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PubMed2006

Incidental findings of pathology and abnormality in pretreatment orthodontic panoramic radiographs.

Panoramic radiographs, in combination with a clinical examination, are routinely used as an aid to orthodontic diagnosis and treatment planning. The aim of this study was to evaluate the prevalence and location of incidental findings of pathology and abnormalities in pretreatment orthodontic panoramic radiographs. A total of 496 patients (232 girls and 264 boys; mean age 11.2 years, SD 2.33) were randomly selected from the Orthodontic Clinic at the Faculty of Odontology, University of Malmö, Sweden. All radiographic examinations were performed between 1999 and 2003 at the Department of Oral Radiology, Faculty of Odontology, University of Malmö, Sweden. Two independent examiners analyzed the radiographs for abnormalities and diagnoses of pathology. However, caries and findings related to the orthodontic treatment plan, such as eruption disturbances and missing or supernumerary teeth, were not recorded. All radiographs with positive findings were reexamined by a third examiner, a specialist registrar in oral radiology. A total of 56 findings in 43 patients (8.7%) were recorded, and significantly more findings were detected in girls (P = .007). The most common findings were radiopacities (idiopathic sclerosis) in alveolar bone (n = 22), thickening of mucosal lining in sinus maxillaris (n = 15), and periapical inflammatory lesions (n = 10). The majority of the periapical lesions and radiopacities were found in the mandible. In most cases, the findings had no consequence for the orthodontic treatment plan and did not require medical or odontological management. However, the clinician should be aware of the potential to detect pathology and abnormality in pretreatment orthodontic panoramic radiographs.

Chi-Square Distribution↗
PubMed2006

Photoradiation and orthodontic movement: experimental study with canines.

OBJECTIVE: The aim of this study was to evaluate, through a double-blind study, the effect of gallinium-aluminium- arsenic (GaAlAs) laser irradiation on the speed of orthodontic movement in canine premolars. METHODS: Eighteen dogs were divided into two groups, and their third molars were extracted. An orthodontic device was placed between the first molar and the second premolar for stabilization purpose. Group I was irradiated with a dosage of 5.25 J/cm(2) on the right side, whereas the left side was used as the control group. Group II was submitted to the same procedure, but was irradiated with a dosage of 35.0 J/cm(2). Irradiations were done every 7 days, for a total of nine irradiations. The orthodontic space was measured every 21 days. RESULTS: The 5.25 J/cm(2) dosage accelerated orthodontic movement during the first observation period, from 0 to 21 days (p < 0.05), whereas the 35.0 J/cm(2) dosage retarded the orthodontic movement in the treated group when compared with the control group, during both the first and second observation periods, from 0 to 42 days (p < 0.05). CONCLUSION: The results suggets that photoradiation may accelerate orthodontic movement at a dosage of 5.25 J/cm(2), whereas a higher dosage, 35.0 J/cm(2), may retard it.

Animals↗
PubMed1997

Collagen synthesis from human PDL cells following orthodontic tooth movement.

The dynamic remodelling processes in the periodontal ligament (PDL) account for the reaction of PDL cells to different orthodontic force simulations. These occur mostly by degradation and synthesis of collagen types I, III, V, VI, XII and XIV. The purpose of this study was to quantify specific collagen types in the PDL from zones of tension and compression of experimental teeth. Such changes could then be correlated with the processes of orthodontic-stimulated tissue breakdown. Maxillary and mandibular premolars of three females and one male patient were orthodontically moved with a box loop for a total of 14 days, prior to tooth extraction. Teeth from the contralateral side of either the maxilla or the mandible served as the untreated controls. A total of seven experimental and seven control teeth were used in this investigation. PDL fibroblasts from the cervical third of the roots corresponding to the compression and tension zones of the experimental and control teeth, respectively, were scraped and cultured in vitro at 37 degrees C in a humidified incubator with 5 per cent CO2/95 per cent air. Collagen synthesis of types I, III, V and VI was quantified by using an ELISA. Application of orthodontic forces in the experimental teeth showed a significant increase (P < 0.05) of the synthesis of all collagen types in the compression as opposed to the tension zones. Collagen synthesis on the compression zone of experimental teeth was not significantly different in the mandible when compared with those of the maxilla. In addition, the proportional distribution of different types of collagen was also not significantly different in the PDL fibroblasts from either zone of experimental teeth of either the maxilla or the mandible. Collagen metabolism in response to orthodontic stimulation appears to be higher in the compression zones and lower in the tension zones. Contrary to what is traditionally assumed in the literature, such findings indicate that in addition to bone resorption, tissue remodelling is very active in zones of compression following the disappearance of the hyalinized areas. These findings constitute a model for future studies on collagen metabolism during orthodontic-stimulated tooth movement.

