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PubMed2002

[Pre- and post-surgical orthodontic objectives and orthodontic preparation].

Orthodontics in combination with orthognathic surgery is a possibility today for correcting sagittal, vertical and transversal dysmorphosis. To do this, orthodontic preparation before surgery is necessary. In the sagittal plane, dental compensations should be removed. In the vertical plane, levelling of a severe mandibular SPEE curve should be accomplished postsurgically, and transverse coordination obtained. Orthodontic preparation is very specific to the type of dysmorphosis: class II malocclusion, class III malocclusion or in open bite. Postsurgical orthodontic treatment is used to finalize tooth alignment as in conventional orthodontics.

Craniofacial Abnormalities↗
PubMed1990

[The study on the orthodontic patients who visited department of orthodontics, Seoul National University Hospital].

From 1965 to 1974, the total number of the orthodontic patients who visited Seoul National University Hospital was only about 1000. But in the last several years the number has been increasing so rapidly that we have about 1000 new orthodontic patients every year. This made it necessary to undertake an epidemiologic study on them so that we can accommodate their orthodontic needs adequately. Accordingly, the present study was done in an attempt to provide reliable quantitative information regarding the characteristics of malocclusion-Angle's classification etc.--of patients who visited Department of Orthodontics, Seoul National University Hospital from 1985 to 1989. The total number was 3305. This study sought to determine the annual trend in total number during 5 years, frequency in each age and sex group and distribution according to Angle's classification. It was found that: 1. Total number of orthodontic patients has been increasing and the number of female patients was 1.55 times as high as that of male. 2. Percentage of Class III malocclusion has been increasing, but that of Class I decreasing. Each percentage of Class I, Class II div. 1, Class II div. 2 and Class III was 35.92%, 13.40%, 1.54%, and 49.14%. 3. Percentages of 8 to 12-year-old group and 12 to 18-year-old group showed decreasing trends, but that of adult patients showed increasing trend.

Adolescent↗
PubMed1991

An American Board of Orthodontics case report. Correction of a Class III mandibular prognathism and asymmetry through orthodontics and orthognathic surgery.

The Class III malocclusion with mandibular prognathism can involve many factors, among which are excessive mandibular growth, underdevelopment of the maxilla, environmental factors, and trauma to the jaws. The correction of this malocclusion can involve an orthodontic or a combined orthodontic-orthognathic approach. Skeletal asymmetries can complicate this situation, making treatment either more difficult, more complicated, or both. This case presentation involves treatment with a combined orthodontic-orthognathic approach. [This case was presented to the American Board of Orthodontics in partial fulfillment of the requirements for the certification process conducted by the Board.]

Adolescent↗
PubMed2004

Orthodontics. Part 6: Risks in orthodontic treatment.

Orthodontics has the potential to cause significant damage to hard and soft tissues. The most important aspect of orthodontic care is to have an extremely high standard of oral hygiene before and during orthodontic treatment. It is also essential that any carious lesions are dealt with before any active treatment starts. Root resorption is a common complication during orthodontic treatment but there is some evidence that once appliances are removed this resorption stops. Some of the risk pointers for root resorption are summarised. Soft tissue damage includes that caused by archwires but also the more harrowing potential for headgears to cause damage to eyes. It is essential that adequate safety measures are included with this type of treatment.

Dental Caries↗
PubMed1992

The in vivo orthodontic banding model for vital teeth and the in situ orthodontic banding model for hard-tissue slabs.

This paper presents the orthodontic banding model for vital teeth and the orthodontic in situ model for slabs of enamel, root surface, dentin, or other mineralized tissues such as shark enamel. The model for vital teeth is an in vivo model, since a crevice for plaque accumulation is created behind orthodontic bands on the buccal enamel surfaces of teeth in situ. Visible white-spot lesions are usually seen after a four-week banding period in the absence of fluoride. The microbiological flora developed behind the bands shows a similarity to that of natural caries. Microradiographic data show that the initial lesion is a softening of the enamel surface. Later, a subsurface lesion develops. A modification of the model has been developed for the use of slabs of mineralized tissues. In this model, slabs are mounted on a removable appliance. The slabs are covered with orthodontic banding material for plaque accumulation. Lesion development in enamel in the two model systems is almost identical. The benefit of the in vivo model is that caries development can be studied on vital teeth in young individuals. The model is independent of the patient's cooperation. No special diet is required, e.g., no sucrose rinsing. In the in situ model, slabs could be examined after one study period and then replaced for another period.

