany.,Department of Orthodontics, Hannover Medical School (MHH), Hannover, Germany
| | | | - Hans-Joachim Helms
- Department of Medical Statistics, University Medical Center Göttingen (UMG), Göttingen, Germany
| | - Dirk Wiechmann
- Private Practice, Kieferorthopädische Fachpraxis, Lindenstraße 44, 49152, Bad Essen, Germany.,Department of Orthodontics, Hannover Medical School (MHH), Hannover, Germany
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25
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Du B, Zhu J, Li L, Fan T, Tan J, Li J. Bone depth and thickness of different infrazygomatic crest miniscrew insertion paths between the first and second maxillary molars for distal tooth movement: A 3-dimensional assessment. Am J Orthod Dentofacial Orthop 2021; 160:113-123. [PMID: 34092464 DOI: 10.1016/j.ajodo.2020.03.036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 03/01/2020] [Accepted: 03/01/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION This research aimed to measure the bone depth and thickness of different insertion paths for safe placement of infrazygomatic crest miniscrews between the first (U6) and second maxillary molars (U7) by 3-dimensional (3D) reconstruction and to explore their clinical significance. METHODS Cone-beam computed tomography data from 36 adult orthodontic patients were obtained to generate 3D models (n = 72) of the infrazygomatic crest region. For each model, the bone depth and thickness of 27 different insertion paths were measured in the region between U6 and U7. The relationship between bone depth and thickness was statistically analyzed. The clinical risk for each insertion path was assessed according to the impacts of bone depth and thickness on insertion failure. RESULTS Maximum bone depth (median, 7.41 mm; mean, 8.42 mm) was present at 13 mm insertion sites with a gingival tipping angle of 50° and a distal tipping angle of 30°. Maximum bone thickness (median, 3.73 mm; mean, 4.00 mm) was present at 17 mm insertion site with a gingival tipping angle of 70° and a distal tipping angle of 30°. There was a significant negative correlation between bone depth and bone thickness (rs = -0.569, P <0.001). Failure rates were significantly different among different insertion paths (P <0.001). CONCLUSIONS Because the bone depth and thickness may affect the safe insertion of infrazygomatic crest miniscrews in the region between U6 and U7 and they are negatively related, a safe insertion protocol design for distal tooth movement should take both into consideration.
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Affiliation(s)
- Bingran Du
- Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, Guangdong, China
| | - Jiuyu Zhu
- Department of Stomatology, the Third Affiliated Hospital of Xinxiang Medical University, Henan, China
| | - Lutao Li
- Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, Guangdong, China
| | - Tiancheng Fan
- Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, Guangdong, China
| | - Jinchuan Tan
- Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, Guangdong, China
| | - Jianyi Li
- Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, and Nanhai Hospital, Southern Medical University, Guangdong, China.
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26
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Nagesh S, Aravind M, Rekhawat A. CAD/CAM Designed Framework for Bone-Anchored Pendulum Appliance. JOURNAL OF INDIAN ORTHODONTIC SOCIETY 2021. [DOI: 10.1177/03015742211005408] [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
This article describes the use of a computer-aided design and manufacturing (CAD/CAM) 3D metal printed adjunctive orthodontic appliance that can be used with palatal miniscrews for molar distalization. CAD/CAM technology was used to fabricate a customized framework for bone-anchored pendulum appliance effectively based on the patient’s palatal contour, location, and the number of implants to be placed.
