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Authors' response. Am J Orthod Dentofacial Orthop 2023; 164:305-306. [PMID: 37634923 DOI: 10.1016/j.ajodo.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/01/2023] [Indexed: 08/29/2023]
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Authors' response. Am J Orthod Dentofacial Orthop 2023; 164:303-304. [PMID: 37634920 DOI: 10.1016/j.ajodo.2023.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 08/29/2023]
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Clinical predictors of potentially impacted canines in low-risk patients: A retrospective study in mixed dentition. Korean J Orthod 2023; 53:106-115. [PMID: 36960721 PMCID: PMC10040294 DOI: 10.4041/kjod22.179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/12/2022] [Accepted: 12/28/2022] [Indexed: 03/25/2023] Open
Abstract
Objective To evaluate the null hypothesis that there is no difference in a set of clinical predictors of potentially impacted canines between low-risk patients with and without displaced canines. Methods The normal canine position group consisted of 30 patients with 60 normally erupting canines ranked in sector I (age, 9.30 ± 0.94 years). The displaced canine group comprised 30 patients with 41 potentially impacted canines ranked in sectors II to IV (age, 9.46 ± 0.78 years). Maxillary lateral incisor crown angulation, inclination, rotation, width, height, and shape, as well as palatal depth, arch length, width, and perimeter composed a set of clinical predictors, which were evaluated on digital dental casts. Statistical analyses consisted of group comparisons and variable correlations (p < 0.05). Results There was a significant association between sex and mesially displaced canines. Unilateral canine displacement was more prevalent than bilateral displacement. The crown of the maxillary lateral incisors was significantly angulated more mesially and rotated mesiolabially in low-risk patients with displaced canines, who also had a shallower palate and shorter anterior dental arch length. Lateral incisor crown angulation and rotation, as well as palatal depth and arch length, were significantly correlated with the canine displacement severity. Conclusions The null hypothesis was rejected. Maxillary lateral incisor angulation inconsistent with the "ugly duckling" stage as well as a shallow palate and short arch length are clinical predictors that can significantly contribute to the early screening of ectopic canines in low-risk patients.
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Twin-block and mandibular anterior repositioning appliances effects in Class II malocclusion correction. Am J Orthod Dentofacial Orthop 2023; 163:181-190. [PMID: 36202696 DOI: 10.1016/j.ajodo.2021.09.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/01/2021] [Accepted: 09/01/2021] [Indexed: 02/01/2023]
Abstract
INTRODUCTION The objective of this study was to compare the cephalometric changes in Class II Division 1 malocclusion patients treated with the Twin-block (TB) and the mandibular anterior repositioning appliance (MARA). METHODS This retrospective study was performed with 132 lateral cephalograms of patients with Class II malocclusion divided into 3 groups: a TB group comprised 21 patients with mean initial and final ages of 10.59 and 11.97 years, respectively, treated for a mean period of 1.38 years; a MARA group comprised 21 patients with mean initial and final ages of 11.98 and 13.20 years, respectively, treated for a mean period of 1.22 years; and a control group included 24 subjects with untreated Class II malocclusion with mean initial and final ages of 10.55 and 12.01 years, respectively, observed for a mean period of 1.46 years. Cephalometric intergroup comparisons regarding the treatment changes (T2 - T1) were performed with the analysis of covariance, followed by Tukey tests. RESULTS Both appliances demonstrated significant restriction of the maxilla and improvement of the maxillomandibular relationship. The MARA produced a significantly greater amount of labial tipping and protrusion of the mandibular incisors than the other groups. The TB showed significant extrusion of the mandibular incisors and molars compared with MARA and control, respectively. Both treated groups reduced the overjet and overbite. The MARA presented a significantly greater reduction in the molar relationship than the other groups. CONCLUSIONS The appliances showed a headgear effect on the maxilla and effectively changed Class II cephalometric parameters through a combination of skeletal and dentoalveolar effects. TB showed a greater increase in LAFH. MARA promoted greater labial tipping and protrusion of the mandibular incisors.
