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PubMed2000

[Orthodontic treatment for adults].

The number of adults undergoing orthodontic treatment has increased strongly and the average age that adult patients undergo orthodontic treatment increased steadily although 3/4 is still younger than 27 years. In adults the facial skeletal pattern can only be changed in a very confined way, consequently in case of an abnormal skeletal pattern one has to choose between a combined orthodontic-surgical approach (which is the case in 18% of the patients) and a compromised orthodontic treatment, if necessary combined with other disciplines. It is still controversial whether tooth movement in adults is slower and more difficult than in adolescents. The same holds true for the risk for loss of periodontal support, for root resorption, for gnathologic problems and for relapse. As related to these variables there appears to be a large individual variation. Many adults show one or more problems in their dentition that may influence their orthodontic treatment. About 60% of the adult patients need a multidisciplinary approach. The development of implantology and of bone regeneration and bone grafting has lead to more combined treatments. The risks of such complex treatment plans are generally larger than those for more simple kinds of treatment. A very careful treatment planning and good communication between the different specialists is essential. Moreover the treatment plan with all its (dis)advantages has to be extensively discussed with the patient.

Adult↗
PubMed2001

The use of general anaesthesia for orthodontic extractions.

AIM: The aims of the study were to evaluate 1) the uptake of general anaesthesia 2) the dental factors influencing use of general anaesthesia for routine orthodontic extractions. RESEARCH DESIGN: Retrospective cross-sectional. PARTICIPANTS: All patients, aged 16 years and under (n=145), currently undergoing orthodontic treatment at the University Dental Hospital of Manchester, who had received extractions, for their current course of treatment. METHOD: Patients were asked to complete a questionnaire after appliance adjustment. MAIN OUTCOME MEASURES: 1) type of anaesthesia received for the most recent orthodontic extractions 2) whether a choice of anaesthesia was given 3) number of permanent teeth removed for the current course of orthodontic treatment 4) previous experience of general anaesthesia. RESULTS: The response was 87%. Twenty-two per cent of patients received general anaesthesia, 64% local anaesthesia and 14% inhalation sedation. Sixty-five per cent of patients were not given a choice of anaesthesia for extractions. Stepwise logistic regression analysis revealed that a patient was more likely to receive a general anaesthetic if: 1) they had received a GA in the past (for fillings or extractions) 2) more than four teeth were extracted. CONCLUSIONS: Local anaesthesia was predominantly used for orthodontic extractions although the use of general anaesthesia was still quite high. The majority of patients were not given a choice of anaesthesia for routine extractions. Previous exposure to general anaesthesia and removal of more than four teeth increased the likelihood of a patient receiving general anaesthesia.

Adolescent↗
PubMedDate not supplied

Demineralization around orthodontic brackets bonded with resin-modified glass ionomer cement and fluoride-releasing resin composite.

PURPOSE: Enamel demineralization adjacent to orthodontic brackets is one of the risks associated with orthodontic treatment. Glass ionomer cements have been shown to decrease enamel demineralization adjacent to brackets and bands but do not exhibit bond strengths comparable to resin composites. The purpose of this in vitro study was to compare a fluoride-releasing resin composite versus a resin-modified glass ionomer cement for inhibition of enamel demineralization surrounding orthodontic brackets. METHODS: Forty-five teeth were randomly assigned to 3 groups of 15 teeth. Fifteen were bonded with Concise (3M), a non-fluoride-releasing resin composite (control); 15 teeth were bonded with Light Bond (Reliance), a fluoride-releasing resin composite; and 15 teeth were bonded with Fuji Ortho LC (GC Corporation), a resin-modified glass ionomer cement. The teeth were placed in an artificial caries solution to create lesions. Following sectioning of the teeth in a buccolingual direction, polarized light microscopy was utilized to evaluate enamel demineralization adjacent to the orthodontic bracket. The area of the lesion was measured 100 microns from the orthodontic bracket and bonding agent. RESULTS: MANOVA (P < .0001) and Duncan's test (P < .05) indicated the resin-modified glass ionomer cement (Fuji Ortho LC) and the fluoride-releasing resin composite (Light Bond) had significantly less adjacent enamel demineralization than the non-fluoride-releasing resin composite control. However, there was no significant difference between the resin-modified glass ionomer cement and the fluoride-releasing resin composite. CONCLUSIONS: Based on the results of this in vitro study, it can be concluded that Fuji Ortho LC and Light Bond exhibit significant inhibition of adjacent demineralization compared to the non-fluoride-releasing control.

