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PubMedDate not supplied

"Real" early orthodontic treatment. From birth to age 8.

This article will introduce new concepts for earlier orthodontic (teeth) and orthopedic (jaw-bone) diagnosis and treatment from birth to age eight. While early orthodontic treatment around age 8 is getting some attention, age 8 is still too late to orthopedically guide proper jaw and airway growth in some children. By age 8, the jaws (maxilla and mandible) grow 80-90% of their adult size. Research shows that small jaws create small airways and increase the likelihood of life-threatening disorders, for life. Since the upper and lower jaw-bones form the gateway to the human airway, a new earlier orthodontic protocol and standard is warranted. Unique Functional Jaw Orthopedic concepts will help form a new early orthodontic protocol. These new concepts may very well help general dentists, pedodontists and orthodontists move dental care into a future world of medical dentistry which will include airway development, bed-wetting, ear disease, heart disease and longevity.

Breast Feeding↗
PubMed2005

Preventive and interceptive orthodontic treatment needs of an inner-city group of 6- and 9-year-old Canadian children.

OBJECTIVE: Early recognition of developing malocclusions and the potential for uncomplicated orthodontic treatment procedures can minimize or eliminate future costly treatment. This study was designed to assess the potential for this approach in children living in a limited-income environment. A modified index for preventive and interceptive orthodontic needs (IPION) was used to determine the need for such treatment in schoolchildren aged 6 and 9 years. METHODS: Two calibrated examiners examined each child independently and assessed several components of his or her occlusion, including molar relationship, crossbite, open bite, overbite and overjet. Dental variables such as presence of caries and early loss of teeth were also noted. Informed consent was obtained and all children present at school on the day of the field study were included. A total of 395 children were divided into 2 groups, aged 6 and 9 years. RESULTS: A high prevalence of caries in the deciduous dentition (30.4% for 6 year olds; 20.6% for 9 year olds) and early loss of primary teeth (11.9% for 6 year olds; 29.4% for 9 year olds) was observed. A large percentage of children had crossbite in the anterior or posterior segments, or both. Open bites were also a common finding. Future orthodontic problems were identified in 28% of this population by using the modified IPION. No statistically significant differences (p > 0.05) were found between sexes or age groups using the chi2 test. CONCLUSIONS: Most of the developing malocclusions identified in this study would be amenable to interceptive orthodontics, consisting of space maintenance, crossbite correction and arch expansion.

Child↗
PubMed2006

[Bone anchorage in orthodontics. A review].

The achievement of absolute anchorage in orthodontics overcoming the reaction forces and moments has been problematic for a long time. This was caused on the one hand by the limitations of the devices available and on the other hand by the dependence on patient cooperation. The introduction of bone anchorage systems changed the traditional way of thinking on orthodontic anchorage. Whereas the application of anchor systems, such as palatal implants and onplants, has specific indications, bone screws with or without plates seem to have the potential of being used on a routine basis. However, appropriate data for more complete understanding of the biological and biomechanical background of this concept of orthodontic anchorage are still lacking. Furthermore, studies on the effectiveness of these systems when compared to the traditional orthodontic anchorage and based on large groups of patients are not available. Well-designed prospective clinical trials substantiating the evidence-based use of these devices are needed.

Bone Screws↗
PubMed1996

Biomechanical considerations for orthodontic treatment of adults.

Biomechanical modifications made to accommodate orthodontic treatment of adult dentitions are generally minor and adhere to the basic laws of physics as they apply to all orthodontic tooth movement. Some adult presentations necessitate changes in treatment strategy from what would otherwise be employed in adolescent patients to achieve similar goals. In other cases, objective themselves may need to be modified because of a lack of growth potential, constraints of treatment mandated by the patient, or the presence of multiple missing or compromised teeth. The possibilities and limitations of orthodontic and dentofacial orthopedic treatment for adults are usually easier to define before beginning therapy than with adolescent patients because the unknown contribution that growth will make has already been discounted. By planning treatment and mechanotherapy taking into account the individual circumstances that may affect the patient's biological response to treatment, realistic goals of orthodontics can be mutually recognized and agreed on by both the provider and the patient before therapy is initiated.

Adult↗
PubMed1997

[Implants and orthodontics].

After a detailed historical review of implantology applied to orthodontics, and an analysis of experimental studies on orthodontic implants, the authors assess the interest of implant clinical uses as anchorage for orthodontic movement, prosthetic supports in agenetic cases or retention devices after orthodontic therapy. Different specifications and requirements are also given for a multidisciplinary approach of treatment plants.

Anodontia↗
PubMed2000

Application of bone remodeling theories in the simulation of orthodontic tooth movements.