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Dual action vertical intra-arch technique. JOURNAL OF CLINICAL ORTHODONTICS : JCO 2022; 56:666-676. [PMID: 37158769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
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Reliability of an indirect bone-probing method for diagnosis of labial bone crest level of the mandibular anterior teeth. Angle Orthod 2022; 92:333-339. [PMID: 35099525 DOI: 10.2319/072321-586.1] [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: 07/01/2021] [Accepted: 12/01/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate the null hypothesis that there would be no difference between the labial bone crest level of the mandibular anterior teeth evaluated with an indirect bone-probing method (IBP) and cone-beam computed tomography (CBCT). MATERIALS AND METHODS Twenty-nine adult patients with a mean age of 32.15 ± 8.75 years were enrolled. An IBP based on indirect tactile perception was used to determine the labial bone crest level of the mandibular anterior teeth clinically. Bone crest perception degree, gingival thickness, and patient discomfort during IBP were also recorded. CBCT scans were used to evaluate the level and thickness of the labial bone crest. IBP and CBCT methods were compared statistically. The significance level was set at 5%. RESULTS There was a significant difference between the labial bone crest level diagnosed by IBP and CBCT. However, the difference was not clinically significant. IBP and CBCT measurements were significantly and strongly correlated (R = 0.74). Thinner gingival tissue was associated with a higher perception of bone crest. Only two patients reported mild to moderate discomfort during IBP. CONCLUSIONS IBP allowed the labial bone crest level to be determined with acceptable clinical accuracy, especially in patients with thinner gingival tissue.
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Development of dentofacial characteristics related to Incontinentia Pigmenti syndrome: A repeated cross-sectional study. Am J Orthod Dentofacial Orthop 2021; 160:66-76. [PMID: 33906773 DOI: 10.1016/j.ajodo.2020.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 03/01/2020] [Accepted: 03/01/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION This research aimed to investigate the dentofacial characteristics of patients with Incontinentia Pigmenti (IP) (or Bloch-Sulzberger) syndrome in childhood, juvenile, and adulthood developmental stages. METHODS Fifteen female patients with a clinical diagnosis of IP, genetically confirmed by molecular testing, were included in this study. The records of 25 nonsyndromic females with Class I occlusion and lateral cephalograms obtained at similar developmental stages were selected from the American Association of Orthodontists Foundation Legacy Collection as a control group. Dentofacial features of subjects with IP and those in the control group were compared statistically using t test and Mann-Whitney rank-sum test (significance was defined as P <0.05). RESULTS In general, patients with IP had shorter maxillary and mandibular length, straight skeletal profile, hypodivergent growth pattern with a tendency to mandibular protrusion, shorter anterior facial height, Class III compensatory positioning of incisors, more retruded lips, and smaller maxillary incisor exposure. The degree of hypodontia severity had a significant impact on skeletal, dental, and soft-tissue features in patients with IP. CONCLUSIONS The results of this study showed that, since childhood, the dentofacial characteristics of patients with IP were progressively distancing from those of nonsyndromic patients with Class I occlusion, presenting their own orthodontic needs.
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Mechanical strength of stainless steel and titanium alloy mini-implants with different diameters: an experimental laboratory study. Prog Orthod 2021; 22:9. [PMID: 33748887 PMCID: PMC7982375 DOI: 10.1186/s40510-021-00352-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 02/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The mechanical strength of mini-implants is a critical factor due to their small diameters. Currently, it is not possible to state whether there is a relevant difference between the mechanical properties of stainless steel (SS-MIs) and titanium alloy mini-implants (TA-MIs). The objective of this study was to test the null hypothesis that there is no difference in the mechanical strength of SS-MIs and TA-MIs, and to analyze, by scanning electron microscopy (SEM), the SS-MI, and TA-MI threads resistance to morphological damage after insertion. METHODS A standardized sample of 504 SS-MIs and TA-MIs with diameters ranging from 1.2 mm to 1.8 mm was used. Torsional fracture was performed in 154 MIs. Flexural strength of 280 MIs was evaluated at 1 mm and 2 mm-deflection. The threads of 70 MIs were morphologically analyzed by scanning electron microscopy (SEM), before and after their insertion in high-density artificial bone blocks. Comparisons between SS-MIs and TA-MIs were performed with t tests or Mann-Whitney U tests. A multiple linear regression analysis was used to evaluate the influence of variables on the ranging of MI mechanical strength. RESULTS SS-MIs had higher fracture torque. The mean difference between the SS-MIs and TA-MIs fracture torque was of 4.09 Ncm. The MI diameter explained 90.3% of the total variation in fracture torque, while only 2.2% was explained by the metallic alloy. The SS-MI group presented a higher deformation force during the 1mm and 2mm-deflection. The mean difference between the flexural strength of SS and TA-MIs at 1 mm and 2 mm-deflection was of 18.21 N and 17.55 N, respectively. There was no noticeable morphological damage to the threads of SS-MIs and TA-MIs. CONCLUSIONS The null hypothesis was rejected. SS-MIs were 13.2% and 20.2% more resistant to torsional fracture and deflection, respectively. The threads of the SS-MIs and TA-MIs were not damaged during the insertion and removal process. Thus, the use of SS-MI can reduce the fracture risk without increasing the MI diameter.
