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Owayda A, Al-Sabbagh R, Farah H, Owayda T, Al-Ahmad S. The effectiveness of the total-maxillary-arch-distalization approach in treating class II division 1 malocclusion: A systematic review. Clin Oral Investig 2024; 28:333. [PMID: 38780877 DOI: 10.1007/s00784-024-05728-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: 08/02/2023] [Accepted: 05/15/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE The objective of this review is to assess the effect of total maxillary arch distalization (TMAD) treatment on the dental, skeletal, soft tissues, and airways during non-extraction camouflage treatment of class II division 1 patients. METHODS We performed a systematic review of the published data in four electronic databases up to April 2023. We considered studies for inclusion if they were examining the effects of TMAD during treatment of class II division 1 malocclusion in the permanent dentition. Study selection, data extraction, risk of bias assessment, and assessment of the strength of the evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool were performed in duplicate. RESULTS Out of the 27 articles that met the initial eligibility criteria, 19 studies were finally selected. Fair to relatively good quality evidence was identified after the risk of bias assessment of the included studies. Out of the 19 selected studies, 5 studies used inter-radicular TADs, 10 studies used modified C- palatal plate (MCPP), 3 studies used infra zygomatic crest (IZC) TADs, 1 study compared buccal TADs versus MCPP, and 1 study compared between cervical headgear and MCPP. The maximum amount of maxillary arch distalization using buccal TADs, MCPP, IZC TADs, and headgear was 4.2mm, 5.4mm, 5mm, and 2.5mm respectively. Different results regarding the amount of dental, skeletal, and soft tissue changes were observed. CONCLUSIONS The current low to very low certainty level of evidence suggests that TMAD is effective in camouflaging class II division 1 malocclusion. Future well-conducted and clearly reported randomized controlled trials that include a control group are needed to make robust recommendations regarding the effect of TMAD with different appliances on dental, skeletal, and soft tissue structures. CLINICAL RELEVANCE TMAD should be given priority with caution in class II patients who refuse the extraction of premolars. TMAD may be considered an adjunctive approach to solve cases associated with high anchorage need or anchorage loss.
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Affiliation(s)
- Amer Owayda
- PhD student, Department of Orthodontics, University of Hama Dental School, Hama, Syria.
| | - Rabab Al-Sabbagh
- Professor of Orthodontics, Department of Orthodontic, University of Hama Dental School, Hama, Syria
| | - Hassan Farah
- Professor of Orthodontics, Department of Orthodontic, University of Hama Dental School, Hama, Syria
| | - Tareq Owayda
- Master student, Department of Pediatric Dentistry, University of Tishreen Dental School, Lattakia, Syria
| | - Sally Al-Ahmad
- Assistant Professor of Orthodontics, Department of Orthodontics, Al Wataniya Private University, Hama, Syria
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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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Raghis TR, Alsulaiman TMA, Mahmoud G, Youssef M. Skeletal and dentoalveolar changes after total maxillary arch distalization using the casted palatal plate vs. buccal miniscrews: A randomized clinical trial. Int Orthod 2023; 21:100808. [PMID: 37647676 DOI: 10.1016/j.ortho.2023.100808] [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: 05/10/2023] [Revised: 07/23/2023] [Accepted: 07/31/2023] [Indexed: 09/01/2023]
Abstract
OBJECTIVES To evaluate treatment changes after total maxillary arch distalization using the casted palatal plate compared with buccal miniscrews. MATERIAL AND METHODS This was a randomized, parallel, two-arm, single center trial. Participants were young adults with class II dental relationships and normal or horizontal growth patterns. The patients were treated with total distalization of the maxillary arch and were randomly allocated, according to the anchorage devices, between the plate group and the minivis group. The primary outcomes were sagittal, vertical and angular changes of molars and incisors, while the secondary outcomes were skeletal and soft tissue changes. Outcomes were evaluated on lateral cephalograms and blinding of outcome assessment was implemented. A multivariate analysis of Variance (MANOVA) tests were used and Bonferroni correction for multiple comparisons with P<0.001. RESULTS Forty patients (33 females and 7 males; mean age 20±3.1 years) where enrolled. A significant distalization of U6 was observed in both groups (4.33mm in the plate group and 1.88mm in the miniscrews group). It was combined with significant intrusion and non-significant distal tipping of the U6 in the plate group (1.85mm and 3.10°, respectively), while intrusion and distal tipping were non-significant in the miniscrew group (0.8mm and 2°, respectively). Both groups showed significant retraction and palatal inclination without vertical changes of U1. Only the plate group produced significant reduction of ANB and Wits. Upper and lower lips were retracted and the nasolabial angle increased significantly in both groups. There was no significant main effect of the appliance type on the comparison of treatment effects between the two groups (P=0.623). However, univariate comparisons showed that the plaque group showed greater distalization of the U6 (P<0.001). CONCLUSIONS Both the casted palatal plate and buccal miniscrews can be viable devices for total distalization of the maxillary arch in the treatment of class II patients. The casted plate may be considered when more extensive distalization is required.