Dental Caries↗
PubMed1991

Orthodontic interactions: the relationships between the orthodontic services in England and Wales.

The manpower distribution and the amount of treatment undertaken by the three orthodontic treatment providing groups was calculated on a national and regional basis. There was marked regional variation in the distribution of orthodontic manpower. It was found that the total orthodontic treatment rate correlated with the distributions of specialist practitioners and general dental practitioners, but not with that of the salaried services. The manpower distribution of specialist practitioners and Community Orthodontists was also related. These results are discussed in terms of the effect of manpower distribution upon demand for treatment and the amount of treatment provided by the orthodontic services.

Adolescent↗
PubMed1993

The use of occlusal indices in assessing the provision of orthodontic treatment by the hospital orthodontic service of England and Wales.

This retrospective study was carried out to assess the need for orthodontic treatment and the standard of treatment provided by a sample of 17 hospital-based orthodontic departments. A total of 1630 sets of patients records were collected and analysed for orthodontic treatment need and standard of treatment with the Index of Orthodontic Treatment Need and the PAR index, respectively. The data were analysed with a variant of analysis of covariance using linear modelling techniques. In general terms it appeared that the hospital service provided treatment of a high standard, in terms of dento-occlusal change, to a caseload of patients that were in need of treatment. The effectiveness of treatment provision was influenced by the grade of operator, the choice of treatment methods and by the departmental attitudes and aspirations.

Appointments and Schedules↗
PubMed1995

A comparison of consecutive orthodontic referrals seen by a consultant unit and specialist orthodontic practitioners.

It has been suggested that the consultant orthodontic service and specialist practitioner service should have different roles, with the former concentrating its treatment input on the management of severe malocclusions. In an attempt to determine whether referring dental practitioners appeared to be aware of these differences, 100 consecutive orthodontic referrals seen at a consultant orthodontist's clinic were compared and contrasted with the same number seen at each of four specialist orthodontic practices located in the same city, and within 4 miles of the consultant unit. Comparisons were made both on the basis of clinical information obtained from study models and from analysis of referral letters. The consultant sample contained a greater proportion of requests for treatment plans, but there were few differences in terms of the range and severity of the actual malocclusions referred to each of these specialist services. The implications of these findings are discussed in relation to possible future developments of orthodontic services in the U.K.

Community Dentistry↗
PubMed1998

[Effects of pregnancy on orthodontic tooth movements: effects of progesterone on orthodontic tooth movements in pregnant rats].

This study evaluated the periodontal responses and progesterone changes to orthodontic tooth movements in pregnant rats. Adult female Sprague-Dawley rats were separated into two groups: non-pregnant and pregnant. All rats were treated with fixed orthodontic appliances that moved the upper incisors in a distal direction during 10 days. At the end of the experiment, the periodontal tissues were examined histologically and immunohistochemically (ABC method). The results showed that in the histological examination of the tension sides of the upper incisors, the bone formation was more obvious in the pregnant group than that in the non-pregnant group. In the immunohistochemical staining, the osteoblasts were positive-stained cells and they exhibited deeper stain and higher percentage in the pregnant group. In a conclusion, the progesterone influences the periodontal reconstruction on orthodontic tooth movements in pregnant rats and may be helpful in alveolar bone formation, which suggests that orthodontic treatments in pregnant patients may not be so harmful as people thought before.

Animals↗
PubMed1990

The shear bond strengths of stainless steel orthodontic brackets bonded to teeth with orthodontic composite resin and various fissure sealants.