Adolescent↗
PubMed2005

Root resorption associated with orthodontic force in inbred mice: genetic contributions.

Root resorption (RR) is an unwanted sequela of orthodontic treatment. Despite rigorous investigation, no single factor or group of factors that directly causes RR has been identified. The purpose of this study was to examine the effect of the genotype on susceptibility or resistance to develop RR secondary to orthodontic force. Nine-week-old male mice from eight inbred strains were used and randomly distributed into control (C) or treatment (T) groups as follows: A/J (C = 9,T = 9), C57BL/6J (C = 7,T = 8), C3H/HeJ (C = 8,T = 6), BALB/cJ (C = 8,T = 6), 129P3/J (C = 6,T = 8), DBA/2J (C = 8,T = 9), SJL/J (C = 8,T = 10), and AKR/J (C = 9,T = 8). Each of the treated mice received an orthodontic appliance to tip the maxillary left first molar mesially for 9 days. Histological sections of the tooth were used to determine RR and tartrate resistant acid phosphatase (TRAP) activity. The Wilcoxon ranked-sum non-parametric test was used to evaluate differences between the groups. The results showed that the DBA/2J, BALB/cJ, and 129P3/J inbred mouse strains are highly susceptible to RR, whereas A/J, C57BL/6J and SJL/J mice are much more resistant. The variation in the severity of RR associated with orthodontic force among different inbred strains of mice when age, gender, food, housing, and orthodontic force magnitude/duration are controlled support the hypothesis that susceptibility or resistance to RR associated with orthodontic force is a genetically influenced trait.

Acid Phosphatase↗
PubMed1999

Socio-economic status and orthodontic treatment need.

OBJECTIVES: This study aimed to examine the relationship between socio-economic status and both normatively assessed and self perceived need for orthodontic treatment. METHODS: More than six thousand 14-year-old children were assessed for orthodontic treatment by trained and calibrated examiners. The Index of Orthodontic Treatment Need was the measuring instrument along with a questionnaire which asked: "Do you think your teeth need straightening?" RESULTS: Normative need for orthodontic treatment (IOTN >3) was more common amongst deprived children than among their affluent counterparts. The same was found for perceived need. However, the children who wanted treatment were not necessarily those who needed it and vice versa. CONCLUSIONS: Socio-economic status affects normatively measured orthodontic treatment need through, as yet, undefined mechanisms. It also affects a person's perception of need for orthodontic treatment, but these two associations are separate. The mismatch of need and desire for treatment is a problem for orthodontists.

Adolescent↗
PubMed2004

Prevalence of traumatic injuries to the permanent incisors in candidates for orthodontic treatment.

The dental records made on presentation of 1367 consecutive patients (731 females and 636 males) for orthodontic treatment at a private orthodontic practice between 1998 and 2002 were examined for data relating to trauma to the permanent incisors. The results showed that 10.3% of these patients had suffered from dental trauma before the onset of orthodontic treatment. The highest prevalence of dental trauma was determined in the 11-15 years age group, corresponding to the dental developmental stage of the late mixed dentition. The most frequently affected teeth were the maxillary central incisors (79.6%), and the most common types of trauma were fracture of enamel-dentin without pulpal involvement (42.7%) and fracture of enamel (33.8%). Compared to patients with normal overjet and adequate lip coverage, the frequency of dental trauma was significantly higher in patients with increased overjet and adequate lip coverage (P = 0.028) or with increased overjet and inadequate lip coverage (P = 0.003). The results of the present study indicate that a significant percentage of candidates for orthodontic treatment, and especially those with increased overjet and inadequate lip coverage, suffer trauma to their permanent incisors before the onset of orthodontic treatment. It might also be concluded that preventive orthodontic treatment of such patients should be initiated and completed before the age of 11, i.e. in the early to middle mixed dentition.