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Short-term efficacy of vacuum-formed maintainer for deciduous second molar space maintenance in the mixed dentition: A single-centre, randomized controlled clinical trial. Orthod Craniofac Res 2020; 24:502-510. [PMID: 33352006 DOI: 10.1111/ocr.12460] [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: 10/23/2020] [Revised: 12/07/2020] [Accepted: 12/16/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To compare the efficacy of vacuum-formed and banded space maintainers for deciduous second molar space maintenance during the mixed dentition. SETTING AND SAMPLE POPULATION The study sample comprised thirty children in the mixed dentition (age range, 5.9 to 9.8 years) with early loss of at least one deciduous second molar. METHODS This was a parallel-group, randomized, active-controlled clinical trial. Patients were randomly allocated to space maintenance performed with vacuum-formed or banded space maintainers with a 1:1 allocation ratio. The main outcome was any change in mesiodistal width of the extraction space. Secondary outcomes included the lingual rolling or axial rotation of the permanent first molar adjacent to the extraction site and extrusion of the antagonist tooth. Dental casts were obtained before appliance installation (T0), after 3 months (T1) and after 6 months (T2). Digital dental casts were measured using Dolphin 3D software. Chi-square, t test or Mann-Whitney and ANOVA or Friedman test were used for intra- and intergroup comparisons (P < .05). RESULTS Baseline characteristics were similar between groups except for chronological age. Statistically, but not clinically significant space loss (mean, 0.32 mm; SD, ± 0.39) occurred with the vacuum-formed space maintainer only at the first trimester (T0-T1). Lingual rolling and axial rotation of the first permanent molar were not significant, as well as extrusion of the antagonist tooth. CONCLUSIONS The results of this study suggested that both tested devices were effective in maintaining space after early extraction of the deciduous second molar over a period of 6 months.
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Effect of Class II camouflage treatment on anterior arch length ratio and canine relationship. Am J Orthod Dentofacial Orthop 2020; 159:e7-e16. [PMID: 33234459 DOI: 10.1016/j.ajodo.2020.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/01/2020] [Accepted: 08/01/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION To evaluate the influence of compensatory tipping of maxillary and mandibular incisors on the anterior arch length ratio and canine relationship in skeletal Class II malocclusion. METHODS The study was based on posttreatment lateral head films and dental casts of 88 patients. The sample was divided into a Class II malocclusion group (32 patients; ANB ≥5° and mean [± standard deviation] age, 20.82 ± 7.67 years) and a Class I malocclusion group (56 patients; 1° ≤ ANB ≤ 2.5° and mean [± standard deviation] age, 19.20 ± 5.04 years). Measurements obtained for anterior arch length and width, Bolton discrepancy, canine relationship, growth pattern, and incisor position were compared between the groups. The canine relationship was correlated with dental and skeletal variables (P <0.05). RESULTS The mean ANB angles were 6.21° and 1.78° for the Class II and Class I malocclusion groups, respectively. The skeletal Class II group presented significantly larger mandibular anterior arch length, producing an unbalanced anterior arch length ratio. The canine relationship was more displaced toward Class II in this group. Anterior arch length ratio was the most influential variable in the canine relationship. The mandibular incisors had a higher compensation degree than the maxillary incisors. The groups were similar regarding overjet, overbite, and growth pattern. CONCLUSIONS Class II malocclusion camouflage treatment with excessive proclination of the mandibular incisors was associated with an increase in mandibular arch length, negatively influencing the anterior arch length ratio and the final canine relationship. Mandibular anterior arch length reduction by interproximal stripping may be necessary in moderate to severe skeletal Class II malocclusion orthodontic treatment.