Acrylic Resins↗
PubMed2000

Effect of chlorhexidine varnish on bacterial levels in plaque and saliva during orthodontic treatment.

The plaque-retentive effects of fixed orthodontic appliances may induce a rapid increase in the amount of plaque. The aim of the present study was to conduct a longitudinal clinical investigation on the antibacterial effect of chlorhexidine-containing Cervitec varnish during orthodontic treatment. Twenty-four subjects (9 male, 15 female), aged 16.5 +/- 2.5 years, participated in the study. At baseline, the subjects' DMF-S scores, stimulated salivary flow rates (ml/min) and levels of salivary Streptococcus mutans (SM) and lactobacilli (LB) were determined using Dentocult SM strip and Dentocult LB methods. After placing the orthodontic appliances, the subjects were treated with Cervitec or a placebo varnish around the bands and brackets. The chlorhexidine varnish was applied randomly in the first or second quadrant, and placebo varnish in the opposite quadrant, according to the split-mouth technique. The varnish application was repeated every 3 months to the same sites. Follow-up samples of saliva and plaque from around brackets and bands were collected at 1, 3, 6, 9 and 12 months. Plaque SM and salivary SM, as well as LB counts were determined as at baseline. The results showed that a significantly higher proportion of plaque samples belonged to the low-risk category (SM count10(5) CFU/ml) on the test side than on the placebo side. Distribution of salivary samples between the low-risk and high-risk categories (based on SM and LB counts) did not change significantly until the end of the follow-up period. The number of new carious lesions after debonding the fixed orthodontic appliance was significantly lower (p < 0.05) in the Cervitec-treated quadrant compared to the placebo varnish-treated quadrant. The results show that the chlorhexidine-containing varnish effectively reduced the number of SM in dental plaque around fixed orthodontic appliances.

Adolescent↗
PubMed1997

[Orthodontic treatment for the surgical correction of mandibular skeletal retrognathism].

The purpose of this paper is to discuss the combining orthodontic treatment that is based on seventeen consecutive patients of severe mandibular skeletal retrognathism who have been treated by orthognathic surgery. Not only the presurgical preparation, but also the presurgical and postsurgical orthodontic treatment and the use of interocclusal splints were introduced. The goals of orthodontic treatment for patients with orthognathic surgery are (1) decompensating the teeth, expanding the upper dental arch, (2) aligning the teeth, (3) leveling the curve of Spee, (4) making the shape and width of upper and lower dental arch harmonious, (5) getting the occlusal equilibrium and fine occlusal contact. The author's experience indicates that: in order to get satisfactory results of esthetics and function, the combination of surgical and orthodontic treatment, the presurgical and postsurgical orthodontic treatment is absolutely necessary and important.

Adolescent↗
PubMed2000

[Correction of dento-maxillofacial deformities by using both of orthodontics and orthognathic surgery].

OBJECTIVE: To study the clinical results and stability after correction of dento-maxillofacial deformities by using both of orthodontics and orthognathic surgery. METHODS: A group of 45 patients with dento-maxillofacial deformities were corrected by preoperative orthodontics-orthognathic surgery-postoperative orthodontics procedure. As a control, another group of 64 patients with the deformities were corrected by orthognathic surgery only. The facial appearance, occlusion and stability of two groups after correction were investigated and compared. RESULTS: In orthodontics and orthognathic surgery group, 62.2% of patients declared that their mastication were improved. Relapse rate of deformities was 4.4%. In orthognathic surgery group, 42.2% of patients declared that their mastication were improved. Relapse rate of deformities was 9.4%. CONCLUSIONS: Using both of orthodontics and orthognathic surgery to correct dento-maxillofacial deformities is a good approach to improve results of correction, keep balance of occlusion and reduce the relapse of the deformities.

Adolescent↗
PubMed2001

[Preliminary study on orthodontic treatment before and after distraction osteogenesis].