Adolescent↗
PubMed2006

Normative and self-perceived orthodontic treatment need of a Peruvian university population.

BACKGROUND: Previous studies on orthodontic treatment need in young adults have shown that up to 50% had malocclusions that needed orthodontic treatment. The aims of this study were to assess the normative and self-perceived need for orthodontic treatment using the Index of Orthodontic Treatment Need (IOTN) and to determine if the treatment need levels were influenced by sex, age and socio-economic status (SES) in a sample of Peruvian young adults. METHODS: 281 first-year students (157 male and 124 female students) with a mean age of 18.1 +/- 1.6 years were randomly selected and evaluated through the Dental Health Component (DHC) and Aesthetic Component (AC) of the IOTN. Structured interview and clinical examination were used to assess the students. Descriptive statistics and Chi-square tests were used for data analysis with statistical significance set at P < 0.05. RESULTS: An intra-examiner reliability of 0.89 was obtained (weighted Kappa). The percentage of students according to SES was 51.2%, 40.6% and 8.2% corresponding to low, medium and high SES respectively. The percentage of students with DHC grades 4-5 was 29.9% whereas the percentage of students with AC grades 8-10 was 1.8%. There were no significant differences in the distribution of normative and self-perceived orthodontic treatment need based on sex, age and SES comparisons. CONCLUSION: Normative orthodontic treatment need was not matched by a similar level of self-perceived treatment need in these young adults. Sex, age and SES were non-significant factors associated with levels of treatment need.

Adolescent↗
PubMed2001

[Orthodontic abnormalities of deciduous and permanent occlusion].

The aim of this study was to examine the trend in orthodontic anomalies for the period from primary to permanent dentition. 246 examinees (132 boys and 114 girls) with orthodontic anomalies were examined for the first time at the age of 4.5-5.5. These examinees were reexamined by the same orthodont at the age of 12.5-13.5. No orthodontic procedures were performed with the children in the meantime. From the period of primary to permanent dentition, 16.3% of orthodontic anomalies developed into eugnathia. During this period, the incidence of Class II Division I anomalies, premature tooth loss and open bite significantly decreased, and the incidence of Class II Division 2 and crowding increased. From primary to permanent dentition 63.4% orthodontic anomalies altered, and 36.6% remained with a stabile diagnosis.

Adolescent↗
PubMed2005

[The integrin beta1 mRNA changes after orthodontic movement of teeth in periodontitis rats].

OBJECTIVE: To study the integrin beta1 mRNA changes after orthodontic tooth movement in normal teeth and periodontitis teeth of rats. METHODS: The OD of positively stained osteoclasts for integrin beta1 mRNA using in situ hybridzation was detected after orthodontic tooth movement in normal teeth and periodontitis teeth groups. RESULTS: Integrin beta1 mRNA expression were detected on all osteoclasts in tooth movement samples of normal and periodontitis teeth. There were stronger positive signals after given orthodontic force in both of the two groups. But no differences were found after 0.5, 1, 2, 3, 5, 7, 10 days since orthodontic tooth movement. The integrin beta1 mRNA signals in normal tooth movement group were not different from that in periodontitis group. CONCLUSION: The integrin beta1 of osteoclasts may play a role in the stability and remodeling of periodontal ligament in orthodontic tooth movement. There were no difference in the OD of integrin beta1 mRNA staining in orthodontic tooth movement between normal teeth group and periodontitis teeth group.

Animals↗
PubMed2006

Adhesives for fixed orthodontic bands.