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Dissipating tooth-mass discrepancy caused by a set of mandibular incisor anomalies. Am J Orthod Dentofacial Orthop 2020; 158:738-751. [PMID: 32736850 DOI: 10.1016/j.ajodo.2019.06.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 06/01/2019] [Accepted: 06/01/2019] [Indexed: 10/23/2022]
Abstract
Dental anomalies are complicating factors of orthodontic treatment, especially when 1 or more anterior teeth are affected. In this case report, a girl, aged 12.5 years with a retrognathic chin; number, size, and position anomalies of the mandibular incisors; and bilateral Class I molar relationship sought orthodontic treatment. Tooth-size ratio discrepancy was dissipated without extraction or prosthetic rehabilitation, and the initial molar relationship was maintained, as well as the straight soft tissue profile. Tipping of maxillary and mandibular incisors, crown torque of canines, restoration of anomalous incisor, and maxillary interproximal enamel reduction were key points for successful treatment. After 18 months, the orthodontic records showed stable results, excellent static and functional occlusion, and good smile esthetics and facial appearance, in addition to a high degree of patient satisfaction with the achieved results.
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Short-term impact of rapid maxillary expansion on ectopically and normally erupting canines. Am J Orthod Dentofacial Orthop 2018; 154:524-534. [DOI: 10.1016/j.ajodo.2018.01.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 01/01/2018] [Accepted: 01/01/2018] [Indexed: 10/28/2022]
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Authors' response. Am J Orthod Dentofacial Orthop 2018; 154:322-324. [PMID: 30173833 DOI: 10.1016/j.ajodo.2018.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 06/26/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
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Factors influencing the effective dose associated with CBCT: a systematic review. Clin Oral Investig 2018; 23:1319-1330. [DOI: 10.1007/s00784-018-2561-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 07/03/2018] [Indexed: 10/28/2022]
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Expanding torque possibilities: A skeletally anchored torqued cantilever for uprighting "kissing molars". Am J Orthod Dentofacial Orthop 2018; 153:588-598. [PMID: 29602351 DOI: 10.1016/j.ajodo.2017.12.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 12/01/2017] [Accepted: 12/01/2017] [Indexed: 01/02/2023]
Abstract
Several uprighting mechanics and devices have been used for repositioning tipped molars. "Kissing molars" (KMs) are an uncommon tooth impaction involving 2 severely tipped mandibular molars with their occlusal surfaces positioned crown to crown, with the roots pointing in opposite directions. Orthodontic uprighting of KMs has not been a usual treatment protocol, and it can be a challenging task due to the severe tipping and double impaction, requiring efficient and well-controlled uprighting mechanics. An innovative skeletally anchored cantilever, which uses the torque principle for uprighting tipped molars, is suggested. This torqued cantilever is easy to manufacture, install, and activate; it is a well-known torque that is effective for producing root movement. A successful treatment of symptomatic KMs, involving the first and second molars, was achieved with this cantilever. Thus, clinicians should consider the suggested uprighting mechanics and orthodontic device as a more conservative alternative to extraction of KMs, depending on the patient's age, involved teeth in KMs, tipping severity, and impaction positions.
