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Orthodontic treatment needs: comparison of two indices.

The Index of Orthodontic Treatment Needs (IOTN) and the Dental Aesthetic Index (DAI) were developed and both claimed to contain the aesthetic and dental components in their criteria of assessing malocclusion. This study was undertaken to assess the reliability of these two indices in assessing orthodontic treatment needs. The indices were applied to 120 pre-treatment study models selected from orthodontic patient records treated at the Department of Orthodontics, University of North Carolina, United States of America. The sample consisted of 60 African-Americans (Black) and 60 American Caucasians (White), age ranged from 12 to 16 years (Mean 13.8). The results showed that the IOTN and the DAI were highly correlated and highly associated statistically (p < 0.0001). The findings of this study indicated that the two indices could be used consistently to identify orthodontic treatment needs in different ethnic groups and are capable of classifying the subjects according to their malocclusion severity for those subjects eligible for treatment in fund constrained situation.

Adolescent↗

[Pre- and post-surgical orthodontic treatment of mandibular asymmetry and prognathism].

OBJECTIVE: The purpose of this study was to analyze the pre- and post surgical orthodontic treatment of mandibular asymmetry and prognathism in our hospital, and to summarize some helpful experiences for future clinical work. METHODS: The data were derived from 21 adults aged from 19 - 28 years who had severe mandibular asymmetry and prognathism. The ANB angle of all patients is from -3 degrees to -8 degrees. The value of wits of all patients is from -7 mm to -14 mm. The deviation of chin point of all patients is from 3 mm to 7 mm. RESULTS: The duration of pre- and post-surgical orthodontic treatment was 10-20 months (mean 18 months) and 5-10 months (mean 7.5 months), respectively. The keys in pre-surgical orthodontic treatment include (1) three dimensional dental decompensation; (2) arch form and transverse discrepancy correction; (3) model surgery and the splint making. The main objective of post surgical orthodontic treatment is to detail the occlusion. CONCLUSIONS: Pre- and post surgical orthodontic treatment is essential for the orthognathic treatment of patients with mandibular asymmetry and prognathism.

Adult↗

Orthodontic specialists education in Europe: past, present and future.

The field of orthodontics developed simultaneously in the USA and Europe, but along somewhat different routes. It is explained that structural changes in Europe resulting in an EU with 25 countries have led to the freedom of exchange of professionals among the Member States which were participating in the EU before May 1, 2004. The European harmonization of dental education is explained. Subsequently, the training of orthodontic specialists in the USA and Europe is dealt with. Furthermore an overview of the Erasmus Programme is given. The role and structure of the European Federation of Orthodontic Specialists Associations (EFOSA) is clarified. The current state of orthodontic specialty training in Europe is described in detail with emphasis on training aspects. Finally, some suggestions are made for the improvement of the training of orthodontic specialists.

Curriculum↗

[A three-dimensional finite element analysis for the biomechanical characteristics of orthodontic anchorage micro-implant].

PURPOSE: To establish a three-dimensional finite element model for orthodontic anchorage micro-implant,and to analyze the influence of different titled angles on the biomechanical characteristics of orthodontic anchorage implant-bone interface. METHODS: ANSYS(Analysis System)finite element analysis software was used to perform the finite element modeling of the micro-implant with 7 different tilted angles, including 30 degrees, 40 degrees, 50 degrees, 60 degrees, 70 degrees, 80 degrees and 90 degrees. A simulated orthodontic force, which was 200 grams, was loaded mesiodistally to the mathematical models. The stress and displacement distribution on the implant-bone interface were analyzed. RESULTS: As the titled angle increased, the Von-Mises stress at the cervix of the implants were 1.0792, 1.0104, 0.8848, 0.8181, 0.7583, 0.6339 and 0.5608MPa, while the displacement were 5.5513, 4.9900, 3.7419, 3.1264, 2.5874, 1.3624 and 0.8027microm CONCLUSION: The micro-implant can be safely loaded with 200 grams of mesiodistal orthodontic force. The increase of the titled angle can efficaciously enhance the ability,implicating that the implant can bear a mesiodistal orthodontic force, vertical angle should be chosen when the micro-implant is embedded. Supported by Natural Science Foundation of Liaoning Province (20042076).

Biomechanical Phenomena↗

Expectations of orthodontic treatment and satisfaction with dental appearance among Nigerian parents [corrected].