BACKGROUND: Orthodontic treatment involves using fixed or removable appliances (dental braces) to correct the positions of teeth. It has been shown that the quality of treatment result obtained with fixed appliances is much better than with removable appliances. Fixed appliances are, therefore, favoured by most orthodontists for treatment. The success of a fixed orthodontic appliance depends on the metal attachments (brackets and bands) being attached securely to the teeth so that they do not become loose during treatment. Brackets are usually attached to the front and side teeth, whereas bands (metal rings that go round the teeth) are more commonly used on the back teeth (molars). A number of adhesives are available to attach bands to teeth and it is important to understand which group of adhesives bond most reliably, as well as reducing or preventing dental decay during the treatment period. OBJECTIVES: To evaluate the effectiveness of the adhesives used to attach bands to teeth during fixed appliance treatment, in terms of:(1) how often the bands come off during treatment; and(2) whether they protect the banded teeth against decay during fixed appliance treatment. SEARCH STRATEGY: Electronic databases were searched: the Cochrane Oral Health Group's Trials Register (July 2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2005), MEDLINE (1966 to July 2005) and EMBASE (1980 to July 2005). A search of the internet was also undertaken. There was no restriction with regard to publication status or language of publication. SELECTION CRITERIA: Randomised and controlled clinical trials (RCTs and CCTs) (including split-mouth studies) of adhesives used to attach orthodontic bands to molar teeth were selected. Patients with full arch fixed orthodontic appliance(s) who had bands attached to molars were included. DATA COLLECTION AND ANALYSIS: All review authors were involved in study selection, validity assessment and data extraction without blinding to the authors, adhesives used or results obtained. All disagreements were resolved by discussion. MAIN RESULTS: Five RCTs and three CCTs were identified as meeting the review's inclusion criteria. All the included trials were of split-mouth design. Four trials compared chemically cured zinc phosphate and chemically cured glass ionomer; three trials compared chemically cured glass ionomer cement with light cured compomer; one trial compared chemically cured glass ionomer with a chemically cured glass phosphonate. Data analysis was often inappropriate within the studies meeting the inclusion criteria. AUTHORS' CONCLUSIONS: There is insufficient high quality evidence with regard to the most effective adhesive for attaching orthodontic bands to molar teeth. Further RCTs are required.

Adhesives↗
PubMed2004

Applications for direct composite restorations in orthodontics.

BACKGROUND AND AIM: Besides prosthetic and indirect, laboratory-produced restorations, the focus of dental therapy is increasingly on restorative measures and direct restorations as minimally invasive treatment concepts. Thus, the use of direct composite restorations with modern restorative materials for the shaping and recontouring of teeth in combination with orthodontic treatment offers a diversified, extensive sphere of application. The aim of the study was to demonstrate applications for direct composite restorations with reference to selected cases. MATERIAL AND METHODS: The composites used were hybrid composites, which offer increased abrasion resistance and color stability and are applied incrementally. Special attention was paid to the shape, color and structure of the tooth. CASE REPORTS: The case reports present patients in whom relatively narrow or peg-shaped teeth were built up with composite to correct various tooth size discrepancies or cuspids were recontoured by means of direct composite restorations following orthodontic space closure in cases with missing lateral incisors. Similarly, space closure was achieved using orthodontically repositioned lateral incisors recontoured to resemble central incisors after traumatic loss of upper central incisors. Finally, direct composite restorations were used for retention following completion of orthodontic treatment. CONCLUSIONS: Observations over recent years confirm the stability of composites in both form and color, as well as their ability to maintain gingival health. Our case reports demonstrate that, subject to a corresponding indication, recontouring single teeth using direct composite restorations can optimize orthodontic treatment results.

Acrylic Resins↗
PubMed2006

Failure investigation of soldered stainless steel orthodontic appliances exposed to artificial saliva.