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Authors' response. Am J Orthod Dentofacial Orthop 2017; 152:14-15. [PMID: 28651762 DOI: 10.1016/j.ajodo.2017.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 04/13/2017] [Accepted: 04/18/2017] [Indexed: 11/30/2022]
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Authors' response. Am J Orthod Dentofacial Orthop 2016; 151:11. [PMID: 28024763 DOI: 10.1016/j.ajodo.2016.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 09/22/2016] [Accepted: 10/11/2016] [Indexed: 11/18/2022]
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Abstract
OBJECTIVE To evaluate the null hypothesis that there is no difference between the vertical compensation necessary to level the clinical crown centers and that required to level the marginal ridges. MATERIALS AND METHODS Initial dental casts selected from 200 patients that met the selection criteria were included. The vertical position of the clinical crown center (VPCC) and marginal ridge (VPMR) of posterior teeth were measured in both arches using a digital height gauge with 0.01mm precision. The vertical discrepancy between the clinical crown centers (VDCC) and marginal ridges (VDMR) of adjacent posterior teeth were calculated and compared. The significance level was set at P < .05. RESULTS In general, vertical discrepancies between VDCC and VDMR were statistically significant (P < .05). Clinically significant differences were observed between the maxillary second premolar and first molar and between the mandibular molars. The VPCC was significantly and positively correlated with patient age. CONCLUSIONS Differences between VDCC and VDMR showed that the VPCC may not be an accurate predictor of marginal ridge leveling because the vertical compensation necessary to level the VPCCs is not similar to that required to level the marginal ridges, requiring caution in its utilization, mainly in teenagers.
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Impact of dentofacial development on early mandibular incisor crowding. Am J Orthod Dentofacial Orthop 2016; 150:332-8. [DOI: 10.1016/j.ajodo.2016.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 02/01/2016] [Accepted: 02/01/2016] [Indexed: 10/21/2022]
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Authors' response. Am J Orthod Dentofacial Orthop 2016; 149:777-9. [PMID: 27241981 DOI: 10.1016/j.ajodo.2016.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 03/02/2016] [Accepted: 03/07/2016] [Indexed: 11/19/2022]
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Extreme Dental Compensation in an Adult Skeletal Class III Malocclusion: 3-Year Follow-up of a Successfully Compromised Treatment. INTERNATIONAL JOURNAL OF ORTHODONTICS (MILWAUKEE, WIS.) 2015; 26:69-76. [PMID: 26349294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Nonsurgical orthodontic treatment of a patient with severe skeletal Class III malocclusion, negative overjet, increased overbite and maxillary crowding is described Although the treatment options included an orthodontic-surgical approach, high cost of the surgical procedure was the main reason for extreme dental compensation to have been performed. Four-premolar extraction protocol associated with intermaxillary Class III elastics were used to correct the malocclusion at the expense of increasing the initial dental compensation without producing any noticeable skeletal change. Satisfactory and stable occlusion was achieved with dental and smile esthetics improvement, but the amount of facial changes was limited by the nonsurgical protocol. The clinical results and implications of compensatory treatment as well as its relevance within the patient context are discussed based on scientific evidences.
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Versatility and benefits of mini-implants for vertical and sagittal anchorage in a growing open bite class II patient. J Orthod 2014; 39:43-53. [DOI: 10.1179/14653121226815] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Influence of occlusal finishing on extraction-site closure stability. J World Fed Orthod 2014. [DOI: 10.1016/j.ejwf.2014.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Efficiency of class I and class II malocclusion treatment with four premolar extractions. J Appl Oral Sci 2014; 22:522-7. [PMID: 24918660 PMCID: PMC4307766 DOI: 10.1590/1678-775720130544] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 03/17/2014] [Indexed: 11/22/2022] Open
Abstract
Four premolar extractions is a successful protocol to treat Class I malocclusion, but
it is a less efficient way when compared with other Class II treatment protocols.
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Abstract
OBJECTIVE To assess the effects produced by the MARA appliance in the treatment of Angle's Class II, division 1 malocclusion. METHODS The sample consisted of 44 young patients divided into two groups: The MARA Group, with initial mean age of 11.99 years, treated with the MARA appliance for an average period of 1.11 years, and the Control Group, with initial mean age of 11.63 years, monitored for a mean period of 1.18 years with no treatment. Lateral cephalograms were used to compare the groups using cephalometric variables in the initial and final phases. For these comparisons, Student's t test was employed. RESULTS MARA appliance produced the following effects: Maxillary growth restriction, no change in mandibular development, improvement in maxillomandibular relationship, increased lower anterior facial height and counterclockwise rotation of the functional occlusal plane. In the upper arch, the incisors moved lingually and retruded, while the molars moved distally and tipped distally. In the lower arch, the incisors proclined and protruded, whereas the molars mesialized and tipped mesially. Finally, there was a significant reduction in overbite and overjet, with an obvious improvement in molar relationship. CONCLUSIONS It was concluded that the MARA appliance proved effective in correcting Angle's Class II, division 1 malocclusion while inducing skeletal changes and particularly dental changes.
