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PubMed2003

Expectations of treatment and satisfaction with dentofacial appearance in orthodontic patients.

The aim of this study was to investigate correlations between satisfaction with dental and facial appearance and expectations of orthodontic treatment. The effects of sex and age on these variables were also explored. A sample of 154 patients who applied for orthodontic treatment at the Academic Centre of Dentistry Amsterdam, The Netherlands, completed 2 questionnaires, containing 16 items on satisfaction with facial appearance and 23 items on expectations of orthodontic treatment. First, the structure of the questionnaires was analyzed. Next, correlations between patients' expectations, satisfaction with facial appearance, age, and sex were examined. A multiple regression analysis was used to estimate the effect of the initial facial satisfaction on expectations of orthodontic treatment. Principal components analysis of the questionnaire about expectations showed 4 factors with an Eigenvalue greater than 1, accounting for 72% of the total variance. These were defined as "general well-being," "self-image/appearance," "future dental health," and "oral function." We found that "satisfaction with facial appearance" could be divided into 2 factors, each with an Eigenvalue greater than 1, accounting for 64% of the total variance. These were interpreted as "general facial appearance" and "dental appearance." Significant correlations were found between satisfaction with dental appearance and patients' expectations. These correlations were invariant over gender, but not over age. It was concluded that satisfaction with dental appearance is a significant predictor of orthodontic patients' expectations of treatment.

Adolescent↗
PubMed2004

In vitro quantification of white spot enamel lesions adjacent to fixed orthodontic appliances using quantitative light-induced fluorescence and DIAGNOdent.

The aims of this in vitro study were 2-fold: 1) to evaluate two fluorescence methods (DIAGNOdent and QLF (quantitative light-induced fluorescence)) for quantification of white spot lesions adjacent to fixed orthodontic appliances; and 2) to determine the inter-observer agreement of the DIAGNOdent and QLF methods for quantification of incipient enamel lesions adjacent to fixed orthodontic appliances. Forty-one premolar teeth with visually sound smooth surfaces or visually white spot enamel lesions were included in the study. Orthodontic brackets were fixed adjacent to the lesions, thus simulating the position of fixed appliances during orthodontic treatment. All teeth were measured using both the DIAGNOdent and QLF methods. Of the 41 teeth, 20 smooth surfaces were randomly selected and analyzed by 4 operators using both DIAGNOdent and QLF. The teeth were sectioned into 300-microm-thick slices using a water-cooled diamond saw and the slices manually ground to 80-100 microm thickness. Histopathology and transverse microradiography were performed to provide the gold standards for verification of lesion depth and mineral loss, respectively. The Spearman rank correlation coefficients between lesion depth determined by histopathology and the DIAGNOdent and QLF were 0.76 and 0.82, respectively, whereas the Pearson correlation coefficients between mineral loss and the two methods were 0.64 and 0.84, respectively. Inter-observer agreement was found to be 0.80 and 0.93 for DIAGNOdent and QLF, respectively. In conclusion, QLF may be a suitable method for quantifying incipient carious lesions adjacent to fixed orthodontic appliances.

Bicuspid↗
PubMed1991

A splint for immediate surgical orthognathic fixation and release during orthodontic treatment.

A splint has been designed for surgical use during the course of orthodontic treatment. The two-piece splint is ligated directly to the orthodontic arch wires. Surgically, the splint has the advantage of saving operative time, of ensuring precise location rapidly in all three planes, and allowing immediate release and replacement. Orthodontically, the splints allow a shorter preoperative phase of orthodontics, with the orthodontic treatment being completed postoperatively to ensure precise tooth positions and functional occlusion.

Dental Occlusion↗
PubMed1991

The influence of orthodontic treatment on previously traumatized permanent incisors.

The reaction of previously traumatized teeth to orthodontic force application was investigated. Four groups of children were examined: group T comprised 56 children who encountered trauma to their maxillary incisors; group O comprised 29 orthodontic patients with intact incisors; group TO comprised 28 previously traumatized orthodontic patients; and group C served as the control group (n = 26). Orthodontic treatment was restricted to tipping movement executed only by means of removable appliances. Groups T, O, and TO were followed up longitudinally by means of clinical and radiographic examinations. In most of the cases the reported trauma occurred to teeth with completed roots and affected the crown only. Group TO presented the highest, though relatively moderate, prevalence of root resorption (27.8 per cent) and was followed by groups O and T (6.7 and 7.8 per cent, respectively) while in the control group no resorption was observed. Electrical pulp testing revealed the highest prevalence of loss of tooth vitality in group TO (7.3 per cent) in which the highest prevalence of pulp obliteration was also found. It can be concluded that the combination of trauma with orthodontic tipping renders the teeth more susceptible to complications, especially to root resorption and loss of vitality.