Enamel decalcification (whitened areas) around orthodontic brackets during therapy is a well-recognized problem. If a fissure sealant could be used to isolate the enamel and yet withstand debonding of the bracket during therapy, this problem might be overcome. The objective of this in vitro study was to determine (1) the shear bond strengths of stainless steel orthodontic brackets bonded to teeth with an orthodontic bonding resin together with a primary coating of various fissure sealants and (2) the fracture sites of these debonded samples. Forty noncarious human canine teeth were divided into four groups of 10 teeth each. In group A, the brackets were bonded to the buccal surfaces of the prepared teeth with a macrofilled orthodontic composite resin only. In groups B, C, and D, the brackets were similarly bonded, except that the teeth were first treated with a fissure sealant--group B having a light-cured unfilled clear fissure sealant, group C having a light-cured microfilled fissure sealant, and group D having a chemically cured opaque fissure sealant. After storage at 37 degrees C for 24 hours, the brackets were subjected to a shear force in an instron machine, and the fracture strengths were recorded, together with the sites of fracture.(ABSTRACT TRUNCATED AT 250 WORDS)

Composite Resins↗
PubMed2006

Psychiatry in orthodontics. Part 2: Substance abuse among adolescents and its relevance to orthodontic practice.

Substance abuse by adolescents is a serious problem that will touch every orthodontic practice. Recent data show that 40% of tenth graders in the United States will use an illicit drug at some time, and 18% will do so in a 30-day period. These are significant figures that should impact orthodontic diagnosis and treatment planning. The nature of orthodontic treatment is unique in that the orthodontist will see relatively healthy adolescent patients on a monthly basis over a period of years. The orthodontist is in a prime position to recognize potential substance abuse problems and make referrals. This article discusses various types of substance abuse, diagnosis, options for referral, and orthodontic implications.

Adolescent↗
PubMed1993

An orthodontic and cephalometric study on the results of the combined surgical-orthodontic approach of the protruded premaxilla in bilateral clefts.

The anatomical aberration of the premaxilla in bilateral cleft lip and palate (BCLP) gives rise to many problems. Orthodontic and orthopaedic treatment alone often fail to correct this deformity. In this study, the results of a combined surgical-orthodontic approach were analysed. 22 BCLP-patients, who had undergone an osteotomy of the premaxilla in combination with secondary or tertiary bone grafting, were involved in this study. Two cephalograms were analysed from each patient, one prior to and one after osteotomy. Dental casts were made prior to orthodontic treatment, prior and after osteotomy of the premaxilla and after final orthodontic treatment. As a control group, BCLP-patients treated by the cleft palate centre, Oslo were used. Treatment planning of these two teams is comparable, except for the fact that in Oslo surgical repositioning of the premaxilla is never performed. Cephalometric values before and after osteotomy of the premaxilla were calculated. These values were corrected for growth by means of the Oslo-data. Differences before and after osteotomy were tested statistically with a paired t-test. After osteotomy, good arch form was achieved, the premaxilla was positioned more superiorly and normal inclination of incisors was achieved. It was not possible, however, to lower a high-positioned premaxilla to a normal vertical relationship.

Adolescent↗
PubMed2026

Radiographic assessment and orthodontic intervention effects on orthodontically induced root resorption: a systematic review and meta-analysis of clinical trials.