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REMOVED: Selective Use of Hand and Forearm Muscles During Bone Screw Insertion: A Natural Torque Meter. J Oral Maxillofac Surg 2013; 71:981. [DOI: 10.1016/j.joms.2013.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Selective use of hand and forearm muscles during mini-implant insertion: a natural torquimeter. J Orthod 2013; 40:89. [DOI: 10.1179/1465312513z.00000000059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Abstract
OBJECTIVE To compare maximum torque produced by different muscular groups and its influence on mini-implant insertion torque and fracture prevention. DESIGN A prospective study involving in vivo and in vitro laboratory experiments. MATERIALS AND METHODS Eighty-seven professionals were evaluated for maximum torque produced using a screwdriver with combined action between thumb and index fingers [maximum digital torque (MDT)] and by forearm supination movement [maximum brachial torque (MBT)]. Ninety mini-implants distributed over nine different diameters and twenty commercially available mini-implants of two different diameters and trademarks were fractured to determine the fracture torque (FT). The fracture resistance index (FRI) was obtained from: FRI_MDT = FT/MDT and FRI_MBT = FT/MBT. The analysis of variance (ANOVA) and t tests were used to compare the groups. RESULTS MDT was smaller than MBT and both were smaller in females. FT increased for each 0·1 mm of diameter increment. FRI_MDT was greater than FRI_MBT for all diameters. FRI_MDT>1 was found when the diameter was greater than or equal to 1·5 mm. FRI_MBT>1 occurred with diameters equal or greater than 1·7 mm for females and 1·8 mm for males. The 1.5 mm and 1.6 mm diameter of commercially available and mini-implants presented FRI_MBT<1 and FRI_MDT>1. CONCLUSIONS Digital torque was 42% smaller than brachial torque, and it was mechanically safer and biologically more compatible, allowing fracture prevention of 1·5 mm or thicker mini-implant diameter due to insertion torque limitation at 15 N/cm.
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RETRACTED: Selective Use of Hand and Forearm Muscles During Bone Screw Insertion: A Natural Torque Meter. J Oral Maxillofac Surg 2012; 70:e598-607. [DOI: 10.1016/j.joms.2012.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 07/11/2012] [Indexed: 10/27/2022]
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Influence of miniscrew dental root proximity on its degree of late stability. Int J Oral Maxillofac Surg 2012; 42:527-34. [PMID: 23062958 DOI: 10.1016/j.ijom.2012.09.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2011] [Revised: 06/06/2012] [Accepted: 09/18/2012] [Indexed: 11/27/2022]
Abstract
Purpose of this study was to evaluate the influence of miniscrew dental root proximity on its late stability degree. 40 miniscrews were inserted between maxillary second premolars and first molars for anterior retraction. Post-surgical radiographs were used to measure the septum width in the insertion site, insertion height, distal and mesial distance from miniscrew to dental root, and the smallest distance between miniscrew and dental root. The miniscrews were divided in two groups according to septum width: ≤3 mm (20 miniscrews) and >3 mm (20 miniscrews). The soft tissue in the insertion site, sensitivity during load, plaque around the miniscrew, and evaluation period were also considered. The results showed no significant difference in miniscrew mobility degree and success rate between groups. Miniscrew dental root proximity did not influence the stability and success rate when the distance between the miniscrew and dental root indicated no periodontal ligament invasion. The overall success rate was 90% and no variable was associated with miniscrew failure. Nevertheless, patient sensitivity was frequently associated with some degree of mini-implant mobility. The septum width did not influence the stability and success rate of this anchorage system, but the extreme root proximity did.