UNLABELLED: Globally in the field of Dental Technology, soldering continues to be the prevailing joining technique for removable orthodontic appliances. The strength of the soldered joint, however, is a growing concern to dental technicians since the commonly employed silver solder undergoes accelerated corrosion and ultimately influences the success of orthodontic appliances intraorally. OBJECTIVE: The goal of this in vitro study was to determine the effects of exposure to artificial saliva on the mechanical strength of orthodontic silver-soldered stainless steel joints. METHODS: One hundred (control group n=20; aged group n=80) soldered specimens were exposed to varying exposure times in Fusayama's artificial saliva. Tensile failure loads of the control and aged groups were measured. Failure modes were evaluated by examining the exposed surfaces, solder microstructure and the fracture morphology using a combination of light microscopy, scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS). RESULTS: A marked decrease in tensile failure load of the joints was recorded after exposure to artificial saliva. Selective attack was identified on the aged solder surfaces, which was attributed to the micro-galvanic effect brought about by the preponderance of Cu-rich phases in the solder microstructure. The selective attack promoted decohesion at the solder/wire interface, thereby reducing the tensile failure load. SIGNIFICANCE: This study helped to elucidate that an association between exposure periods and microstructure of soldered orthodontic joints exists and that their combined effects positively influence the tensile strengths of orthodontic soldered joints.

Analysis of Variance↗
PubMed2002

Orthodontic teaching practice and undergraduate knowledge in British dental schools.

AIM: The aim was to survey current orthodontic teaching practice in the undergraduate syllabus at British dental schools and to test the abilities of undergraduate students according to the requirements of the GDC regulations. MATERIALS AND METHODS: Information collected by means of a questionnaire sent to each dental school in 1998 was compared with similar data from 1994. The orthodontic knowledge and treatment planning ability of students was assessed by a multiple-choice examination paper completed by a random 10% sample of students from each dental school. RESULTS: In 1998 on average 195 curriculum hours were devoted to orthodontics and each student treated five patients. The teaching of fixed appliances had increased considerably between 1994 and 1998. The average MCQ score was 58% (range 39-72%). Students scored well on questions that tested basic knowledge but much less well when they were required to apply that knowledge. Only three schools felt that it was realistic to expect undergraduates to formulate orthodontic treatment plans, as they are required to do by the GDC. CONCLUSION: Results support the view that undergraduate orthodontic training should concentrate on diagnosis and recognition of problems rather than on providing limited exposure to treatment techniques.

Clinical Competence↗
PubMed1997

The professional perception of orthodontic treatment complexity.

OBJECTIVE: To assess the current professional concept of orthodontic treatment complexity. DESIGN: Cross sectional survey of practitioners' views towards recently completed orthodontic treatments. SETTING: Specialist and non-specialist practitioners in General Dental Services in North Western and Mersey regions. The sampling was carried out between 1993-95. SUBJECTS AND METHODS: All practitioners undertaking orthodontic treatments in the GDS in the North Western and Mersey regions were invited to participate. Practitioners submitted consecutively started cases for scrutiny by analysis of study models and pre-treatment and post-treatment questionnaires. 280 cases were collected. Data were analysed using multiple linear regression. MAIN OUTCOME MEASURES: The occlusal changes were assessed using the Index of Orthodontic Treatment Need and the Peer Assessment Rating. Self administered questionnaires employed 5-point Likert type scales to record practitioners' and patients' opinions. RESULTS: It appears that the concept of complexity is related to the occlusal changes which occur during orthodontic treatment. Attempts to define treatment complexity identifies factors which are of questionable validity and could be easily manipulated in practice setting. CONCLUSIONS: The present concepts of treatment complexity appear to be somewhat flawed. There is no occlusal index of complexity which is particularly satisfactory but as a crude interim measure 3 grades of complexity are proposed based on the PAR index.

Adolescent↗
PubMed1997

Functional unilateral posterior crossbite. Orthodontic and functional aspects.

The purpose of the study was to evaluate the effect of early orthodontic treatment of functional unilateral posterior crossbite (FUPC) and to evaluate temporomandibular function in the short and long term. Orthodontic treatment consisted of slow expansion of the maxillary dental arch by means of a removable expansion plate, with flat coverage of the occlusal surfaces of the left and right posterior teeth. Evaluation of the occlusion showed a strong correlation between the crossbite side and the direction of the RCP-ICP slide and with the side of first occlusal contact in RCP. In 26 of 27 children that were treated (one withdrew), the average time required for correction of the crossbite was 7 months, followed by a retention period, on average, for 6 months after completion of treatment. Early orthodontic treatment resulted in an elimination of occlusal disturbances, and the crossbite remained stable on follow-up during an average of 8 years after the retention period, except in two children with a class III tendency. In nine other children an orthodontic anomaly had developed requiring further treatment (two children showed crowding and seven children showed a class II malocclusion). This study showed that FUPC can be treated adequately by early orthodontic intervention; however, its correction does not guarantee the absence of functional disturbances at a later age. Therefore, FUPC should be treated early in order to achieve normal growth and development rather than to prevent temporomandibular disorders.

