A Literature Review of t Extraction Decision and Outcomes in Orthodontic Treatment

OBJECTIVES

To provide an organized resource for clinicians and patients to use to understand the treatment options and outcomes for orthodontics in terms of extracting or not extracting permanent teeth.

METHODS

Literature published from January 2000 to current was searched in the electronic databases Cochrane Central Register of Controlled Trials and PubMed. Study inclusion criteria included comparing the extraction technique versus no extraction, average age of participants was 10 years old, and if relevant, crowding between 4-10 mm. Each article was arranged by type of extraction and malocclusion corrected to find similarities. The data was observed for common variables measured.

RESULTS

From the 23 articles reviewed, 10 appear to fit the criteria. Although some studies showed contradicting results, there can be some associations drawn. A trend can be noted of an increase in the incisor mandibular plane angle (IMPA), an increase in lower lip thickness, and proclination of incisors after orthodontic treatment with no extractions. In extraction cases, findings were almost the opposite, as lips are more retruded and incisors are more retracted. These findings, along with the other variables, provide an insight as to what facial profiles would be best suited for which treatment.

CONCLUSIONS

Patients with more proclined incisors and more protrusive lips may be better with an extraction treatment plan to help compensate for these traits. Ultimately, to decide the best treatment, each case should be assessed individually, as other factors, such as crowding, age, and malocclusion, can lead to vastly different results.

Influence of patient head positioning on measured axial tooth inclination in panoramic radiography

OBJECTIVE

Panoramic radiographs are routinely used to assess the mesiodistal axial inclination of teeth (MDAI) in orthodontic treatment. These radiographs are sensitive to minor deviations from standard head position that result in image distortions. The aim of this study is to measure and quantify the changes in MDAI on panoramic radiograph resulting from changes in patient head position.

MATERIALS AND METHODS

The testing devise was a human skull with guide wires placed on the facial surface of the teeth and alveolar process along the long axis of each tooth. Panoramic radiographs were captured digitally with the orientation of the skull in Frankfurt horizontal plane parallel to the floor and with 1 degrees , 2 degrees , 5 degrees , 7 degrees , and 10 degrees both superior and inferior rotations. The mesiodistal tooth angulations were determined using MIPAC software (DentalEye and LEAD Technologies, Inc. 2005).

RESULTS

The more distal the position of the tooth in the arch the greater the change in MDAI with a change in vertical head position. A maximum change of approximately 10 degrees was observed in MDAI of both the maxillary and mandibular molars with a corresponding superior head tilt of 10 degrees. The Mandibular anteriors displayed significant inconsistencies in MDAI with both superior and inferior head tilt. A superior head tilt produced a greater change in mesiodistal angulation than did an inferior head tilt.

CONCLUSIONS

Accurately taken panoramic radiographs can serve as a convenient tool for evaluating the MDAI before, during and after orthodontic treatment. Additional radiographs are recommended for the mandibular anteriors.

Cephalometric findings in patients with Papillon-Lefèvre syndrome

INTRODUCTION

Literature regarding oral conditions in patients with Papillon-Lefèvre syndrome (PLS) often covers the periodontal aspects, but no literature was found describing specific craniofacial findings in this group. The aim of this retrospective study was to investigate the cephalometric findings of patients with PLS.

METHODS

Lateral cephalograms of 8 patients with PLS were traced, and hard- and soft-tissue variables were analyzed.

RESULTS

Class III skeletal relationship was evident (ANB angle, 2 degrees +/- 3.1 degrees ; Wits appraisal, -9.1 mm +/- 3.7 mm). Other findings include maxillary retrognathia, decreased lower facial height, retroclined mandibular incisors, and upper lip retrusion.

CONCLUSIONS

Patients affected with PLS have a Class III skeletal pattern. These findings can be of clinical value not only for diagnosis, but also for proper treatment planning.

Surgically assisted rapid palatal expansion: a literature review

Transverse maxillomandibular discrepancies are a major component of several malocclusions. Orthopedic and orthodontic forces are used routinely to correct a maxillary transverse deficiency (MTD) in a young patient. Correction of MTD in a skeletally mature patient is more challenging because of changes in the osseous articulations of the maxilla with the adjoining bones. Surgically assisted rapid palatal expansion (SARPE) has gradually gained popularity as a treatment option to correct MTD. It allows clinicians to achieve effective maxillary expansion in a skeletally mature patient. The use of SARPE to treat MTD decreases unwanted effects of orthopedic or orthodontic expansion. Our aim in this article is to present a comprehensive review of the literature, including indications, diagnosis, guidelines for case selection, a brief overview of the surgical techniques, orthodontic considerations, complications, risks, and limitations of SARPE to better aid the clinician in the management of MTD in skeletally mature patients.

Category 4: Class II Division 2 malocclusion with deep overbite

This case report was part of the resident display of cases sponsored by the College of Diplomates of the American Board of Orthodontics at the annual session of the American Association of Orthodontists, May 20-24, 2005, in San Francisco, Calif.

Delayed tooth eruption: pathogenesis, diagnosis, and treatment. A literature review

Delayed tooth eruption (DTE) is the emergence of a tooth into the oral cavity at a time that deviates significantly from norms established for different races, ethnicities, and sexes. This article reviews the local and systemic conditions under which DTE has been reported to occur. The terminology related to disturbances in tooth eruption is also reviewed and clarified. A diagnostic algorithm is proposed to aid the clinician in the diagnosis and treatment planning of DTE. The sequential and timely eruption of teeth is critical to the timing of treatment and the selection of an orthodontic treatment modality. This review addresses the need for a more in-depth understanding of the underlying pathophysiology of DTE and gives the clinician a methodology to approach its diagnosis and treatment.