Adolescent↗
PubMed1992

On the prediction of dentist-evaluated patient compliance in orthodontics.

The aim of the present study was to determine to what degree social and psychological patient variables can predict orthodontic co-operation evaluated by dentists 3 and 6 months after the beginning of treatment. The subjects were 94 patients from seven orthodontic practices. They received a questionnaire with four subscales: impulsiveness, dominance, anxiety, and orthodontic attitudes. Compliance was assessed by an 11-item instrument based on the studies of Slakter et al. (1980). None of the social indices could predict co-operation, but the psychological scales for orthodontic attitudes, impulsiveness and dominance showed a significant relationship to later co-operation. The combination of all psychological variables (regression equation) could explain co-operation 3 months later to 12.1 per cent and to 16.8 per cent 6 months later. The implications for psychological guidance in orthodontics and future research are discussed.

Adolescent↗
PubMed2000

Effect of a static magnetic field on orthodontic tooth movement in the rat.

Orthodontic tooth movement may be enhanced by the application of a magnetic field. Bone remodelling necessary for orthodontic tooth movement involves clastic cells, which are tartrate-resistant acid phosphatase (TRAP) positive and which may also be regulated by growth hormone (GH) via its receptor (GHR). The aim of this study was to determine the effect of a static magnetic field (SMF) on orthodontic tooth movement in the rat. Thirty-two male Wistar rats, 9 weeks old, were fitted with an orthodontic appliance directing a mesial force of 30 g on the left maxillary first molar. The appliance incorporated a weight (NM) or a magnet (M). The animals were killed at 1, 3, 7, or 14 days post-appliance insertion, and the maxillae processed to paraffin. Sagittal sections of the first molar were stained with haematoxylin and eosin (H&E), for TRAP activity or immunohistochemically for GHR. The percentage body weight loss/gain, magnetic flux density, tooth movement, width of the periodontal ligament (PDL), length of root resorption lacunae, and hyalinized zone were measured. TRAP and GHR-positive cells along the alveolar bone, root surface, and in the PDL space were counted. The incorporation of a SMF (100-170 Gauss) into an orthodontic appliance did not enhance tooth movement, nor greatly alter the histological appearance of the PDL during tooth movement. However significantly greater root resorption (P = 0.016), increased width of the PDL (P = 0.017) and greater TRAP activity (P = 0.001) were observed for group M at day 7 on the compression side. At day 14 no differences were observed between the appliance groups.

Acid Phosphatase↗
PubMed2000

The congenitally missing upper lateral incisor. A retrospective study of orthodontic space closure versus restorative treatment.

Orthodontic treatment for patients with uni- or bilateral congenitally missing lateral incisors is a challenge to effective treatment planning. The two major alternatives, orthodontic space closure or space opening for prosthetic replacements, can both compromise aesthetics, periodontal health, and function. The aim of this retrospective study was to examine treated patients who had congenitally missing lateral incisors and to compare their opinion of the aesthetic result with the dentists' opinions of occlusal function and periodontal health. In this sample, 50 patients were identified. Thirty had been treated with orthodontic space closure, and 20 by space opening and a prosthesis (porcelain bonded to gold and resin bonded bridges). The patient's opinion of the aesthetic result was evaluated using the Eastman Esthetic Index questionnaire and during a structured interview. The functional status, dental contact patterns, periodontal condition, and quality of the prosthetic replacement was evaluated. In general, subjects treated with orthodontic space closure were more satisfied with the appearance of their teeth than those who had a prosthesis. No significant differences in the prevalence of signs and symptoms of temporomandibular dysfunction (TMD) were found. However, patients with prosthetic replacements had impaired periodontal health with accumulation of plaque and gingivitis. The conclusion of this study is that orthodontic space closure produces results that are well accepted by patients, does not impair temporomandibular joint (TMJ) function, and encourages periodontal health in comparison with prosthetic replacements.

Adolescent↗
PubMed2005

Recolonization of mutans steptococci on teeth with orthodontic appliances after antimicrobial therapy.

