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PubMed1995

[Evaluation of presurgical orthodontic correction of the mandibular prognathism].

The aim of this study was to evaluate the effects of presurgical orthodontic correction of the mandibular prognathism. The sample consisted of two groups of surgical cases. The cases of the mandibular prognathism in group I with lower anterior dental compensation received presurgical orthodontic decompensation, and the cases in group II without lower anterior dental compensation did not receive presurgical orthodontic decompensation. The results showed that before presurgical orthodontic treatment, significantly differences existed between the two groups variable ILi/OL and ANB. After presurgical orthodontic correction lower incisors position in group I was very close to that in the group II, this means that the presurgical orthodontic treatment significantly changed the position of the lower incisors.

Adolescent↗
PubMedDate not supplied

Extractions prior to comprehensive orthodontic treatment in the mixed dentition.

Studies concerning the prevalence of extractions prior to orthodontic treatment have been limited in scope. This quasi-experimental analysis from secondary data explores patient and provider variables as they relate to extractions prior to comprehensive orthodontic therapy in the mixed dentition. This national database contains 38,529 children who had at least one comprehensive orthodontic (mixed dentition) visit within a 27-month period (January 1987-March 1989). Because of the relatively small number of Class III malocclusion cases, an equal allocation, random sample method was used in choosing children from the three Angle malocclusion classifications and the seven NIDR regions. Of those selected 24.7% had one or more extractions prior to orthodontic treatment, with 56% occurring at either 11 or 12 years of age. There were slightly more extraction cases for the Class I malocclusion children (26.7%) than either Class II (23.1%) or Class III (24.1%). Those children who had an orthodontic extraction were slightly older (P < 0.05). There were no statistically significant differences relating to orthodontic extractions for the following patient and provider variables: gender, malocclusion classification, years since dental graduation, and type of dental practice. There were regional differences among extraction rates for pediatric dentists, with those from the NIDR Midwest region more likely to have children receiving one or more extractions.

Adolescent↗
PubMed1995

Orthodontic considerations in orthognathic surgery.

It is important for the oral and maxillofacial surgeon to understand the orthodontic decision-making process as it pertains to the orthognathic surgery patient to facilitate interprofessional communication. The orthodontic diagnostic process integrates the needs of the dentition, the requirements of facial balance, and the constraints of orthodontic mechanics to arrive at the best collective recommendation in each case. The orthodontic treatment objectives, extraction patterns, and types of mechanics used in orthognathic surgery cases may vary from those used in nonsurgical orthodontic regimens, in which the dentition is considered in the context of the largely immutable skeletal pattern. The goal of presurgical orthodontic treatment is to prepare the dentition for maximal surgical correction so that, at the time of surgery, the dental arches are compatible with the postsurgical position and facial balance is achieved.

Dental Occlusion↗
PubMed1997

Clinical orthodontics in predoctoral education. Six years of experience at Indiana University.

Since 1990, clinical achievement in orthodontics has been a graduation requirement at Indiana University. To be certified for graduation, all dental students must treat at least one limited orthodontic problem and observe the retention of at least one previously treated, limited orthodontics patient. Although clinical orthodontics for adults appears to be a very successful addition to the predoctoral curriculum, the specific accreditation requirements that mandated it have been rescinded. However, the positive response of the students, apparent acceptance by the orthodontic community, and the national acclaim afforded the program indicate that a hands-on clinical experience in orthodontics is a positive addition to the predoctoral curriculum.

Accreditation↗
PubMed1997

Perceptions of orthodontic appliances among grade seven students and their parents.

A survey of 468 Grade Seven students and 437 parents in the North Brisbane region was undertaken to determine perceptions of orthodontic appliances. Based on responses to statements on the survey, a Perception Score was created for both students and parents in relation to both fixed and removable appliances. Both students and parents had more negative perceptions of fixed appliances than of removable appliances. Fixed appliances were perceived to attract more teasing, to cause more problems in the maintenance of oral hygiene and to be more painful than a removable plate. Respondents also felt that children would have to be more careful about what they eat when wearing fixed appliances. Approximately forty per cent of students and parents did not know whether teeth could be damaged by orthodontic appliances nor whether the appliances would cause discomfort. Parents had significantly more negative perceptions of both types of orthodontic appliances than did the students. The Perceptions scores were not significantly influenced by whether the students attended a private or public sector dentist, the frequency of dental visits, any history of orthodontic treatment, nor by the parents' level of education and their occupations. A forewarning about experiences of orthodontic appliances would better prepare patients and assist operators in providing the community with a more comprehensive orthodontic service.