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Affiliation(s)
- Shweta Nagesh
- KLE Society’s Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - M Aravind
- KLE Society’s Institute of Dental Sciences, Bengaluru, Karnataka, India
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Bayome M, Park JH, Bay C, Kook Y. Distalization of maxillary molars using temporary skeletal anchorage devices: A systematic review and meta‐analysis. Orthod Craniofac Res 2021; 24:103-112. [DOI: 10.1111/ocr.12470] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 01/09/2021] [Indexed: 08/30/2023]
Affiliation(s)
- Mohamed Bayome
- Department of Preventive Dental Sciences, College of Dentistry King Faisal University Al Hofuf Saudi Arabia
- Department of Postgraduate Studies Universidad Autónoma del Paraguay Asunción Paraguay
| | - Jae Hyun Park
- Postgraduate Orthodontic Program Arizona School of Dentistry & Oral Health, A.T. Still University Mesa AZ USA
- Graduate School of Dentistry Kyung Hee University Seoul Korea
| | - Curt Bay
- Department of Interdisciplinary Health Sciences Arizona School of Health Sciences, A.T. Still University Mesa AZ USA
| | - Yoon‐Ah Kook
- Department of Orthodontics Seoul St. Mary’s Hospital The Catholic University of Korea Seoul Korea
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Bechtold TE, Park YC, Kim KH, Jung H, Kang JY, Choi YJ. Long-term stability of miniscrew anchored maxillary molar distalization in Class II treatment. Angle Orthod 2020; 90:362-368. [PMID: 33378427 PMCID: PMC8032303 DOI: 10.2319/051619-335.1] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 11/01/2019] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE To investigate treatment stability of miniscrew-anchored maxillary distalization in Class II malocclusion. MATERIALS AND METHODS This retrospective study included a distalization (n = 19) and a control (n = 19) group; a patient group with minor corrections served the control. Lateral cephalograms of 38 adult patients were taken before (T0), immediately after (T1), and 3-4 years after (T2) treatment. Horizontal and vertical movement and tipping of the maxillary first molars (U6) and central incisors (U1) were measured along with skeletal craniofacial parameters at three time points to compare the two groups regarding the achieved treatment effects and their stability. RESULTS Total arch distalization therapy led to 4.2 mm of distal movement of U6 without distal crown tipping (0.6° of axis change) and 3.3° of occlusal plane steepening. Over an average retention period of 42 months, maxillary total arch distalization provided high stability of treatment results, showing the same amount of mesial movement (0.7 mm) as the control group. CONCLUSIONS In Class II treatment, miniscrew-anchored maxillary total arch distalization can provide stable distal movement of the maxillary first molars and central incisors.
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29
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Reis RS, Henriques JFC, Janson G, Freitas KMS, Moura W. Dental, skeletal and soft tissue effects of the Distal Jet appliance: A prospective clinical study. Dental Press J Orthod 2020; 24:56-64. [PMID: 31994647 PMCID: PMC6986189 DOI: 10.1590/2177-6709.24.6.056-064.oar] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 11/25/2018] [Indexed: 11/22/2022] Open
Abstract
Objective: This study evaluated the dental, skeletal and soft tissue effects in Class II malocclusion patients treated with Distal Jet appliance, compared to an untreated control group. Methods: 44 patients with Class II malocclusion were divided into two groups: Group 1 (experimental) - 22 patients, mean age of 12.7 years, treated with the Distal Jet appliance for a mean period of 1.2 years; Group 2 (control) - 22 untreated patients, mean age of 12.2 years, followed by a mean period of 1.2 years. Lateral cephalograms were obtained before treatment (T0) and at the end of the distalization (T1).Independent t test was used to identify intergroup differences. Results: When compared to control group, the Distal Jet produced a significant increase in mandibular plane angle (0.7 ± 2.0o). The maxillary second molars presented distal inclination (6.6 ± 3.8o), distalization (1.1 ± 1.1 mm) and extrusion (1.3 ± 2.1 mm). The maxillary first molars distalized by 1.2 ± 1.4 mm. The maxillary first premolars mesialized by 3.4 ± 1.1 mm. The maxillary incisors showed slight labial tipping of 4.3 ± 4.7o and were protruded by 2.4 ± 1.7 mm. There were no significant changes in the facial profile. The overjet increased 1.5 ± 1.1 mm and overbite had no significant changes. Conclusion: The Distal Jet appliance is effective to distalize the maxillary first molars, but promotes increase in mandibular plane angle, distal inclination, extrusion and distalization of maxillary second molars, mesialization of maxillary first premolars, proclination and protrusion of maxillary incisors, and increase in overjet, when compared to a control group.