OBJECTIVE: To get some guidelines for the orthodontic treatment before and after distraction osteogenesis (DO). METHODS: DO was performed in 4 patients maxilla and two for mandible. The patients were aged from 19 to 25 (average 21.5). We try to sum up the procedures and clinical experiences of pre- and post-surgery orthodontics. RESULTS: The procedures and experiences obtained are the followings: 1. Pre-surgery orthodontics for DO is simplified as alignment of dental arch in a short period. 2. Post-surgery orthodontics for DO is more complicated and peculiar. The main task is to make the opened posterior teeth occlude as soon as possible by light force vertical elastics. At the same time, some cross elastics may be needed for correction of posterior occlusal relationship. 3. Expansion of upper arch may be needed in some patients because of constricted dental arch. 4. Class II or III elastics may be used for prevention of relapse after DO. CONCLUSIONS: DO is a new technique in orthognathic surgery. Post-surgery orthodontics is more complicated and important in the treatment course.

Adult↗
PubMed2001

[Clinical problems of orthodontics and orofacial orthopedics at the turn of the millennium].

The author gives an overview of orthodontic profession among the dental specialties. Educational problems of orthodontics in the new age are also discussed as well as treatment quality assurance possibilities and conditions. Future treatment possibilities of retrospectively rehabilitative adult orthodontics and interceptively prospective early treatment of children are referred. The article also cover the 3D imaging of the human face, animation of the craniofacial complex, and Cephalometric 3D analysis as areas of scientific research and realities. The need for restandardizing of orthodontic slot size to simplify and to minimize changeover problems in orthodontics basic hardware--the wires and brackets--are also addressed.

Humans↗
PubMed2001

Orthodontic treatment standards in a public group practice in Sweden.

The aim was to assess the orthodontic treatment service provided by 6 orthodontists in a group practice in Malmö. One hundred cases were randomly selected from the model store. The Index of Complexity, Outcome and Need (ICON) was used to assess the need, complexity of the problem, outcome, the degree of improvement and whether the completed case was acceptable or not. The reliability of the examiner using the ICON was assessed using Root Mean Square. Logistic regression analysis was employed to explore the variables related to acceptability of the finish and duration of treatment. The younger the patient at the start of treatment the lower initial ICON score, with short treatment duration were associated with an acceptable finish. Three out of 100 cases were deemed as not requiring orthodontic treatment and 36 cases were classified as very difficult to treat. Nevertheless, 71 cases out of the 100 exhibited acceptable finishes with 27 indicating substantial or great improvement. 6 cases finished treatment with ICON scores greater than 43 indicating need for orthodontic treatment. The treatment on average took 22 months. An objective appraisal of the quality of orthodontic care in a group practice in Malmö has been undertaken. Seventy-one cases were completed with acceptable occlusions. The Index of Complexity, Outcome and Need appears to be a valuable tool to assess the multiple facets of orthodontic provision.

Adolescent↗
PubMed2002

Objective and subjective need for orthodontic treatment in Stockholm County.

The objective and subjective need for orthodontic treatment according to a modified version of the treatment priority index of the Swedish National Board of Health and Welfare (index scores 0 to 4), was studied in 1281 children and teenagers, aged between 8 and 16 years and living in the Stockholm area. Furthermore, differences between different parts of the Stockholm County with respect to need for orthodontic treatment, and the subjective demand for treatment were also recorded. Five areas with varying population structures were studied. The results showed that the prevailing objective and subjective need for treatment varied in the areas studied. The prevalence of objective need for treatment varied between 23.8% and 28.9%. The subjective need for treatment ranged from 21.6% to 30.3%. The highest prevalence of treatment need was found in areas with a large immigrant population. In all the investigated areas was the subjective demand for treatment 1-1.5% less than the objective need for treatment. On the basis of the present data, it can be concluded that neither the objective, nor the subjective need for orthodontic treatment exhibits any tendency to decline. The results do not, therefore, support the policy that the public financial resources for orthodontic treatment could be reduced due to a lowered need for treatment. Severe malocclusions may result in impaired craniomandibular function and have an unfavourable influence on facial and dental attractiveness, which may in turn have psychosocial implications. There is an obvious risk that the frequency of such problems may increase in the population, if children with great or very great need for treatment are denied adequate orthodontic care due to lack of sufficient resources.

Adolescent↗
PubMed2002

Pathologic status and changes in mandibular third molar position during orthodontic treatment.