The aim of this study was to investigate correlations between satisfaction with dental appearance and expectation of orthodontic treatment. The effects of sex and age on these variables were also explored. A sample of 466 parents comprising 238 (51.1%) males and 228 females (48.9%) were randomly surveyed in Ibadan Nigeria. Their ages ranged from 18 to 73 with mean age of 36.89 +/- 12.27 (SD). They were asked whether they were satisfied or otherwise with their dental appearance and to indicate their expectation of orthodontic treatment. A multiple regression analysis was used to estimate the effect of the dental satisfaction on expectation of orthodontic treatment as well as the influence of age and sex on orthodontic expectations. Significant correlation was not found between satisfaction between dental appearance and parents' expectations. These correlations were invariant over gender, but not over age. It was concluded that satisfaction with dental appearance is not a significant predictor of parents' expectations of orthodontic treatment among the study sample but age was.

Adolescent↗

Personality traits in adolescence and satisfaction with orthodontic treatment in young adulthood.

OBJECTIVE: This study aimed to determine whether personality traits are associated with satisfaction with orthodontic treatment by age 26. METHODS: A prospective observational cohort study was conducted with 1,037 individuals, one-third of whom had received orthodontic treatment by age 26. A comprehensive personality assessment was conducted at age 18 using the multidimensional personality questionnaire. At age 26, orthodontic outcome was rated as either 'Excellent', 'Pretty good', 'Fair' or 'Poor'. RESULTS: Those who were less satisfied (rating their treatment outcome as 'Fair' or 'Poor') scored lower on the personality traits of control and social closeness, and higher on stress reactivity. Individuals with low scores on social closeness were twice as likely (Odds ratio: 2.07) to be less satisfied with their orthodontic result. CONCLUSIONS: Individuals who are impulsive, stress-reactive or socially isolated are more likely to be disappointed with their orthodontic outcome. Pretreatment knowledge about certain aspects of personality might be useful to practising orthodontists.

Adolescent↗

Nickel ions release in patients with fixed orthodontic appliances.

AIM: The extent to which orthodontic appliances can cause contact allergies due to nickel release is a controversial matter. Since the data provided by literature are contrasting, the Authors think that it is important to analyse nickel ions released in organic tissues by means of a plasma spectrometer. METHODS: About 100 intact hairs were taken from 15 patients wearing fixed orthodontic appliances. The hairs had been washed 12 to 24 h before, in order to limit environmental contamination. The same procedure was carried out on a control group corresponding in sex, age and abode. The samples of hair were taken from at least 3 different scalp sites: frontal, vertex and occipital areas. RESULTS: According to the spectrophotometric analysis of the hair, there were no differences in nickel concentrations between the test group (0.50 mg/g on average) and control group (0.64 mg/g) (*P<0.005). The mean value was reduced even further if minimum and maximum values were excluded (test group 0.46 mg/g, control group 0.52 mg/g). Even though there was a slight difference (0.14 mg/g), it showed that more nickel concentration was found in the control sample (without orthodontic appliances) to a maximum of 2.20 mg/g. This suggests that environmental contamination, in particular diet, has an influence on ion concentration. Other studies also confirm that gut absorption of nickel released in the mouth by orthodontic appliances is much lower than the absorption of nickel release through diet. CONCLUSIONS: It can be assumed that orthodontic appliances do not release significant values of nickel to be a risk factor to the patient's health.

Adolescent↗

The severity of malocclusion and need for orthodontic treatment in correspondence with the age.

Awareness of the age related situation as to the malocclusion prevalence in population and orthodontic treatment need is very important and useful for planning an orthodontic care, especially taking into account the interdisciplinary aspect of the problem. The aim of this study was to investigate the degree of severity of malocclusion and the need of orthodontic treatment in three different age groups of population in Latvia. The study group comprised samples of 12-13-yr-olds (n=46), 18-yr-olds (n=32) and 35-44-yr-olds (n=278). The Index of Complexity, Outcome and Need (ICON) was used for the assessment of the results. In order to provide the accuracy use of ICON, more than 4 missing teeth and prosthetic restorations were chosen as an exclusion factor for the age group 35-44 years. A statistically significant difference was determined between the mean ICON values in 12-13 and 18 year-old age groups. Professionally defined orthodontic treatment need according to ICON score >43 was determined to be higher in the age group 18 year-olds. Overall, the tendency for orthodontic treatment complexity grade was observed to increase with the age.

Adolescent↗

[Clinical analysis of PLI, GI and SBI in patients with fixed orthodontic appliances].