Adolescent↗
PubMed1993

A survey on orthodontics and the dental practitioner.

A questionnaire was mailed to locally trained Division One dental surgeons. The questionnaire was designed to assess the practice of orthodontics, the undergraduate orthodontic curriculum in relation to the dental practitioner and continuing orthodontic education. The results showed that the undergraduate orthodontic curriculum was of limited use to the practitioner and that there was a need for a continuing orthodontic education programme. Information pertaining to various aspects of orthodontic practice was presented.

Curriculum↗
PubMed1999

A closer look at General Dental Service orthodontics in England and Wales. I: Factors influencing effectiveness.

OBJECTIVE: To evaluate factors influencing effectiveness in General Dental Service (GDS) orthodontics. DESIGN: Retrospective analysis of systematic 2% sample of GDS (England and Wales) cases. METHOD: Records of cases were collected during 1991. Assessment involved occlusal indices and data from National Health Service forms for 1,411 cases. Multivariate analyses were used with Peer Assessment Rating Index (PAR) score at Finish as the outcome indicator. RESULTS: Dual arch fixed appliances: achieved lower Finish PAR scores than other appliances; only 1.5% of the variance was explained, by treatment time and Dental Health Component of the Index of Orthodontic Treatment Need (DHC). Finish PAR was unaffected by Starting PAR. All other appliances: the model explained 25% of the variance for Finish PAR, which varied with Starting PAR and DHC scores. Social class had effects of little clinical significance, but the data suggested availability of orthodontic treatment was poorer in 'manual class' areas. Orthodontic qualifications, number of arches treated and mixed dentition starts had no significant effects when submitted to multivariate analysis. CONCLUSIONS: The importance of appliance selection is reinforced: dual arch fixed appliances are generally more consistent. Lower social class areas may be poorly provided with orthodontic services.

Age Factors↗
PubMed2000

A radiographic comparison of apical root resorption after orthodontic treatment with 3 different fixed appliance techniques.

Apical root resorption is an undesirable, but frequent side effect of orthodontic treatment, and therefore improvements in orthodontic techniques and materials are in constant development to decrease it. One of the most recently developed orthodontic techniques is the Bioefficient Therapy that uses contemporary orthodontic materials. Therefore, the primary objective of this study was to compare the amount of root resorption after orthodontic treatment between the simplified standard edgewise technique (group 1), the edgewise straight wire system (group 2), and the Bioefficient Therapy (group 3). It was also the purpose of this investigation to evaluate the amount of root resorption in the whole sample studied and the prevalence of root resorption in the upper and lower incisors. Thus, periapical radiographs were obtained with the long cone paralleling technique for the upper and lower incisors from 30 patients for each group. Root resorption was ranked by scores by 2 examiners who had an excellent intra and interexaminer calibration by Kendall concordance coefficient. Results of the Kruskal-Wallis test demonstrated that group 3 (Bioefficient Therapy) presented less root resorption than the others. It was speculated that the factors responsible for the lesser resorption in this technique were the use of heat-activated and superelastic wires with the bracket design in this technique as well as the use of a smaller rectangular stainless steel wire (0.018 x 0.025 inch) in a 0.022 x 0.028 inch slot during incisor retraction and the finishing stages, as compared to the other techniques. Considering the whole sample, there was no root resorption in 2.25% of the analyzed teeth. There was only a slight resorption in 42.56%, a moderate resorption in 53.37%, an accentuated resorption in 1.40% and an extreme root resorption in only 0.42% of the teeth. The prevalence of resorption for each incisor indicated, in decreasing order, a greater resorption for the upper centrals, followed by the upper laterals, lower centrals, and lastly the lower lateral incisors.

Adolescent↗
PubMed2002

Advances in orthodontics.

There has been tremendous progress in orthodontics since Edward Angle first popularised the fixed orthodontic appliance at the turn of the century. Recent years have seen an increased demand for orthodontic treatment from both adolescents and adults and, in addition, patient and clinician expectations of treatment outcomes continue to rise. A desire for more aesthetic materials has resulted in both smaller and 'tooth-coloured' appliances. Improvements in technology, often outside orthodontics, have also led to the development of new materials. The best example of this was the development of nickel titanium alloy by the NASA space programme, which was subsequently adapted for use in nickel titanium archwires. Other technological advances adopted for use in orthodontics include magnets, computerised imaging systems and distraction osteogenesis. This review paper looks at some of the innovations in the fields of materials as well as in techniques and appliance systems.