The aim of the present study was to compare the recolonization pattern of mutans streptococci on densely colonized teeth with and without fixed orthodontic appliances after treatment with a 40 per cent chlorhexidine (CHX) varnish (EC 40, Explore). Healthy subjects free of carious lesions requiring fixed orthodontic appliance treatment but with high bacterial mutans streptococci saliva counts were recruited (n = 10). For baseline registration, plaque from buccal sites was sampled and cultivated on Dentocult strips. Following professional tooth cleaning, CHX varnish was applied to all teeth for 8 minutes. Subsequently, orthodontic brackets and bands were inserted in either the upper or lower arch. Eight weeks after varnish application the degree of recolonization with mutans streptococci was reassessed on the buccal sites. Statistical analysis showed that recolonization with mutans streptococci was significantly higher (P < 0.05) on teeth with orthodontic appliances. The results indicate that the use of fixed orthodontic appliances creates artificial environments suitable for the proliferation of mutans streptococci after CHX varnish suppression.

Analysis of Variance↗
PubMed2006

Nickel in dental plaque and saliva in patients with and without orthodontic appliances.

The aim of this study was to compare the content of nickel in the saliva and dental biofilm in young patients with and without orthodontic appliances. The possible influence of a dietary intake of nickel on recorded nickel levels was examined. Nickel content in unstimulated whole saliva and in dental plaque of 24 boys and girls (mean age 14.8 years) with intraoral fixed orthodontic appliances was compared with 24 adolescents without such an appliance. Sample collection was set up to exclude nickel contamination. Diet intake was recorded for the preceding 48 hours to account for the influence of recent nickel content in food. Saliva and plaque were analysed for nickel content using an electrothermal atomic absorption spectrometric (ETAAS) method. The acidified saliva samples were analysed as Millipore-filtered saliva with filter-retained fractions and plaque following dissolution in acids. No significant difference in nickel content of filtered saliva was found between the test and the control samples (P = 0.607); the median values of nickel content were 0.005 and 0.004 mug/g saliva, respectively. On the other hand, a significant difference was found for the filter-retained fraction (P = 0.008); median values for nickel were 25.3 and 14.9 mug/g, respectively. A significant difference in nickel content between test and control samples was also found in plaque collected at various tooth sites (P = 0.001; median values 1.03 and 0.45 mug/g, respectively). A stronger difference was found when comparing plaque collected from metal-covered tooth surfaces than from enamel surfaces of orthodontic patients. No association could be found between calculated dietary intake of nickel and recorded nickel in the test and control samples. It is concluded that nickel release occurs into the dental plaque and components of saliva of orthodontic patients, a situation that may reflect time dependence of its release from orthodontic appliances into the oral cavity and an aggregation of nickel at plaque sites.

Adolescent↗
PubMed1999

Orthodontics and infective endocarditis.

Infective endocarditis associated with orthodontics is a rare occurrence. Unfortunately, many orthodontic practitioners do not treat patients potentially at risk of developing endocarditis due to the lack of practical guidelines and fear of precipitating the infection. Additionally, many patients that undergo orthodontic treatment are inappropriately prescribed antibiotic cover for procedures that have a minimal bacteraemic risk. In this paper the literature linking orthodontic treatment and infective endocarditis is examined. Recommendations are made for the appropriate management of patients at risk of infective endocarditis for orthodontic procedures. Refereed Paper

Adult↗
PubMed2002

Attitudes of UK consultants to teledentistry as a means of providing orthodontic advice to dental practitioners and their patients.

OBJECTIVE: To determine UK orthodontic consultants' attitudes to the provision of orthodontic advice to general dental practitioners by electronic means. DESIGN: Questionnaire. SETTING: Conducted by email and surface mail as appropriate in August 2000. SUBJECTS: All those UK NHS orthodontic consultants contained in the membership lists of the Consultant Orthodontists Group of the British Orthodontic Society. OUTCOME: An 86 per cent response was obtained from the 231 consultants. RESULTS: More than half (58 per cent) of the consultants were interested in providing an electronic diagnostic service for the general dental practitioners in their locality and 70 per cent were in favour of further research into this possibility. Provided this was mediated through their GDP, only 26% would oppose consultant advice being given electronically from a centralized source. CONCLUSIONS: A majority of UK orthodontic consultants support the concept of using teledentistry to make their advice more accessible to dentists and patients.

Adult↗
PubMed2002

A qualitative study of teenagers' decisions to undergo orthodontic treatment with fixed appliance.