PURPOSE: The aim of the present study was to carry out a detailed analysis of the data on PLI, GI, SBI in fixed orthodontic patients. METHODS: 375 middle school students aged 12 to 15 years old were selected as control group, including 196 boys and 179 girls. 331 patients with fixed orthodontic appliances aged 12 -15 years from city were used as experimental group, including 101 boys and 230 girls without mouth-breathing. Gingival index (GI), sulcus bleeding index (SBI), and plaque index (PLI) were recorded for each individual patient six months after being with orthodontic appliances. Four upper and four lower incisors were assessed, the data of the two groups were analyzed with SPSS 10.0 software package for Student's t test. RESULTS: It was found that there were significant higher PLI, GI and SBI values in orthodontic treated patients (P<0.01). Although there was no significantly difference in PLI value between boys and girls (P>0.05) in the experimental group, there were statistically significant higher GI and SBI values compared boys with girls (P<0.01). There were significantly higher PLI and GI values in boys' lower incisor(P<0.01). Oral health care was difficult in patients with fixed orthodontic appliances. Boys' oral hygiene was poorer than girls'. CONCLUSION: In order to maintain periodontal health, it is very important to strengthen oral hygiene to children who receive fixed appliance, especially in boys, as well as control the level of plaque accumulation in the lower incisors.

Adolescent↗

[Orthodontic anchorage in the era of osseointegration].

The introduction of the concept of osseointegration had a profound impact on dentistry of the 20th century. The idea of using this concept in orthodontics already started in the late 70th. There demand for achieving optimal esthetic results in a minimal treatment time, and the significant increase in the number of adult orthodontic patients, made osseointegration an essential adjunct to orthodontic therapy. The use of osseintegrated anchorage devices helps the clinician to overcome one of the most limiting aspects of orthodontic therapy--inadequate anchorage. In the last years a large variety of osseointegrated anchorage devices have been developed and introduced in orthodontics. The purpose of the present article is to present several cases that illustrate how to solve anchorage problems by the using the principles of osseointegration and mechanical retention. The selection of the most appropriate anchorage device for each specific case will be emphasized.

Adolescent↗

Orthodontics in the Mediterranean Area.

The article describes on the results of the first Workshop that SIDO organized in December 2005 in Cairo getting together twenty Countries who discussed Orthodontics in the Mediterranean Area. The aim was to take a picture, for the first time, of the state of Orthodontics in the different Mediterranean Countries using it as basis for a further co-operation. Progress in Orthodontics (published in English, indexed in Medline, free of charge website and downloading) was offered by SIDO as the means for a scientific and organizational sharing, and to spread a Mediterranean Orthodontic culture all over the world. The first step toward mutual understanding was completed and for the first time we collected data and the Mediterranean Orthodontic Integration Project (MOIP), on which we can base a coming meeting and debate, was introduced.

Education, Dental, Continuing↗

[Surgery before orthodontic treatment: a concept for timing the combined therapy of skeletal dysgnathias].

Postsurgical orthodontic treatment will prevent several disadvantages of the presurgical orthodontic approach: 1. Orthodontic tooth-movements do not interfere with compensatory biological responses. 2. The dental arch alignment is similar to the procedures of any class-I-orthodontic treatment; i.e. dental movements can be based on an already corrected skeletal relation. 3. A possible postsurgical relapse may be easily compensated within the postsurgical orthodontic treatment. Presurgical corrections of dento-alveolar discrepancies are only required to limit an excessive vertical disclusion necessary for a correct sagittal and transverse positioning of the jaws.

Combined Modality Therapy↗

[Orthodontic treatment of adults with periodontal disease].

Orthodontic treatment has diversified in recent years along with progress in other dental specialties. Adult orthodontic treatment has become more popular as patients appreciate the need for a higher level of oral health accompanied with progress in orthodontic objectives and treatment methods. At the same time, patients with periodontal disease in number every year. Recently, two adult females with periodontal disease, one with crowding (20 y 1 m at her initial visit) and the other with bimaxillary protrusion (34 y 9 m at her initial visit), obtained good occlusion and periodontal health through orthodontic treatment. As a result of free mandibular movement by applied mild orthodontic forces and balanced occlusion, infrabony defects improved to achieve a higher level of the alveolar crest.

Adult↗

[Organization model for mass orthodontic prophylaxis in integrated pediatric institutions].

A model is proposed for the organization of mass orthodontic prophylaxis in the integrated pediatric institutions (IPI), covering the following more important activities: I. Follow-up care of the organized pediatric groups in the crêches and nurseries with a view to orthodontic prophylaxis. II. Analysis of the data from the prophylactic examinations, written down in special cards, worked out by the authors. According to the needs of the children they are distributed in four follow-up groups. III. Mass orthodontic prophylaxis. The more important measures of primary and secondary mass orthodontic prophylaxis are established and grouped respectively. IV. Visual-educational materials. V. Colour film of the model. The proposed model is admitted to illustrate and convincingly present the possibilities of the mass prophylaxis in IPI and, in parallel, it could serve as a programme for mass orthodontic prophylaxis.