The relative contribution of radiographic methods and characteristics of the orthodontic intervention to orthodontically induced root resorption (OIRR) remains unknown. The aims of this systematic review and meta-analysis were to (1) estimate the pooled OIRR effect across orthodontic intervention versus comparator contrasts, (2) compare pooled estimates by radiographic method (2D [two-dimensional] vs. 3D/CBCT [three-dimensional/cone-beam computed tomography]), and (3) explore whether force mechanics (intrusive versus nonintrusive) modified OIRR magnitude. Seven randomized controlled trials and one prospective study (January 2010-October 2025) were included. Only OIRR was the outcome, reported as correlation coefficients (r). The primary analysis combined within-study intervention-versus-comparator estimates. Subgroup analysis of 2D versus 3D/CBCT imaging was prespecified, whereas post-hoc analysis of intrusive versus nonintrusive mechanics was performed. The pooled analysis for the primary outcome showed a small, nonsignificant OIRR effect (r = 0.07; 95% confidence interval [CI]: -0.12 to 0.27; p = 0.372) with high heterogeneity (I2 = 84.0%). Radiographic method did not change the pooled estimates significantly (p = 0.331). Force-mechanics analysis showed that intrusive mechanics was related to significantly higher root resorption than nonintrusive mechanics (r = 0.40; 95% CI = 0.15 to 0.65 versus r = -0.03; 95% CI = -0.16 to 0.10; p < 0.001). This accounted for 87.1% of the between-study variance. The average orthodontic intervention effect on OIRR was small and not significant; however, the OIRR magnitude was strongly affected by force mechanics, particularly by intrusive forces. There was no significant difference in pooled estimates by radiographic method; however, 3D/CBCT provides superior volumetric quantification and should be used judiciously according ALARA (as low as reasonably achievable) principles.

Root Resorption↗
PubMed1999

The community and orthodontic care. Part II: Community-perceived importance of correcting various dentofacial anomalies. Part III: Community perception of the importance of orthodontic treatment.

Part II. A professionally-managed telephone survey was undertaken to assess the community-perceived importance of correcting various dentofacial anomalies. The sample included 505 respondents, aged eighteen and over, from metropolitan and non-metropolitan households across the state of Victoria. The sample distribution had a 95 per cent confidence limit with a 5 per cent margin of error and closely matched the known population distributions for age, sex and geographical location. This article forms part two of a series. It was found that the correction of functional problems such as "difficulty chewing or speaking" was considered to be very important, regardless of age, sex or geographical area. The correction of other factors such as "top teeth which stick out in front", "bottom teeth which stick out in front" or "crooked or crowded front teeth" was also considered to be important. "Spaced front teeth" was the factor considered least important for correction within all groups. It is interesting to note that, for all factors, correction seemed to be considered more important by females and non-metropolitan respondents than by males and metropolitan respondents, In contrast to previous studies in which it has been suggested that patients seek treatment mainly for reasons of aesthetics, the results of this study have shown a definite community recognition of the importance of functional problems as well. Part III. A professionally-managed telephone survey was undertaken to assess the community's perceptions of the importance of having "straight teeth and a nice smile", to assess if a Medicare (the Australian government health benefit scheme) rebate should be provided for orthodontic treatment and to assess whether respondents had any private health insurance that would help cover the cost of orthodontic treatment. The sample included 505 respondents, aged eighteen and over,, from metropolitan and non-metropolitan households across the state of Victoria. The sample distribution had a 95 per cent confidence limit with a 5 per cent margin of error and closely matched the known population distributions for age, sex and geographical location. It was found that a very large percentage of respondents considered the need for "straight teeth and a nice smile" to be very important. This finding is supported by the many studies showing the importance of facial attractiveness to the lives of all people, young and old. Only a small percentage of respondents indicated that they had any private dental health insurance that would help cover the cost of orthodontic treatment. Efforts should be made to inform those responsible for the planning of orthodontic services in both the public and private sectors of the importance of the community's perceptions of aesthetics, and the large amount of published work that reinforces the impact of facial attractiveness on people's lives.

Adolescent↗
PubMed1999

The community and orthodontic care. Part I: community-perceived need and demand for orthodontic treatment.

A professionally managed telephone survey was undertaken to assess community-perceived need and demand for orthodontic treatment, and to determine the proportion of the community with a history of having some form of orthodontic treatment. The sample included 505 respondents, aged eighteen and over, from metropolitan and non-metropolitan households across the state of Victoria in Australia. The sample distribution had a ninety-five per cent confidence limit with a five per cent margin of error, and closely matched the known population distributions for age, sex and geographical location. From the survey it can be concluded that apparently forty-four per cent of Victorian families include someone who has already received some form of orthodontic treatment. Twenty-five per cent of the survey respondents perceived some need for the treatment of a family member; only fifteen per cent of respondents, however, reported that someone in their family actually wanted treatment. This survey has established baseline values for community perceived need and demand for orthodontic treatment. Use of these values should assist in future resource management within both the public and private sectors.