Adolescent↗
PubMed2001

[Orthodontic implications in the correction of the transverse dimension in orthognathic surgery].

Transverse skeletal discrepancies are treated in skeletally mature patients with an association of orthodontics and surgical procedures. The orthodontics procedures used depend on the type of surgical maxillary expansion performed. Orthodontics procedures performed before surgery are designed around the analysis of frontal asymmetry. Indications and proper treatment strategy for surgically-assisted maxillary expansion, or for Lefort I osteotomy depend on the magnitude of the transverse deficiency. The orthodontics implications of facial asymmetry remains one of the specific points requiring special care before and after surgery. Long length orthodontics stabilization is required after surgically-assisted rapid maxillary expansion to limit transversal relapse by use of a rigid fixation or another auxiliary stabilizing arch wire.

Adult↗
PubMed1988

Treatment of adults with lingual orthodontic appliances.

With the advent of lingual orthodontic treatment, an alternative became available to the adult patient who preferred to avoid the unesthetic appearance of conventional orthodontic appliances. The newer brackets and archwires described in this article, in combination with the proven technique developed by the author and others, has made lingual orthodontic treatment a practical reality. The appliance has been shown to be as effective as labial counterparts in correcting all types of malocclusions. New laboratory and indirect bonding techniques have eliminated the need for intricate wire bending and have reduced patient chair time and overall treatment time. Because of the premature introduction of early lingual appliances, many dental practitioners mistakenly believe that lingual treatment is less effective than labial treatment. As more examples of successful treatment are seen, dental practitioners will be more apt to refer patients to orthodontists proficient in this technique. Many graduate orthodontic programs now are teaching this technique to their residents. About 3000 patients currently are starting treatment with lingual appliances each year. This represents only about 1 per cent of adult patients. It is projected that this slowly will climb to about 10 per cent of adult orthodontic treatment over the next 5 years. The increased cost of this treatment, coupled with the resistance on the part of many orthodontists to learn the new technique, seem to be the limiting factors.

Adolescent↗
PubMed1979

Body image, self-concept, and the orthodontic patient.

Four major criterion groups--orthodontic retention patients, prospective orthodontic patients, a population sample, and mothers of prospective patients--were established. Appropriate relationships between groups and subgroups were studied with regard to body-image and self-concept satisfaction, to body-image and self-concept importance, and other factors. The findings include the following: 1. There was no significant difference in body-image and self-concept satisfaction of importance between prospective orthodontic patients and the population sample. 2. There was no significant difference in body-image and self-concept satisfaction or importance between prospective orthodontic patients and orthodontic patients in retention. 3. There was a significant difference between prospective orthodontic patients' self-concept importance and their mother's perception of self-concept importance. There teen-agers placed more emphasis on their self-concept than did their mothers. 4. There was no significant difference between any of the groups in body-image and self-concept satisfaction or importance with change in age (11 to 16 years). 5. Girls scored significantly lower in both body-image and self-concept satisfaction than did the boys at these ages (11 to 16 years). 6. Patients with Class III malocclusion scored significantly lower than the other malocclusion groups in all categories of body-image and self-concept satisfaction and importance.

Adolescent↗
PubMed1979

Effect of metabolic alteration of periodontal fibers on orthodontic tooth movement. An experimental study.

In the present study orthodontic force was applied to the molars of rats treated with the lathyrogen beta-aminopropionitrile (BAPN). New bone formation was measured at two alveolar locations after 9 days of force application. Observation resulted in the following conclusions: 1. New alveolar bone formation in response to orthodontic force in BAPN-treated rats statistically exceeded corresponding bone formation in control animals when measured at two tension sites in the periodontal ligament. 2. BAPN administration produced disorganization of the collagenous fibers of the periodontium of experimental animals. Multiple eosinophilic cell-free areas were found distributed throughout the radicular portions of affected periodontal ligaments. Normal ligament function architecture was disrupted in treated animals. The areas of periodontium surrounding orthodontically treated teeth exhibited relatively normal organization under these conditions, while the periodontium of adjacent nonorthodontically treated teeth was markedly disorganized. Orthodontic stimulation of the periodontium of BAPN-treated rats may have disrupted the formation of eosinophilic cell-free areas characteristically seen in the periodontium of the experimental group. 3. The present results suggest that the typical histologic response to orthodontic force application can occur in the presence of a chemically and physically altered periodontium. The quantitative data collected infer that fiber tension on the alveolus may not be absolutely necessary to stimulate bone formation. Distortion of the alveolus related to force application may be a more important factor initiating bone response. However, the fibers of the periodontium may play a passive role in transferring orthodontic force to the alveolus.