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Affiliation(s)
- Rachelle Simões Reis
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
| | - José F C Henriques
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
| | - Guilherme Janson
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
| | | | - Wilana Moura
- Universidade de São Paulo, Faculdade de Odontologia de Bauru, Departamento de Ortodontia (Bauru/SP, Brazil)
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30
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Zymperdikas VF, Yavropoulou MP, Kaklamanos EG, Papadopoulos MA. Effects of systematic bisphosphonate use in patients under orthodontic treatment: a systematic review. Eur J Orthod 2020; 42:60-71. [PMID: 31009953 DOI: 10.1093/ejo/cjz021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Bisphosphonates are a class of drugs prescribed for several osseous related disorders owing to their ability to regulate bone turnover, which could in turn affect orthodontic treatment outcomes. OBJECTIVE To examine the effect of bisphosphonate (BP) use on orthodontic patients through clinical and radiographic measurements. SEARCH METHODS Systematic and unrestricted search of 17 databases complemented with additional hand-searches were performed up to March 2019. SELECTION CRITERIA Articles reporting on human patients with a history of BPs administration that received orthodontic treatment were eligible for inclusion. DATA COLLECTION AND ANALYSIS Data regarding the medical profile of the patients, the specific type of malocclusion and the performed treatment plan, as well as the clinical and radiographic outcomes were extracted. Quality assessment was performed by the ROBINS-I tool for the cohort studies and by a slightly modified checklist from the original one proposed by Agbabiaka et al. for the case reports. RESULTS 7 articles (1 retrospective cohort study and 6 case reports) were eventually included in the present review including 122 subjects (29 patients and 93 controls) reporting on the clinical and radiographic changes following orthodontic treatment of patients during or after BPs use. BPs seem to have a controversial effect on the clinical and patient-reported variables, even though the majority of the included patients presented with compromised treatment results and a rather slow rate of tooth movement. Most radiographic findings revealed mild root resorption, widened periodontal ligament spaces and sclerotic changes on the surrounding alveolar bone. However, these results should be interpreted with caution, due to the limited number of the eligible articles and their limitations. LIMITATIONS The included studies were of rather low quality due to study design and incomplete reporting. CONCLUSIONS AND IMPLICATIONS BP administration seems to be associated with compromised clinical outcomes, prolonged treatment time, and moderate changes on the roots and surrounding tissues of orthodontic patients. REGISTRATION Non-registered. FUNDING None.
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Affiliation(s)
- Vasileios F Zymperdikas
- Department of Orthodontics, School of Health Sciences, Faculty of Dentistry, Aristotle University of Thessaloniki, Greece.,Department of Training and Operations, Military Hospital of Thessaloniki, Greece
| | - Maria P Yavropoulou
- 1st Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Greece
| | - Eleftherios G Kaklamanos
- Hamdan Bin Mohammed College of Dental Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Moschos A Papadopoulos
- Department of Orthodontics, School of Health Sciences, Faculty of Dentistry, Aristotle University of Thessaloniki, Greece
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Two distalization methods compared in a novel patient-specific finite element analysis. Am J Orthod Dentofacial Orthop 2019; 156:326-336. [PMID: 31474262 DOI: 10.1016/j.ajodo.2018.09.017] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 09/01/2018] [Accepted: 09/01/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Orthodontic mini-implants aid in the correction of distocclusions via direct anchorage (pull from mini-implant to teeth) and indirect anchorage (teeth pulled against other teeth anchored by the mini-implant). The aim of this study was to compare stress levels on the periodontal ligament (PDL) of maxillary buccal teeth in direct and indirect distalization against orthodontic mini-implants and accounting for individual variation in maxillary anatomy and biomechanical characteristics of the compact bone. METHODS A 3D model of the maxilla containing the different components (teeth, PDL, trabecular and cortical bones) was generated from a computed tomographic scan. Cortical bone was divided into several areas according to previously defined zones. Bone stiffness and thickness data, obtained from 11 and 12 cadavers, respectively, were incorporated into the initial model to simulate the individual cortical bone variation at the different locations. Subsequently, a finite element analysis was used to simulate the distalization modalities. RESULTS Stresses at the buccal, palatal, mesial, and distal surfaces were significantly different between adjacent teeth under stiffness but not thickness variation. In both distalization modalities, low or no significant correlations were found between stress values and corresponding cortical bone thicknesses. High significant and inverted correlations were observed at the first molar between stress amounts and cortical bone stiffness (direct modality: -0.68 < r < -0.72; indirect modality: -0.80 < r < -0.82; P <0.05). CONCLUSIONS With the use of a novel finite element approach that integrated human data on variations in bone properties, findings suggested that cortical bone stiffness may influence tooth movement more than bone thickness. Significant clinical implications could be related to these findings.