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Mini-implant insertion based on tooth crown references: a guide-free technique. Int J Oral Maxillofac Surg 2012; 41:128-35. [DOI: 10.1016/j.ijom.2011.07.902] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Revised: 04/09/2011] [Accepted: 07/20/2011] [Indexed: 11/26/2022]
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Effect of mini-implant diameter on fracture risk and self-drilling efficacy. Am J Orthod Dentofacial Orthop 2011; 140:e181-92. [DOI: 10.1016/j.ajodo.2011.06.016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Revised: 06/01/2011] [Accepted: 06/01/2011] [Indexed: 10/17/2022]
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Influência da largura do septo inter-radicular sobre a estabilidade dos mini-implantes. Dental Press J Orthod 2011. [DOI: 10.1590/s2176-94512011000200005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: este estudo teve como objetivo avaliar a influência da largura do septo inter-radicular no local de inserção de mini-implantes autoperfurantes sobre o grau de estabilidade desses dispositivos de ancoragem. MÉTODOS: a amostra consistiu de 40 mini-implantes inseridos entre as raízes do primeiro molar e segundo pré-molar superiores de 21 pacientes, com o intuito de fornecer ancoragem para retração anterior. A largura do septo no local de inserção (LSI) foi mensurada nas radiografias pós-cirúrgicas e, sob esse aspecto, os mini-implantes foram divididos em dois grupos: grupo 1 (áreas críticas, LSI<3mm) e grupo 2 (áreas não críticas, LSI>3mm). A estabilidade dos mini-implantes foi avaliada mensalmente pela quantificação do grau de mobilidade e a partir dessa variável foi calculada a proporção de sucesso. Avaliou-se também: a quantidade de placa, altura de inserção, grau de sensibilidade e período de observação. RESULTADOS: os resultados obtidos demonstraram que não houve diferença estatisticamente significativa para o grau de mobilidade e proporção de sucesso entre os mini-implantes inseridos em septos de largura mesiodistal crítica e não crítica. A proporção de sucesso total encontrada foi de 90% e nenhuma variável demonstrou estar relacionada ao insucesso dos mini-implantes. No entanto, observou-se maior sensibilidade nos pacientes cujos mini-implantes apresentavam mobilidade, e que a falha desses dispositivos de ancoragem ocorria logo após sua inserção. CONCLUSÃO: a largura do septo inter-radicular no local de inserção não interferiu na estabilidade dos mini-implantes autoperfurantes avaliados neste estudo.
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Long-term stability of surgical-orthodontic open-bite correction. Am J Orthod Dentofacial Orthop 2010; 138:254.e1-254.e10; discussion 254-6. [DOI: 10.1016/j.ajodo.2010.03.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Revised: 03/01/2010] [Accepted: 03/01/2010] [Indexed: 11/30/2022]
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Predictable drill-free screw positioning with a graduated 3-dimensional radiographic-surgical guide: a preliminary report. Am J Orthod Dentofacial Orthop 2009; 136:722-35. [PMID: 19892291 DOI: 10.1016/j.ajodo.2007.12.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Revised: 12/01/2007] [Accepted: 12/01/2007] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Mini-implants are placed in restricted sites, requiring an accurate surgical technique. However, no systematic study has quantified technique accuracy to reliably predict the surgical risks. Therefore, a graduated 3-dimensional radiographic-surgical guide (G-RSG) was proposed, and its inaccuracy and risk index (RI) were estimated. METHODS The sample consisted of 6 subjects (4 male, 2 female), who used mini-implant anchorage. Ten drill-free screws (DFS) were placed by using the G-RSG. The central point of the mesiodistal septum width (SW) was the selected implant site on the presurgical radiograph. The distances between DFS and the adjacent teeth (5-DFS and 6-DFS) were measured to evaluate screw centralization and inaccuracy degree (ID). These distances were statistically compared by independent t tests, and inaccuracy was determined by the expression ID = (5-DFS - 6-DFS)/2, which represents deviation of the mini-implant's final position regarding the central point initially selected. Then SW, ID, and screw diameter (SØ) were combined to estimate the surgical risk with RI expressed by RI = SØ/SW - ID. RESULTS The 5-DFS and 6-DFS distances were not significantly different. The ID of the G-RSG was 0.17 mm. The low ID ensured a safe RI (<1) in spite of the restricted SW. CONCLUSIONS The G-RSG accuracy allowed fine prediction of the final DFS position in the interradicular septum, with a low RI, which is a helpful tool to estimate surgical risks.