PURPOSE: The purpose of this study was to evaluate the changes in mandibular third molar (M3) position and pathologic status associated with M3 in the cases orthodontically treated. MATERIALS AND METHODS: This study was carried out on a total of 76 subjects, 42 males and 34 females ranging in age from 18 to 23 years. Thirty of them were treated without extractions (non-extraction group), 26 were treated with the extraction of four first premolars (extraction group), and 20 did not receive orthodontic treatment (control group). Positional changes of third molars and pathologic status associated with M3s in the cases treated orthodontically were evaluated radiographically and clinically. Data were analyzed with parametric and non-parametric tests. RESULTS: It was clinically observed that 18% of third molars in the non-extraction group and 15% of those in the extraction group erupted in normal position; 83% of third molars in both groups erupted partially in a mesioangular position. However, it was determined that 43% of the teeth that partially erupted developed pericoronitis and 4% had dental caries. It was determined radiographically that there was insufficient space for most of the M3s to erupt in the orthodontically treated cases and the angulations of these teeth were not sufficiently improved. CONCLUSIONS: In this study, it was determined that 83% of the M3s in orthodontically treated cases partially erupted in a mesioangular position and 43% of these teeth were associated with pericoronitis.

Adolescent↗
PubMed2002

Neuromuscular evaluation of post-orthodontic stability: an experimental protocol.

To prevent relapse after orthodontic treatment, retention is often considered indispensable. Soft tissues are thought to have a significant influence on dental movements. To quantify the influence of masticatory muscles on post-treatment relapse, and in an attempt to avoid unnecessary procedures, 2 male orthodontic patients (13 and 30 years old at debonding) were followed up. The patients completed 2 years of fixed orthodontic treatment and received no post-orthodontic retention. After 1 week and again after 6 months, alginate impressions of dental arches and a surface electromyographic (EMG) assessment of the masseter and temporalis muscles during maximum voluntary clenching were performed. The younger patient received surface EMG monitoring once a month for the first 6 months and at the 1-year follow-up appointment. Arch dimensions and the 3-dimensional inclination of the facial axis of the clinical crown (FACC) were measured using a computerized digitizer. Symmetry in muscular contraction was measured by the percentage overlapping coefficient (POC), and potential lateral displacing components were assessed by the torque coefficient (TC). At the 6-month follow-up, no clinical modifications were observed. Quantitative evaluation assessed that arch dimensions had changed slightly (up to 1 mm). While the adolescent patient had no modifications in FACC inclinations, the 30-year-old patient showed significant alterations (up to 18 degrees). In all examinations of the adolescent patient, POC was higher than 86% and TC was lower than 10%. In the adult, POC was inside the normal range, while all TCs were higher than 10.5%. The larger TC measured in the adult may explain the larger modifications in the 3-dimensional position of his dental crowns. In conclusion, a surface EMG assessment may help in the detection of patients who might need post-orthodontic retention.

Adolescent↗
PubMed2001

GDP referrals for orthodontic treatment.

OBJECTIVE: To assess the accuracy of the information provided by General Dental Practitioners (GDPs) in referral letters for orthodontic treatment. DESIGN: An audit. SETTING: Orthodontic Department, Royal Aberdeen Children's Hospital, Aberdeen. METHOD (SUBJECTS): Prospective assessment of GDP referrals over a two month period. Information provided by referrals compared with British Orthodontic Society guidelines. RESULTS: A total of 103 new referrals were assessed. Only 25 (24%) patients knew why they were referred. Nineteen (18%) patients were keen on treatment before being explained what treatment was indicated. Nine (8%) patients declined treatment after being explained the risk/benefit of the treatment. Approximately one third of the patients examined had inadequate oral hygiene. Five (4%) patients had more than two active carious lesions. Forty two (41%) referrals provided no information or missed important malocclusion features. None of the letters provided details of patient's general medical practitioner. CONCLUSIONS: The present audit has highlighted a number of recurring problems with GDP referrals to a hospital orthodontic department. It has indicated a need to inform referring GDPs about the minimum information required in their referral letters. It is suggested that referring dentists should follow the recommendations of the British Orthodontic Society.

General Practice, Dental↗
PubMed2003

Origins of the extraction controversey in American orthodontics (1880-1910).