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Cassetta M, Brandetti G, Altieri F. Miniscrew-supported distal jet versus conventional distal jet appliance: A pilot study. J Clin Exp Dent 2019; 11:e650-e658. [PMID: 31516664 PMCID: PMC6730999 DOI: 10.4317/jced.55780] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 05/23/2019] [Indexed: 11/05/2022] Open
Abstract
Background Maxillary molar distalization is the most frequently used nonextraction treatment in the correction of Class II malocclusion. The use of traditional intra-oral devices shows unreliable results. Nowadays the use of miniscrew-supported appliances helps prevent anchorage loss. The aim of this pilot study is to compare the amount of upper first molar distalization and the dentoalveolar side effects using traditional distal jet appliance and miniscrew-supported distal jet appliance. Material and Methods 20 patients were randomly assigned to receive a treatment with miniscrew-supported distal jet appliance (Group A) or with traditional distal jet appliance (Group B). To ensure a safe and minimally invasive miniscrew insertion a surgical guide was used. Digital models and lateral cephalograms were obtained and analyzed before orthodontic treatment and at 6-month follow-up. Intergroup differences were determined using T- test. The significance was set at p ≤0.05. The intra-operator reliability was evaluated using a 2 sample T-test. The difference was not statistically significant (P ≤0.05 ), demonstrating an intra-operator reliability. Results In Group A, a greater maxillary first molar distalization was recorded (P=0.002). Considering the dentoalveolar side effects, in Group A, a spontaneous distalization of the first premolars and a retroclination of central incisors were determined. In Group B, the first premolars tipped mesially with a proclination of the maxillary central incisors. Conclusions Miniscrew-supported distal jet appliance achieved a greater first molar distalization at 6-month follow-up and did not cause dento-alveolar side effects, such as the mesial drift of the premolars and the incisors. Key words:Molar distalization, distal jet appliance, skeletal anchorage, miniscrew, 3D printed surgical guide.
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Affiliation(s)
- Michele Cassetta
- DDS, PhD (Associate Professor) Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Italy, School of Dentistry
| | - Giulia Brandetti
- MS (Research Assistant) Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Italy, School of Dentistry
| | - Federica Altieri
- DDS, PhD (Research Assistant) Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Italy, School of Dentistry
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Soheilifar S, Mohebi S, Ameli N. Maxillary molar distalization using conventional versus skeletal anchorage devices: A systematic review and meta-analysis. Int Orthod 2019; 17:415-424. [PMID: 31255550 DOI: 10.1016/j.ortho.2019.06.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The purpose of this study was to systematically review the evidence regarding conventional versus skeletal anchorage devices for molar distalization. METHOD An electronic search was conducted. Hand searching was done in the reference lists of included studies and some journals. Studies comparing conventional and skeletal anchorage for molar distalization in Angle class I or II malocclusions were assessed. Presence of periodontal disease, second or third molar extraction and application of tooth accelerating methods led to exclusion of studies. Generic-inverse variance approach was used for meta-analysis by use of the mean difference and random-effect model. Risk of bias was evaluated in included studies. RESULTS A total of 1996 articles were found; of which, 1991 were excluded. The mean amounts of molar distalization/tipping in skeletal anchorage and conventional anchorage groups were 5.35mm/8.44° and 4.25mm/8.31°, respectively, which were not significantly different. The mean amounts of premolar movement in skeletal anchorage and conventional anchorage groups were -0.96mm and +2.21mm, respectively, which was statistically significant (P=0.004). Duration of treatment in skeletal anchorage and conventional anchorage groups was 8.23 months and 7.95 months, respectively, which were significantly different (P=0.0001). Risk of bias was assessed to be high. CONCLUSION The conventional and skeletal anchorage devices were not significantly different in terms of the amount of molar distalization/tipping. However, the anchorage loss was lower in the skeletal anchorage group. The treatment time was shorter in the conventional anchorage group. More studies with proper design are required.
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Affiliation(s)
- Sepideh Soheilifar
- Hamadan university of medical sciences, dental research centre, orthodontic department, Hamadan, Iran
| | | | - Nazila Ameli
- Semnan university of medical sciences, dental school, orthodontic department, Semnan, Iran.
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