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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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Steegman RM, Renkema AM, Schoeman A, Kuijpers-Jagtman AM, Ren Y. Volumetric changes in the upper airway on CBCT after dentofacial orthopedic interventions - a systematic review. Clin Oral Investig 2023; 27:5737-5754. [PMID: 37723313 PMCID: PMC10560168 DOI: 10.1007/s00784-023-05207-8] [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: 05/30/2023] [Accepted: 08/13/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVE To provide a critical overview of the effect of various orthodontic and/or dentofacial orthopedic interventions on three-dimensional volumetric changes in the upper airway. MATERIALS AND METHODS Four databases were searched for clinical studies concerning 3D volumetric assessments based on CBCT before and after orthodontics interventions. The quality of the studies was assessed using the quality assessment tool of the National Heart, Lung and Blood Institute. After the use of inclusion and exclusion criteria, the pre-and post-treatment volumes were used to visualize the effect of various orthodontics interventions. RESULTS A total of 48 studies were included in this review and none of which were RCTs. The quality of all included studies was assessed as medium. Overall, there is a tendency for an increase in airway volumes after various orthodontic interventions, except for studies concerning extraction therapy with fixed appliances in adults, in which both increases and decreases in airway volumes have been reported. CONCLUSION Orthodontic treatment by growth modification and non-extraction therapy with fixed appliances, regardless of the malocclusion, generally showed positive effects on the airway volume. Orthodontic treatment in combination with extractions does not provide an unambiguous insight. A consensus on the methodology of the airway measurement and nomenclature is urgently needed in order to gain insight into the effect of different interventions on three-dimensional airway changes. CLINICAL RELEVANCE Various orthodontic treatments do not negatively influence the upper airway volume. However, extraction therapy in adults should be chosen with caution, especially in subjects belonging to a group susceptible to airway obstruction.
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Affiliation(s)
- Ralph M. Steegman
- Department of Orthodontics, University of Groningen, University Medical Center Groningen, BB72 300001, Hanzeplein 1, Groningen, 9700RB The Netherlands
- Zijlweg Orthodontie, Orthodontic Private Practice, Haarlem, The Netherlands
| | - Anne-Marie Renkema
- Department of Orthodontics, University of Groningen, University Medical Center Groningen, BB72 300001, Hanzeplein 1, Groningen, 9700RB The Netherlands
| | - Adriaan Schoeman
- Department of Orthodontics, University of Groningen, University Medical Center Groningen, BB72 300001, Hanzeplein 1, Groningen, 9700RB The Netherlands
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland
- Faculty of Dentistry, Universitas Indonesia, Jakarta, 10430 Indonesia
| | - Yijin Ren
- Department of Orthodontics, W.J. Kolff Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Zhou Z, Sun L, Zhang F, Xu Y. Three-dimensional evaluation of alveolar bone and pharyngeal airway dimensions after mandibular dentition distalization in patients with Class III malocclusion: a retrospective study. Head Face Med 2023; 19:41. [PMID: 37649064 PMCID: PMC10466725 DOI: 10.1186/s13005-023-00382-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/10/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND To three-dimensionally evaluate changes of the alveolar bone around the mandibular anterior teeth and pharyngeal airway dimensions in adults with Class III malocclusion before and after orthodontic treatment of mandibular dentition distalization. METHODS In this retrospective study, cone-beam computed tomography (CBCT) scans of 20 patients with Class III malocclusion who underwent mandibular dentition distalization were obtained both before and after treatment. Three-dimensional changes of the thickness and vertical marginal bone levels around mandibular incisors and canines were assessed and compared. And airway volumes of the palato-, glosso-, laryngopharynx and the minimum axial area were measured and compared before and after treatment. RESULTS A significant decrease of lingual bone thickness of mandibular incisors, partial labial and lingual bone thickness of canines were observed (P < 0.05). The reduction in root length of incisors and canines, labial and lingual vertical marginal bone levels were significant after orthodontic treatment. No significant correlations between mandibular dentition distalization and pharyngeal airway dimensions were observed. CONCLUSIONS Mandibular dentition distalization could result in the loss of alveolar bone around anterior teeth in Class III malocclusion, especially for the cervical marginal bone. Pharyngeal airway dimensions were not affected to a high extent after distalization. TRIAL REGISTRATION Retrospctively registered.