Child↗

[Infection control in orthodontics: infective agents and modality of transmission. 1].

Adequate attention to prevention of cross-contamination in dental operatory is largely ignored by orthodontists. This occurs for two principal reasons. The first one is that orthodontic patients, usually children, are erroneously considered a low-risk population. The second one is that orthodontic procedures are usually considered nontissue invasive and not able to produce contamination of staff, patients or instruments. Nevertheless, since 1972, we know that we can find HBsAg in saliva too and moreover we cannot exclude to see blood in the mouth of our patients during orthodontic procedures. Furthermore the high volume of patients that orthodontists see every day and the possibility to treat orthodontically adult patients, take the risk of cross-contamination in orthodontic at the same level of other dental practices. The aim of the Authors is to sensitize orthodontists to the risk of cross-contamination giving the latest data of prevalence of hepatitis, tuberculosis and AIDS in adolescent population.

Acquired Immunodeficiency Syndrome↗

Diagnosis and treatment planning for the surgical-orthodontic patient.

Contemporary orthognathic surgery has made it possible to reposition either or both jaws in one piece or as segmental osteotomies. This has provided the patient, who has a severe dentofacial problem, with the option of having all components of their malocclusion and facial aesthetic concerns addressed. The close collaboration between the orthodontist and the surgeon provides a comprehensive diagnosis and treatment plan to be generated. The goal of the presurgical phase of orthodontics is to remove the dental compensations and allow optimum surgical correction of the jaw discrepancy. A short phase of orthodontic treatment postoperatively is usually necessary to detail the final occlusion. A systematic approach to diagnosis and treatment planning is discussed in the context of the problem-oriented approach. The application of this approach is illustrated in a case report of the combined orthodontic-surgical treatment of a patient who benefited from a two-jaw surgical procedure with pre- and postoperative orthodontic treatment. The principles of presurgical orthodontic treatment are discussed and should avoid any counterproductive tooth movements that can be part of the surgical correction. Tooth movements done as part of the postoperative treatment should avoid compromising the surgical outcome. Illustrations of the cephalometric prediction tracing and its application to the diagnosis and treatment plan of the patient discussed in the case report is an important aspect in providing the dentofacial patient with a representation of the expected treatment outcome.

Cephalometry↗

Orthodontic considerations in prosthetic and restorative dentistry.

Orthodontic treatment no longer is limited to adolescents. The past 20 years have shown an enormous increase in number of adults treated. Many orthodontists now report that 35 to 40 per cent of their patients are adults. Indeed, there are orthodontists who limit their practices exclusively to adult orthodontics. Prosthodontists and restorative dentists rely on orthodontics as a means of providing more comprehensive care to a wide variety of patients. These patients present with diverse problems and a collaborative effort between orthodontist and restorative dentist often is necessary to achieve an optimal treatment result. An overview of restorative problems that can be ameliorated by orthodontic treatment has been shown. Common problems addressed, were, for example: anterior crowding, insufficient pontic space, lack of abutment parallelism, crossbites, diastemas, and premature contact relationships. Less common, but even more demanding of orthodontic-prosthetic cooperation, are problems involving orthognathic surgical procedures and the rehabilitation of patients with congenital abnormalities. A rationale for the collaboration of orthodontists and restorative dentists was demonstrated. As technology burgeons, it becomes more and more necessary for one discipline to rely on the expertise of another. Our colleagues, in their various specialties, have made such enormous advances in sophistication that it has become virtually impossible to absorb all that is new in all areas. Collaboration not only is desirable, but has become mandatory, if we are to provide the highest level of care for our patients.

Humans↗

[Method for assessment and control of deposited plaque upon removable plastic orthodontic apparatuses].

The keeping of oral hygiene is of great importance during orthodontic treatment--for prophylaxis of caries and gingivae. The authors propose and Index for the hygiene of orthodontic apparatuses (IHOA) for the broad orthodontic practice, that is based on staining and scraping of the accumulated plaque by four fields of the removable orthodontic apparatus--in contact with the dental-gingival and mucosal surfaces. The scores from 0 to 3 enable the modification of the behaviour of the stomatologist and parents as regards the motivation, control and necessity of additional means for attaining the desired hygiene of the orthodontic apparatus.

Dental Plaque↗