Extraction of permanent teeth in the course of orthodontic treatment remains controversial. Today, opinions vary widely as to how frequently such extractions are necessary. Many dentists appreciate, however, that in the 1920s and 1930s, orthodontists virtually never prescribed extraction. The movement to abolish extraction therapy in orthodontics really began in the late Nineteenth Century. Led by Edward H. Angle, this "New School of Orthodontics," despite an explosion of activity during the first decade of the Twentieth Century, did not rapidly succeed in its mission. During the period considered in this study, dentists continued to extract teeth to treat orthodontic problems and even many experts in orthodontics continued to vociferously defend this practice. Claims of the extremists, whether in favor of or against extraction, did not benefit from true scientific evidence. Dentists based their theories on experience or mere conjecture. The situation today is not very different. Before taking an unqualified stand on the issue of extraction, one should realize that, historically, such stands have proven unconvincing. The fashion of a period may favor one side over the other only for the situation to reverse in the next period.

History, 19th Century↗
PubMed2003

[The prevalence of orthodontic treatment need in Urumqi Han's adolescent].

OBJECTIVE: To assess the severity of malocclusion and the need for orthodontic treatment in Urumqi Hans' adolescent. METHODS: 562 children aged from 11-19 years old were chosen randomly and were investigated. The severity of malocclusion and the need for orthodontic treatment were assessed using the Malocclusion Severity Index (MSI, Hill PA 1992). RESULTS: The MSI scores for this population were 21.91 +/- 17.09 in male and 22.28 +/- 17.26 in female, respectively, there were no significant differences between sexes (P > 0.05). According to the classifications of MSI scores, the rates of the need for orthodontic treatment were 54.55% in male and 55.40% in female. CONCLUSIONS: (1) The rates of orthodontic treatment need in Urumqi Hans' adolescent were highly frequent. (2) The MSI is a simple precise valid index for assessing the orthodontic Treatment Need. It is suggested to be used widely.

Adolescent↗
PubMed2003

[Unwillingness or overconfidence. Orthodontics as a dental specialty].

January 31st 1953, fifty years ago, orthodontics was the first dental specialty to be recognized in The Netherlands. This article describes the development to this. After the Second World War the dentist emancipated rapidly and dentistry became an academic profession in 1947. At that time the dentist was assumed to have knowledge of every field in dentistry and for orthodontics as a specialty there was no role to play. A few years later the Board of the Dutch Dental Association had to conclude--with some distaste--that a specialty in orthodontics was inevitable. As the chairman of the subcommittee for orthodontics the Groningen professor of orthodontics K.G. Bijlstra (1905-1985) had an important role in this process. November 16th, 1953 the first fifteen orthodontists were registered in The Netherlands.

History, 20th Century↗
PubMed2003

[Biocompatibility and resistance to corrosion of orthodontic wires].

Various materials are currently used to make orthodontic wires. This article suggests a synthesis on their resistance to corrosion and biocompatibility. In the first part, after a review of some basic notions on the corrosion processes, the authors develop the electrochemical characteristics of the three main groups of alloys used in orthodontics. They study more precisely corrosion resistance of nickel-titanium alloys and, through their own experimental results, they show that this type of alloy is subject to corrosion in acid and fluoridated environment. In the second part, the authors study those alloys biocompatibility. They first mention nickel toxicity and allergy induced by this element. Then, biocompatibility of alloys used in orthodontics is assessed following studies on the release of metallic elements from orthodontic wires, and studies on cell-compatibility when in contact with those wires. It is proved that the state of materials surface has a very high influence on their biocompatibility. As a conclusion, in spite of numerous studies carried out so far, showing a satisfactory biological behaviour of those orthodontic wires, many questions are yet to be answered: long term in vivo performances of those materials have not yet been exactly assessed. Further studies must definitely be carried out.

Biocompatible Materials↗
PubMed2004

[Class II malocclusion. Time and cost of a combined orthodontic and surgical treatment].

During orthodontic treatment of 29 patients with a Class II malocclusion, the remaining overjet was corrected surgically by intraoral mandibular distraction osteogenesis. The patients were divided in two groups. Group A was treated orthodontically in a two-phase approach, using functional and fixed appliances. Group B was treated in a one-phase approach with only fixed appliances. Before treatment the differences in age, gender and severity of the malocclusion between the groups, were not statistically significant. After distraction-osteogenesis, all orthodontic treatments could be finished successfully. The mean treatment time was for group A 44.2 and for group B 28.6 months. The difference was statistically significant (p < 0.001). The mean orthodontic treatment time after distraction osteogenesis was 9.1 months. The mean cost for the orthodontic treatment was not statistically significant different between the groups.

Adolescent↗