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Affiliation(s)
- Zhijie Zhou
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomotology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Liangyan Sun
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomotology, Fudan University, Shanghai, China
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China
| | - Fan Zhang
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomotology, Fudan University, Shanghai, China.
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China.
| | - Yan Xu
- Department of Orthodontics, Shanghai Stomatological Hospital & School of Stomotology, Fudan University, Shanghai, China.
- Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China.
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Kim S, Lee NK, Park JH, Ku JH, Kim Y, Kook YA, Kuo Chou AH, Vaid NR. Authors' response. Am J Orthod Dentofacial Orthop 2023; 163:145. [PMID: 36710059 DOI: 10.1016/j.ajodo.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/01/2022] [Indexed: 01/30/2023]
Affiliation(s)
- Suchan Kim
- Daejeon, Seongnam, and Seoul, South Korea, Mesa, Ariz, and Chennai, India
| | - Nam-Ki Lee
- Daejeon, Seongnam, and Seoul, South Korea, Mesa, Ariz, and Chennai, India
| | - Jae Hyun Park
- Daejeon, Seongnam, and Seoul, South Korea, Mesa, Ariz, and Chennai, India
| | - Ja Hyeong Ku
- Daejeon, Seongnam, and Seoul, South Korea, Mesa, Ariz, and Chennai, India
| | - Yoonji Kim
- Daejeon, Seongnam, and Seoul, South Korea, Mesa, Ariz, and Chennai, India
| | - Yoon-Ah Kook
- Daejeon, Seongnam, and Seoul, South Korea, Mesa, Ariz, and Chennai, India
| | - Alex Hung Kuo Chou
- Daejeon, Seongnam, and Seoul, South Korea, Mesa, Ariz, and Chennai, India
| | - Nikhilesh R Vaid
- Daejeon, Seongnam, and Seoul, South Korea, Mesa, Ariz, and Chennai, India
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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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Simakova AA, Gorbatova LN, Grjibovski AM, Arutyunyan KS, Ryzhkov IA. [Dimensions of the upper airways and its impact on the dentoalveolar system development]. STOMATOLOGIIA 2022; 101:93-99. [PMID: 35362710 DOI: 10.17116/stomat202210102193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Due to the high mobility and variability of bone structures and soft tissues surrounding the upper respiratory tract, the exact boundaries for measuring and normalizing the size of the respiratory tract have not yet been determined. Studies have determined the relationship between the narrowing of the upper jaw and a decrease in the transverse dimensions of the airways, as well as a positive effect in changing the size of the airways after orthodontic treatment and/or orthognathic surgery. Nevertheless, the results of research in this area may differ greatly from different specialists, which indicates that the topic is poorly studied and it is necessary to continue and expand the range of scientific works to assess the state of the upper respiratory tract and their relationship with the orthodontic status.