Adolescent↗
PubMed2004

Orthodontics. Part 11: orthodontic tooth movement.

Orthodontic tooth movement is dependent on efficient remodelling of bone. The cell-cell interactions are now more fully understood and the links between osteoblasts and osteoclasts appear to be governed by the production and responses of osteoprotegerin ligand. The theories of orthodontic tooth movement remain speculative but the histological documentation is unequivocal. A periodontal ligament placed under pressure will result in bone resorption whereas a periodontal ligament under tension results in bone formation. This phenomenon may be applicable to the generation of new bone in relation to limb lengthening and cranial-suture distraction. It must be remembered that orthodontic tooth movement will result in root resorption at the microscopic level in every case. Usually this repairs but some root characteristics apparent on radiographs before treatment begins may be indicative of likely root resorption. Some orthodontic procedures (such as fixed appliances) are also known to cause root resorption.

Biomechanical Phenomena↗
PubMed2002

Occlusal interferences in orthodontic patients before and after treatment, and in subjects with minor orthodontic treatment need.

Different opinions have been expressed concerning the effect of orthodontic treatment on mandibular function. One factor discussed is occlusal interferences. The aim of this study was to establish the prevalence of occlusal interferences in 210 orthodontic patients before (mean age 12 years 8 months) and after (mean age 16 years 10 months) treatment and to compare them with subjects with minor orthodontic treatment need. The results showed a decrease in retruded contact position/intercuspal position (RCP/ICP) interferences in all morphological deviations, age, and gender groups. The prevalence of mediotrusion interferences decreased in some types of malocclusions whilst in others there was no change. One reason for this is that treatment was started when the majority of the patients had no second or third molars erupted. At the final registration, the second molars were erupted in all patients, and the third molars were erupted in approximately 25 per cent. Mediotrusion interferences were more consistent with basal morphological deviations, for example, Class III relationships and anterior open bite were more consistent in the same person, and more difficult to eliminate than RCP/ICP interferences. RCP/ICP interferences, often caused by dental deviation in position, size, and shape, were easier to correct. Optimal orthodontic treatment, if necessary, including selective grinding, will decrease the prevalence of occlusal interferences.

Adolescent↗
PubMed2003

The value of the aesthetic component of the Index of Orthodontic Treatment Need in the assessment of subjective orthodontic treatment need.

Previous studies carried out using the Index of Orthodontic Treatment Need (IOTN) have reported that the Aesthetic Component (AC) has limited use in schoolchildren. The purpose of this study was to estimate whether dental concern expressed by the grade of the AC chosen by subjects is reliable and whether it may be predictive for potential co-operation. Such a correlation would indicate if the AC of the IOTN may help to identify individuals interested in orthodontic treatment who would co-operate well, and consequently who might derive the greatest benefits. The investigation was carried out in north-west Poland among 84 schoolchildren (42 girls and 42 boys) aged 12 years and was based on a questionnaire and clinical examination. The questionnaire contained items relating to the subjective assessment of dental appearance, demand for orthodontic treatment, the influence of the dentition on the general appearance, and any functional disorders (speech, mastication, muscular pain, etc.). Clinical examination was carried out at the schools each time by the same dentist. For statistical analysis chi-square (Yates corrected) and McNemar tests were used. A probability at the 5 per cent level or less (P < 0.05) was considered statistically significant. The outcome shows that the AC of the IOTN moderately reflects the subjective perception of dental aesthetics and demand for orthodontic treatment. The results indicate that using professional rating the AC scale does not seem to be more precise or reliable than self-evaluation. The correlation between dental concern and the AC would be higher if the 'no treatment need' category was split into two parts (e.g. 1-2 'no need', 3-4 'slight need') or the 'borderline need' category was moved two grades lower. The AC would then help to identify patients interested in treatment who would potentially be co-operative.

Attitude to Health↗