Alveolar Process↗
PubMed1986

Personality characteristics as predictors and sequelae of surgical and conventional orthodontics.

The aims of this study were to determine the effects of surgical and conventional orthodontics on patients' body image and self-esteem and the association between personality characteristics and postoperative reports of pain, paresthesia, swelling, and satisfaction among 90 patients who underwent surgical orthodontics. Patients who underwent surgery completed questionnaires before their operations and up to 6 months after surgery. Self-esteem and body image were compared longitudinally between these patients and 33 persons who were undergoing orthodontic treatment only and 33 persons who had decided against treatment. Results suggest that patients' self-esteem, body image, and degree of extroversion are unrelated to postsurgical satisfaction and discomfort. Neuroticism was correlated with satisfaction, so that patients who scored in the higher range on a scale of neuroticism were less satisfied immediately after surgery and at removal of fixation wires. Neurotic patients also were more likely to complain of pain and swelling 6 months after surgery. Surgical patients held a more negative facial image and were more introverted than those in the other two groups but were similar in other personality traits before surgery. Both surgical and orthodontic patients improved significantly in body image over time, with the greatest increase among the former. Similar shifts in self-esteem occurred for the three groups, suggesting that surgery per se may not be the major determinant of longitudinal changes in self-esteem. Notably, the positive effect of surgery and orthodontic treatment on body image is an important motive for many persons seeking treatment. Results of this study provide important insights into how to prepare and counsel patients undergoing orthodontic treatment with and without surgery.

Body Image↗
PubMed2005

Expression of mRNA for osteoprotegerin and receptor activator of nuclear factor kappa beta ligand (RANKL) during root resorption induced by the application of heavy orthodontic forces on rat molars.

INTRODUCTION: Receptor activator of nuclear factor kappa beta ligand (RANKL) activates osteoclast differentiation, whereas this activity is blocked by osteoprotegrin (OPG), so that the relative expression of these 2 proteins might contribute to bone and root resorption during orthodontic tooth movement. We describe experiments with RANKL and OPG mRNA expression in rats subjected to orthodontic forces. It was hypothesized that the ratios of RANKL to OPG expression would increase during root resorption processes. METHODS: Fixed Sentalloy (GAC, Bohemia, NY) closed-coil springs capable of delivering approximately 100 g of force were applied for mesial movement of the mandibular left first molar in 9 male, 7-week-old Wistar rats; the right mandibular molar was used as an internal control for each animal. After 14 days, the rats were killed; tissues from 2 rats were examined by paraffin histology, and high-quality messenger ribonucleic acid (mRNA) was extracted from 4-mm widths of the mesial bony tissues in the remaining animals. RESULTS: Paraffin sections showed osteoclastic resorption of roots on the mesial surfaces of teeth subjected to orthodontic forces. The integrity of mRNA was confirmed by reverse transcriptase polymerase chain reaction (RT-PCR) for the housekeeping gene GAPDH, and that of primers specific for OPG and RANKL was determined by RT-PCR for these genes in material isolated from the UM106 rat cell line known to express both proteins. Densitometric analysis of the RT-PCR OPG product showed an increase in background levels of OPG mRNA in bony tissues subjected to orthodontic forces in all animals studied (P < .05). In contrast, low levels of mRNA for RANKL were detected in only 5 animals and only in association with orthodontic forces. CONCLUSIONS: Data are consistent with changes in levels of OPG and RANKL in tissues subjected to orthodontic forces and experiencing root resorption.

Animals↗
PubMed2006

Aspirin, acetaminophen, and ibuprofen: their effects on orthodontic tooth movement.