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Affiliation(s)
- A A Simakova
- Northern State Medical University, Arkhangelsk, Russia
| | - L N Gorbatova
- Northern State Medical University, Arkhangelsk, Russia
| | - A M Grjibovski
- Northern State Medical University, Arkhangelsk, Russia
- West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
- Al Farabi Kazakh National University, Almaty, Kazakhstan
- North-Eastern Federal University, Yakutsk, Russia
| | | | - I A Ryzhkov
- Northern State Medical University, Arkhangelsk, Russia
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Orabi N, Flores-Mir C, Elshebiny T, Elkordy S, Palomo JM. Pharyngeal airway dimensional changes after orthodontic treatment with premolar extractions: A systematic review with meta-analysis. Am J Orthod Dentofacial Orthop 2021; 160:503-515.e3. [PMID: 34479766 DOI: 10.1016/j.ajodo.2021.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 03/01/2021] [Accepted: 03/01/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The objective of this research was to evaluate the effect of orthodontic extraction on the pharyngeal airway volume and Minimum cross-sectional area (MCA) in growing and adult patients. METHODS Seven databases, unpublished gray literature, and the references list of the identified articles were electronically searched for relevant studies that met our eligibility criteria. Included studies assessed the effect of dental extraction or sagittal dental movements on pharyngeal airway dimensions. The quality of the included studies was assessed using the methodological index for nonrandomized studies. In addition, a meta-analysis was conducted using the RevMan 5 (Nordic Cochrane Centre, Cochrane Collaboration, Copenhagen, Denmark). RESULTS In 7 studies, 268 treated patients with a mean age of 19.1 ± 7.6 years and 342 nonextraction control group subjects with a mean age of 19.3 ± 7.2 years were included. Compared with the control group, no statistically significant difference was found in total, nasopharyngeal, glossopharyngeal, oropharyngeal volume, or MCA (P >0.05) in the extraction group except in oropharyngeal volume in which a statistically significant increase in the volume 0.41 cm3 (95% CI, 0.05-0.80; P = 0.03) was detected. The clinical significance of this increase is questionable. Included studies showed a moderate to high risk of bias. CONCLUSIONS There is no strong evidence to support the concept that premolar extractions in bimaxillary protrusion or crowded growing and adult patients reduce either pharyngeal airway volume or MCA. Moreover, as the level of evidence was considered very low for all variables, the magnitude, and direction of the summaries have to be interpreted with caution. Future studies with better quality could significantly affect the direction and strength of the results. TRIAL REGISTRATION NUMBER PROSPERO CRD42018089924.
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Affiliation(s)
- Noha Orabi
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio; School of Dental Medicine, Cairo University, Cairo, Egypt; Department of Orthodontics, School of Dentistry, Cairo University, Cairo, Egypt; Private Practice at Wenger Orthodontics, Mayfield Heights, Ohio.
| | - Carlos Flores-Mir
- Department of Orthodontics, Faculty of Medicine and Dentistry, Univesity of Alberta, Edmonton, Alberta, Canada
| | - Tarek Elshebiny
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
| | - Sherif Elkordy
- Department of Orthodontics, School of Dentistry, Cairo University, Cairo, Egypt
| | - Juan Martin Palomo
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
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Chou AHK, Park JH, Shoaib AM, Lee NK, Lim HJ, Abdulwhab AA, Alfawaz F, Kook YA. Total maxillary arch distalization with modified C-palatal plates in adolescents: A long-term study using cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2021; 159:470-479. [PMID: 33558030 DOI: 10.1016/j.ajodo.2020.02.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 01/01/2020] [Accepted: 02/01/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The aims of this study were to evaluate the long-term skeletodental effects, the volume of maxillary tuberosity, and airway space changes after maxillary molar distalization using modified C-palatal plate (MCPP) in adolescents with Class II malocclusion. METHODS The sample consisted of 20 adolescent patients (MCPP group; mean age, 12.9 ± 1.0 year) who underwent bilateral distalization of their maxillary dentition and 20 subjects as a control group. In the MCPP group, cone-beam computed tomography images were taken before distalization, at the end of the treatment, and during retention with a minimum of a 3-year posttreatment follow up period. Repeated measures ANOVA followed by post-hoc analysis with the Bonferroni test were used to identify significant differences between time points. RESULTS After the long-term observation period, sagittal skeletal and dental relationships were maintained (there were no significant changes in ANB, occlusal plane angle, and overjet postretention). The vertical skeletal dimension did not change during treatment and was stable at the long-term follow-up (the mandibular plane angle and ANS-Me were relatively well maintained). The volume of the maxillary tuberosity showed no significant change during long-term retention. However, the volume was significantly smaller in the treatment group than in the control group (P <0.0001). There were no significant airway space changes after distalization and the postretention period. In addition, there was no significant difference between the MCPP and control groups. CONCLUSIONS Improved sagittal skeletal and dental relationships because of treatment were maintained in the long-term evaluation. There was no negative long-term effect on airway space associated with the maxillary arch distalization. Therefore, these findings might be beneficial for clinicians in diagnosis and treatment planning for Class II malocclusion in adolescents.