OBJECTIVE: The aim of this study was to describe thoughts and values influencing young people's choices to undergo orthodontic treatment. SUBJECTS AND METHODS: Twenty-eight patients (11 boys), aged 13-19 years, at an orthodontic clinic in the western part of Sweden participated. Open, taped interviews, lasting about 1 hour, were conducted with each subject and analysed by the grounded theory method. Five descriptive categories, each related to several subcategories, were generated in the analysis and labelled: 'being like everyone else', 'being diagnosed', 'focusing on the mouth', 'obeying social norms' and 'forced decision-making'. OUTCOME: Category forced decision-making was identified as a core category, describing the power in the social process, resulting in the decision to undergo orthodontic treatment. CONCLUSIONS: Motivation for the decision to undergo orthodontic treatment seemed to be social norms, and the beauty culture in their reference group and in society in general. The teenagers were not fully conscious of these external influences. Their opinion, as a group, was that they had made an independent decision to undergo orthodontic treatment.

Adolescent↗
PubMed2003

In vivo evaluation of two new moisture-resistant orthodontic adhesive systems: a comparative clinical trial.

OBJECTIVE: To evaluate and compare the clinical performance of two new moisture-resistant orthodontic adhesive systems: a chemically-cured composite resin (Unite, 3M Unitek, Monrovia, California, USA) in conjunction with a special moisture-resistant primer (Transbond MIP, 3M Unitek, Monrovia, California, USA); and a fluoride-releasing light-cured compomer (Assure, Reliance Orthodontic Products, Inc., Itasca, Illinois, USA). DESIGN: Randomized controlled clinical trial using the 'split-mouth' technique. SETTING: Department of Orthodontics, Aristotle University of Thessaloniki. SUBJECTS (MATERIALS) AND METHODS: Twenty-five consecutively started patients (13 females and 12 males) requiring fixed appliance orthodontic treatment. INTERVENTIONS: Four-hundred-and-thirty-six stainless steel brackets bonded to all teeth except molars using two different moisture-resistant orthodontic adhesive systems. MAIN OUTCOME MEASURES: Bond failure rates during a period of 9 months were estimated for each adhesive system and the corresponding bracket survival curves were plotted using the Kaplan- Meier product-limit estimate. Bracket survival distributions with respect to adhesive material, tooth location, patient's gender and operator, were then compared by means of a log-rank test. Bond failure interface was determined using the Adhesive Remnant Index. RESULTS: Assure recorded a higher bond failure rate (13.8 per cent) than Unite & MIP (7.3 per cent). The corresponding bracket survival curves were found to be significantly different (P < 0.05). Premolars exhibited higher bond failures than incisors and canines (P < 0.001), while half (49.8 per cent) of the total bond failures occurred during the first 2 months of treatment. The predominant mode of failure was within the bonding material. CONCLUSION: The new moisture-resistant adhesive systems under study were found to be clinically efficient, though Assure exhibited a significantly higher bond failure rate than Unite and Transbond MIP. The higher frequency of adhesive failures observed with Assure might indicate a possible weak point at the adhesive-bracket interface.

Adhesives↗
PubMed2004

Nickel allergy and orthodontic treatment.

OBJECTIVES: Tolerance induction to prevent development of nickel allergy has been suggested with permanent dental braces. We wanted to find out which effect orthodontic treatments had had on the development of nickel allergy in university students. STUDY DESIGN: We examined and patch tested 153 students, of whom 113 had a history of pierced skin, and 70 a history of orthodontic treatment roughly 10 years earlier. RESULTS: All except one student with pierced skin were females. Development of nickel allergy was significantly associated with skin piercing (54% compared with 12%). At the time of the study, there was a slight but non-significant difference in the prevalence of nickel allergy between students who had been subjects for orthodontic treatment (49%) compared with non-treated ones (58%) if they had pierced skin. There were no significant differences in the development of nickel allergy among students who had had permanent dental braces before (50%) or after skin piercing (48%). However, from 40 students without skin piercing four of 11 (three males) with a history of permanent braces had developed nickel allergy, as compared with none of 22 (P = 0.008) without orthodontic treatment suggesting possibility of sensitization through dental devices. CONCLUSIONS: Orthodontic treatment may not lead to tolerance induction on all occasions, and sensitization through permanent devices seems to be possible.

Adolescent↗
PubMed1984

Orthodontic treatment-service studied retrospectively in a group of Danish children aged 15-16 years.