INTRODUCTION: Orthodontic patients often take analgesics for pain during treatment. But various analgesics have different capacities to inhibit prostaglandins, and these differences might affect tooth movement. The purposes of this study were to determine by direct measurement the effects that acetylsalicylic acid, ibuprofen, and acetaminophen have on orthodontic tooth movement in rats and to evaluate histologically the differences in bone resorption in the pressure area in rats treated with these analgesics. METHODS: Thirty-six adult male Wistar rats were divided in 4 groups of 9 each. Orthodontic appliances were placed on the rats' incisors. In the 3 experimental groups, analgesics were diluted in reverse osmosis water and delivered via a gastric tube: 100 mg/kg acetylsalicylic acid, or 30 mg/kg ibuprofen, or 200 mg/kg acetaminophen. Control animals received only the reverse osmosis water. At the end of the experimental period, the rats were killed and histological examinations were performed. RESULTS: Analysis of variance showed statistically significant differences between the control group, which was given reverse osmosis water, and the groups given aspirin and ibuprofen. There were also statistically significant differences between the acetaminophen group and the ibuprofen and aspirin groups, respectively. There was no significant difference between the acetaminophen group and the control group, or between the aspirin and ibuprofen groups. Tooth movement was similar in the groups. CONCLUSIONS: The results indicate that nonsteroidal anti-inflammatory analgesics such as aspirin and ibuprofen diminish the number of osteoclasts, probably by inhibiting the secretion of prostaglandins, thereby reducing orthodontic tooth movement. Acetaminophen did not affect orthodontic tooth movement in rats, and it might be the analgesic of choice for treating pain associated with orthodontic treatment.

Acetaminophen↗
PubMed2003

Lactate dehydrogenase activity in gingival crevicular fluid during orthodontic treatment.

During orthodontic treatment, the early response of periodontal tissues to mechanical stress involves several metabolic changes that allow tooth movement. Many studies have evaluated such modifications by analysis of various host metabolites released into the gingival crevicular fluid (GCF). This study used a cross-sectional design to examine the lactate dehydrogenase (LDH) activity in GCF to assess whether GCF LDH can be proposed as a sensitive marker for periodontal tissue modifications during orthodontic tooth movement. Thirty-seven subjects, 16 males and 21 females (mean age 18.7 years, range 14.0 to 26.7 years), participated in this study. Each subject underwent a session of professional oral hygiene and received oral hygiene instructions; 2 weeks later, a fixed orthodontic appliance was placed on the maxillary arch. A randomly selected maxillary canine was considered as the test tooth, and its antagonist, which had no appliance, was used as the control tooth. From 2 to 12 weeks after orthodontic appliance placement, GCF was harvested from both experimental teeth at the mesiobuccal angle, for GCF volume and LDH activity determinations. Clinical monitoring consisted of recording supragingival plaque presence, bleeding on probing, and probing depth at the same collection sites. The results showed that no differences in clinical conditions and GCF volume occurred between the experimental teeth. On the contrary, GCF LDH activity in the test teeth was significantly greater than that of the control teeth (P <.01). Moreover, no differences were found in the enzymatic activity between the sexes by experimental tooth, and no significant correlation was present between GCF LDH activity and patients' ages within experimental teeth. Our enzymatic results initially indicated a possible role of GCF LDH during the early phases of orthodontic treatment and therefore warrant further study as a possible diagnostic tool for tissue response during orthodontic treatment.

Adolescent↗
PubMed2004

Gingival endothelial and inducible nitric oxide synthase levels during orthodontic treatment: a cross-sectional study.

This study uses a cross-sectional design to examine the endothelial and inducible nitric oxide synthase (eNOS and iNOS, respectively) levels of gingival tissue. Fifteen subjects, 10 female and 5 male individuals (aged 14.6-21.2 years; mean 17.4 +/- 1.8 years), who needed extraction of the four first premolars for orthodontic reasons and who had indications for a gingivectomy were enrolled in the study. In each patient, two maxillary/mandibular premolars were extracted, and two months later an orthodontic appliance was placed in the same arch. A canine undergoing treatment for distal movement served as the test tooth (TT), whereas its contralateral canine was used as the control tooth (CT). The CT was included in the orthodontic appliance but was not subjected to the orthodontic force. Two weeks after the orthodontic appliance placement, clinical data consisting of the presence of supragingival plaque, bleeding on probing, and probing depth were collected from each experimental tooth. Immediately after, gingival tissue was collected from the distal aspect of each TT and CT for immunohistochemistry, messenger RNA reverse transcription by polymerase chain reaction, and Western blot analysis for both eNOS and iNOS. The results showed that no differences in clinical conditions occurred between the experimental teeth. On the contrary, both the eNOS and iNOS levels and the expression of the TTs were significantly greater than those of the CTs (all comparisons significant to P < .01). Our results indicate a role for gingival eNOS and iNOS during the early phases of orthodontic treatment in humans.

Adolescent↗