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Affiliation(s)
- Alex Hung Kuo Chou
- Division of Orthodontics, Dentistry Hospital, Seoul St. Mary's Hospital, 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
| | - Ahmed M Shoaib
- Division of Orthodontics, Dentistry Hospital, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Nam-Ki Lee
- Department of Orthodontics, Section of Dentistry, Seoul National University Bundang Hospital, Seongnam, Gyeonggi Province, South Korea
| | - Hee Jin Lim
- Division of Orthodontics, Dentistry Hospital, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Ahmad Ali Abdulwhab
- Division of Orthodontics, Dentistry Hospital, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Fawaz Alfawaz
- Division of Orthodontics, Dentistry Hospital, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea
| | - Yoon-Ah Kook
- Division of Orthodontics, Dentistry Hospital, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea.
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Halim IA, Park JH, Liou EJW, Zeinalddin M, Al Samawi YS, Bay RC. Preliminary study: evaluating the reliability of CBCT images for tongue space measurements in the field of orthodontics. Oral Radiol 2020; 37:256-266. [PMID: 32418067 DOI: 10.1007/s11282-020-00443-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 05/03/2020] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Accurately measuring tongue space is challenging, but this information can be useful to many dental specialties. This study was intended to estimate the reliability of using cone-beam computed tomography (CBCT) to measure tongue space, which includes tongue volume and the oral cavity air capacity. METHODS For this preliminary study, CBCT images from ten participants (five females and five males, mean age of 29.8 ± 3.3 years) were available for evaluation. Each participant was radiographed two times (T0 and T1). The average time between T0 and T1 was 15.8 ± 3.7 days. CBCT scans were standardized to reduce variability. Three-dimensional landmarks were established to identify tongue space and 3D image analysis software (SimPlant® 17 Pro; Materialise Dental, Leuven, Belgium) was used to measure the volume circumscribed by the landmarks. Two investigators independently calculated airway, tongue dimensions, and total tongue space for CBCT image T0 twice (day 1 and day 14), and T1 once. Intraclass correlation coefficients (ICCs) were used to estimate intra-rater and inter-rater reliability. Bland-Altman charts were constructed to demonstrate agreement within and between raters. RESULTS The intra-rater and inter-rater ICCs of the CBCT measurements at T0 were excellent (> 0.90). Measurements for T0 vs. T1 show good (0.75-0.90) intra-rater and excellent (> 0.90) inter-rater reliability. Bland-Altman charts show that 90-95% of the total measurements fall within the 95% limits of agreement for both intra- and inter-rater pairs CONCLUSIONS: The results of this preliminary study suggest that the landmarks chosen to measure the overall tongue space are reproducible and can be measured clearly using CBCT.