In a group of adolescent children in 9th grade attending a municipal dental health service, a certain amount of orthodontic treatment has been performed. 27% of the children had completed, or were undergoing, orthodontic appliance therapy. 9% of the children had completed extraction therapy only. 4% were recorded as discontinued appliance treatments and 3% as discontinued after extraction of permanent teeth as the only treatment. 21% had no anomalies and no treatment and 36% had a malocclusion but no treatment carried out. The effect of the orthodontic service was studied on the group as a whole according to the frequency and pattern of change in four selected malocclusion symptoms and to the degree of personal satisfaction about dental appearance and any orthodontic appliances. The individuals most satisfied with the results from their orthodontic treatment were found in the three middle socioeconomic groups.

Adolescent↗
PubMed1992

Changes in radiographic bone level in orthodontically treated teenagers over a 4-year period.

In 1984 the prevalence of subjects with radiographic bone loss was assessed in all 14-year-old schoolchildren in Oslo (n = 2767). An overrepresentation of subjects with bone loss was found among those undergoing orthodontic treatment. The aim of the present study was to assess the effect of orthodontic treatment on the prevalence and incidence of radiographic bone loss during the following 4-yr period. Bitewing radiographs from 1984, 1986, and 1988 of a sample of 438 subjects from the original population constituted the study material. Bone loss was recorded if the distance from the alveolar crest to the cementoenamel junction exceeded 2 mm. 111 subjects (25.3%) had received orthodontic treatment. In 1984, 18 of them (16.2%) exhibited bone loss. The corresponding figure for the 327 non-treated children was 14 (4.3%). The incidence of subjects with new tooth sites with bone loss among those with a record of previous orthodontic treatment was 1.1% and 3.2% in the periods 1984-86 and 1986-88, respectively. Among those who had never received such treatment the incidence figures were 3.2% in the period 1984-86 and 2.0% in the last period. The results indicated that the majority of the bone loss observed during or immediately after termination of orthodontic treatment was transient in nature.

Adolescent↗
PubMed1993

Concern for dental appearance among Norwegian young adults in region with low uptake of orthodontic treatment.

The purpose of the present study was to examine orthodontic concern among orthodontically untreated young adults living in an area where the relative number of children receiving treatment was only 15-20% and to compare orthodontic concern among these individuals with that of untreated persons from an area with a higher treatment frequency. All the subjects were clinically examined and impressions for dental study casts, radiographs and photographs were taken. The subject's occlusion was classified according to two methods: 1) allocation to one of four groups according to the national Need for Orthodontic Treatment Index (NOTI), and 2) allocation to one of three groups according to presence or absence of six Anterior Occlusal Traits (AOT). Frequencies of NOTI scores demonstrated that in the study group more individuals were in need of treatment relative to the comparison group. Reported concern was at the same level in both groups, and significantly related to NOTI and AOT scores. The individuals in the area with the low treatment frequency were generally less aware of their anterior traits compared to the individuals in the area with a higher treatment frequency. The results indicated that a long-term low uptake of orthodontic treatment among children in the particular area was not accompanied by a similar increase in concern about own dental appearance in early adulthood.

Adolescent↗
PubMed2005

The theory of reasoned action and patient compliance during orthodontic treatment.

OBJECTIVES: The aim of the present study was to investigate the potential of the theory of reasoned action (TRA) for the prediction and understanding of patients' intention to comply during orthodontic treatment and to analyze the effect of two additional variables in the model, namely perceived behavioral control and anticipated regret. Moreover, (the determinants of) intentions of orthodontic patients to comply during treatment were compared with (the determinants of) intentions of parents to stimulate this cooperation. METHODS: A questionnaire was handed out to patients and parents visiting the Department of Orthodontics of the Academic Centre of Dentistry in Amsterdam. In both the patient and parent sample, independent-sample t-tests, correlation analyses and stepwise regression analyses were conducted. Variables in both samples were compared and tested. RESULTS: The extended version of the TRA explained 20% of the variance in the patients' intention to comply. The patients' anticipated regret, attitude and motivation to comply were significant determinants of the patients' intention to comply. In addition, the parents' attitude toward compliance was a significant predictor. The role of parents in enhancing patients' intentions to comply cannot be neglected. CONCLUSION: Our findings suggest that patients' intentions to comply during orthodontic treatment are influenced by factors outside of the TRA. Therefore, it is recommended to develop a new model, in which factors of the TRA are included, which can be used specifically for the study of compliance in orthodontics.

Adolescent↗