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Authors' response. Am J Orthod Dentofacial Orthop 2008. [DOI: 10.1016/j.ajodo.2008.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Effects of accentuated and reversed curve of Spee on apical root resorption. Am J Orthod Dentofacial Orthop 2008; 133:261-8; quiz 328.e2. [DOI: 10.1016/j.ajodo.2006.01.050] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2005] [Revised: 01/20/2006] [Accepted: 01/30/2006] [Indexed: 10/22/2022]
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Evaluation of root resorption after open bite treatment with and without extractions. Am J Orthod Dentofacial Orthop 2007; 132:143.e15-22. [PMID: 17693358 DOI: 10.1016/j.ajodo.2006.10.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2006] [Revised: 10/25/2006] [Accepted: 10/30/2006] [Indexed: 10/23/2022]
Abstract
INTRODUCTION In this study, we evaluated the root resorption degree in open bite and normal overbite patients, treated with and without premolar extractions. METHODS A sample of 120 patients was selected and divided into 4 groups. Group 1 comprised 32 patients treated with premolar extractions with an initial mean age of 14.01 +/- 2.58 years and an initial mean overbite of -3.45 +/- 0.23 mm. Group 2 included 28 open bite patients treated without extractions, with an initial mean age of 13.27 +/- 2.75 years and an initial mean overbite of -3.10 +/- 0.24 mm. Group 3 comprised 30 patients with normal overbite, treated with premolar extractions, having a mean age of 13.28 +/- 1.79 years and a mean overbite of 1.09 +/- 0.24 mm at the beginning of treatment. Group 4 consisted of 30 patients with normal overbite, treated without extractions, at a mean age of 12.87 +/- 1.43 years and a mean overbite of 1.67 +/- 0.24 mm at the beginning of treatment. The groups were matched by initial age, treatment time, and malocclusion type. Pretreatment and posttreatment periapical radiographs were used to evaluate the amount of root resorption. The groups were compared by using the Kruskal-Wallis and Dunn nonparametric tests. Correlations between the degree of root resorption and amount of tooth movement, usage time of anterior vertical elastics, and treatment time were investigated with the Spearman correlation coefficient. RESULTS No statistically significant difference was found between the root resorption degrees of open bite vs normal overbite groups, but the extraction groups had statistically significant greater root resorption than the nonextraction groups. Significant correlations were observed in the extraction groups between root resorption degree and amount of overjet correction and retraction of maxillary incisor apex. CONCLUSIONS Root resorption was similar between open bite and normal overbite treatment protocols, but extraction treatment showed greater root resorption than nonextraction treatment. There was a statistically significant correlation of overjet correction and retraction of maxillary central incisor apices with the degree of root resorption.
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Treatment stability with the eruption guidance appliance. Am J Orthod Dentofacial Orthop 2007; 131:717-28. [PMID: 17561049 DOI: 10.1016/j.ajodo.2005.04.048] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2005] [Revised: 04/01/2005] [Accepted: 04/01/2005] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Although the eruption guidance appliance has been used to correct Class II malocclusions for many years and its effects have been demonstrated, there is no study on the stability of the changes it produces. Therefore, the objective of this study was to investigate the long-term stability of cephalometric dentoskeletal and occlusal changes after eruption guidance appliance therapy. METHODS Thirty-nine patients were evaluated. Occlusal evaluations were made with the peer asseessment rating index, and anterior tooth irregularity was evaluated with the Little irregularity index. Cephalometric and occlusal data were obtained at pretreatment, posttreatment, and postretention. The data were analyzed by dependent 1-way analysis of variance (ANOVA) for comparison between the 3 stages of the experimental group, with the Newman-Keuls test as a second step. To compare the cephalometric experimental group changes with mean population changes, the t test was used. RESULTS Cephalometrically, in the postretention stage, overjet remained stable, overbite showed significant relapse, and molar relationship improved toward a Class I relationship. The peer asseessment rating index showed stability of the occlusion. The Little irregularity index demonstrated a statistically significant relapse of crowding in the postretention stage. CONCLUSIONS Cephalometrically, overjet and molar relationship were stable in the long term after treatment with the eruption guidance appliance; however, there was relapse of the overbite. Occlusally, correction of the malocclusion elevated by the peer assessment rating was stable. There was relapse of the anterior teeth crowding.
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A three-dimensional radiographic-surgical guide for mini-implant placement. JOURNAL OF CLINICAL ORTHODONTICS : JCO 2006; 40:548-54. [PMID: 17062906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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