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Affiliation(s)
- Ivan A Halim
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, 5835 East Still Circle, Mesa, AZ, 85206, USA
| | - Jae Hyun Park
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, 5835 East Still Circle, Mesa, AZ, 85206, USA. .,Graduate School of Dentistry, Kyung Hee University, Seoul, Korea.
| | - Eric J W Liou
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Mohammad Zeinalddin
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Yazan Sharif Al Samawi
- Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A.T. Still University, 5835 East Still Circle, Mesa, AZ, 85206, USA
| | - R Curtis Bay
- Department of Interdisciplinary Health Sciences, A. T. Still University, Mesa, AZ, USA
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Ng JH, Song YL, Yap AUJ. Effects of bicuspid extractions and incisor retraction on upper airway of Asian adults and late adolescents: A systematic review. J Oral Rehabil 2019; 46:1071-1087. [PMID: 31281971 PMCID: PMC6851666 DOI: 10.1111/joor.12854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/23/2019] [Accepted: 06/28/2019] [Indexed: 12/17/2022]
Abstract
OBJECTIVES This systematic review aimed to assess the effects of bicuspid extractions and incisor retraction on airway dimension, hyoid position and breathing of adults and late adolescents. METHODS The review was conducted according to PRISMA guidelines. Eight databases including PubMed, EMBASE, Web of Science and Scopus were searched to August 2018. Minimum age of participants was 16 years. The intervention was dual-arch bicuspid extractions with incisor retraction. Outcomes were airway dimension, hyoid position and breathing assessment. RESULTS All nine publications meeting inclusion criteria were from Asia. They were divided into three Asian subregions. All East Asian lateral cephalometric studies reported anteroposterior airway narrowing at the oropharynx and sometimes the hypopharynx. However, the narrowing was small, comparable to measurement errors, and highly variable. Two out of three East Asian computed tomography (CT) studies described reductions in airway dimensions. The single functional breathing study showed increased simulated flow resistance after incisor retraction in East Asians. South Asian studies had mixed findings, with some reporting significant airway narrowing. The single study from West Asia found no significant airway or hyoid changes. CONCLUSIONS Airway response to bicuspid extractions and incisor retraction varied substantially when assessed with cephalometry. CT measurements present larger effect sizes and smaller variations, providing stronger evidence of airway narrowing. Orthodontic extractions for incisor retraction may be more frequently indicated in Asia, and East Asians seem particularly susceptible to airway narrowing and postero-inferior hyoid movement with incisor retraction. Better designed CT studies are needed for confirmation due to small effect size and large variability.
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Affiliation(s)
- Jing Hao Ng
- National Dental Centre SingaporeSingaporeSingapore
| | - Yi Lin Song
- National Dental Centre SingaporeSingaporeSingapore
| | - Adrian U. J. Yap
- National Dental Centre SingaporeSingaporeSingapore
- Department of Dentistry, Ng Teng Fong General HospitalNational University Health SystemSingaporeSingapore
- Faculty of DentistryNational University of SingaporeSingaporeSingapore
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Korkmaz YN, Buyuk SK, Genç E. Comparison of hyoid bone positions and pharyngeal airway dimensions in different body mass index percentile adolescent subjects. Cranio 2018; 38:286-291. [PMID: 30394203 DOI: 10.1080/08869634.2018.1543828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Increased body mass index (BMI) is a growing problem worldwide and can affect medical conditions through morphological structures. The purpose of this study was to examine the hyoid bone position and pharyngeal airway dimensions on the sagittal section in different BMI percentile adolescent subjects. METHODS Fifty-five adolescent patients were subdivided into three groups, considering their BMI percentiles: Normal-weight (16 subjects), overweight (20 subjects), and obese (19 subjects). A total of 13 linear and angular parameters of head posture angle, pharyngeal airway dimensions, and hyoid bone positions were investigated on 55 lateral cephalometric radiographs. RESULTS Except for one hyoid bone measurement (RGN-H), there was no significant difference among groups. The RGN-H distances of obese and overweight adolescent subjects were higher than normal-weight adolescent subjects. CONCLUSION Obese, overweight, and normal-weight adolescent subjects were likely to have similar hyoid bone position and pharyngeal airway dimensions.
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Affiliation(s)
- Yasemin Nur Korkmaz
- Department of Orthodontics, Faculty of Dentistry, Abant Izzet Baysal University , Bolu, Turkey
| | | | - Esra Genç
- Department of Orthodontics, Faculty of Dentistry, Ordu University , Ordu, Turkey
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