Child↗
PubMed2001

Experimental salivary pellicles on the surface of orthodontic materials.

The purpose of this study was to define the composition of salivary pellicles that form on the surfaces of orthodontic materials and to further investigate whether qualitative differences exist between the composition of adsorbed salivary pellicles that form on 3 different orthodontic materials: stainless steel bracket metal, elastomeric ligature ring, and bracket bonding resin. Experimental pellicles were formed by incubating these materials in fresh human parotid or submandibular-sublingual saliva for 2 hours. Pellicles were extracted with sodium dodecyl sulfate buffer and lyophilized. They were then subjected to sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting to identify the adsorbed salivary components. Remarkable differences in the profiles of pellicle components were found, dependent on the type of orthodontic materials. The pellicle components on the bracket metal were almost the same as those found on the elastomeric ligature ring. Salivary protein adsorption patterns to bonding resin showed different features. Distinct differences were also found between the surface-binding affinities of the same salivary proteins from different glandular salivas. These results may be explained on the basis that binding sites for specific proteins on the surfaces of the materials are covered by molecules of submandibular-sublingual saliva, probably mucins. The results of this study provide valuable information concerning initial bacterial adhesion to the surfaces of orthodontic materials, as well as information that could be used in the development of orthodontic materials with enhanced surface properties.

Adhesives↗
PubMed2001

A clinical and histological evaluation of titanium mini-implants as anchors for orthodontic intrusion in the beagle dog.

The aim of this study was to determine the anchorage potential of the titanium mini-implant for orthodontic intrusion of the mandibular posterior teeth. Six mini-implants were surgically placed around the mandibular third premolars on each side in 3 adult male beagle dogs. On the buccal site, three mini-implants were placed distal to the apex of the distal root of the third premolar, at the interradicular septa of the third premolar, and mesial to the apex of the mesial root of the third premolar, as linearly as possible. The same procedure was performed at the lingual site on both sides of the mandibular third premolars in each dog. Bilateral interradicular mini-implants on both the buccal and the lingual sites were used as the anchorage for the intrusion of the third premolars (loaded implants) and the other mini-implants were used as control (unloaded) implants. In 6 weeks, an intrusive force (150 g) was applied between the interradicular implants on the buccal and the lingual sites by closed coil springs run across the crowns of the third premolars. After 12 to 18 weeks of orthodontic intrusion, the animals were killed and their mandibles were dissected and prepared for histologic and fluorescent observation. The results indicated that the mandibular third premolars intruded 4.5 mm, on average, after 12 to 18 weeks of orthodontic force application, with mild root resorption at the furcation area as well as the root apex. All the mini-implants remained stable during orthodontic tooth movement without any mobility or displacement. The morphometrical findings indicated that the calcification of the peri-implant bone on the loaded implants was equal to or slightly greater than those of the controls. In addition, 6 of the 36 mini-implants were removed after tooth movement, and all of them were easily removed with a screwdriver. These findings suggest that mini-implants are effective tools for the anchorage of orthodontic intrusion in beagle dogs.

Alveolar Process↗
PubMed1995

The influence of social class, gender, and peers on the uptake of orthodontic treatment.

The accurate prediction of the future demand for orthodontic treatment requires an understanding of the factors which influence the uptake of orthodontic treatment. This paper examines the influence of social class, gender, and peer group on the uptake of orthodontic treatment. A representative random sample comprising five-hundred-and-forty 15- and 16-year-old adolescents were interviewed in school. The results indicate that familiarity with orthodontic appliances among a subject's peer group has a greater influence on the uptake of orthodontic treatment than the subject's social class or gender.

Adolescent↗