A numerical model that calculates bone apposition and resorption around a tooth root on the basis of bone remodeling theories was developed to simulate orthodontic tooth movements. The model was used to calculate different kinds of orthodontic tooth movements, that were then compared with the expected movements based on clinical experience. For simulation of the movements the root of a canine was modeled in an idealized way in the form of an elliptical paraboloid and was processed with a finite element program. The finite element model was loaded with defined force systems. Two model assumptions were used to calculate the bone remodeling process. The mechanical loads firstly in the periodontal ligament and secondly in the alveolar bone were taken to simulate the following tooth movements: 1. mesial tipping around the center of resistance (force system at the bracket: isolated torque MY = 5 Nmm), 2. rotation around the long axis of the tooth (MZ = 5 Nmm), 3. uncontrolled tipping around the root tip (FX = 1 N, MZ = 5 Nmm), 4. canine retraction (FX = 1 N, MY = -9.5 Nmm, MZ = 5 Nmm), 5. and 6. extrusion/intrusion (FZ = +/- 0.5 N, MX = +/- 2.5 Nmm). Comparison with clinical experience was performed by calculating the orthodontic tooth movements based on the assumption of a fixed position of the center of resistance. It could be demonstrated that the numerical model of orthodontic bone remodeling can be used to calculate orthodontic tooth movements. However, the results are strongly dependent on the model assumptions. The model simulating the bone remodeling on the basis of the loading of the periodontal ligament delivers results that are in very good accordance with the biomechanical assumptions of the position of the center of resistance. However, marked side effects occurred with the second model, especially in the simulations of uncontrolled tipping, translation and intrusion/extrusion. Clinically, these side effects cannot be observed.

Bone Remodeling↗
PubMed2006

Experimental model of tooth movement by orthodontic force in mice and its application to tumor necrosis factor receptor-deficient mice.

Orthodontic tooth movement is achieved by mechanical loading; however, the biological mechanism involved in this process is not clearly understood owing to the lack of a suitable experimental model. In the present study, we established an orthodontic tooth movement model in mice using a Ni-Ti closed coil spring that was inserted between the upper incisors and the upper first molar. Histological examination demonstrated that the orthodontic force moved the first upper molar mesially without necrosis of the periodontium during tooth movement. The number of TRAP-positive osteoclasts on the pressure side significantly increased in a time-dependent manner. Quantitative real time-based reverse transcription-polymerase chain reaction analysis demonstrated increased levels of mRNA for cathepsin K. Immunohistochemical staining revealed the expression of tumor necrosis factor-alpha (TNFalpha) in periodontium on the pressure side of the first molar during orthodontic tooth movement. When this tooth movement system was applied to TNF type 1 receptor-deficient mice and TNF type 2 receptor-deficient mice, tooth movement observed in TNF type 2 receptor-deficient mice was smaller than that in the wild-type mice and TNF type 1 receptor-deficient mice. The number of TRAP-positive osteoclasts on the pressure side was significantly small in TNF type 2 receptor-deficient mice compared with that in TNF type 1 receptor-deficient mice on day 6 after application of the appliance. The present study indicates that TNFalpha signaling plays some important roles in orthodontic tooth movement.

Acid Phosphatase↗
PubMed1979

A radiographic evaluation of the response of previously avulsed teeth and partially avulsed teeth to orthodontic movement.

Orthodontic movement, as documented in this study, can be accomplished successfully in the case of completely avulsed and partially avulsed teeth which have been reimplanted. These teeth respond to normal orthodontic forces and duration of treatment time by conventional orthodontic techniques and retention. Apical root resorption does occur more readily in these teeth before, during, and after orthodontic treatment. Six of the eighty-one involved teeth were lost because of complete root dissolution. The involved teeth which were reimplanted immediately without pulpal treatment and their integrity protected as living tissue were successfully treated orthodontically with no known losses as of this writing. It will be interesting to observe the tissue response of these avulsed teeth in the years ahead. How will time and circumstances deal with these teeth?

Adolescent↗
PubMed1986

Reconstruction of alveolar width for orthodontic tooth movement: a case report.

A problem that has limited orthodontic treatment is lack of buccal-lingual alveolar width into which teeth can be moved. Causes may range from surgical obliteration to physiologic constriction after tooth removal. Lack of buccal-lingual alveolar width does not have to be an orthodontic limitation anymore. A technique used routinely to graft alveolar clefts can remedy this problem. Autogenous cancellous bone is placed subperiosteally on the buccal aspect of the constricted edentulous space. The flap is closed over the bone. The adjacent teeth may be orthodontically moved into the grafted edentulous area in approximately 6 weeks. Long-term follow-up has revealed excellent orthodontic stability, periodontal health, and dental vitality. A case report of one patient with loss of buccal-lingual alveolar space is presented. It is concluded that loss or lack of sufficient buccal-lingual alveolar width no longer must be an orthodontic limiting factor.

Adult↗
PubMed1986

Influence of orthodontic treatment on root development of autotransplanted premolars.

The aim of this study was to clarify whether orthodontic movement of autotransplanted premolars will affect the final root length of the transplants. A group of 29 autotransplanted premolars that had been orthodontically treated was compared with a group of 30 autotransplanted premolars that had not been orthodontically treated. Contralateral teeth in both groups served as controls. The root lengths of the transplants as well as the controls were measured on the radiographs immediately after transplantation and also after orthodontic treatment and complete root formation. The results demonstrated that there was no statistically significant difference between the original and final root lengths of the transplants in the two samples or between the contralateral teeth. The autotransplantation of the premolars resulted in an average shortening of 1 to 2 mm compared to the contralateral control teeth. Futhermore, orthodontic movement of the transplants appeared to have a tendency to shorten the final root length.

Adolescent↗
PubMed1987

Effect of pulsed electromagnetic fields on orthodontic tooth movement.

The purpose of this study was to determine whether the application of a simple surgically noninvasive, pulsed electromagnetic field could increase both the rate and amount of orthodontic tooth movement observed in guinea pigs. In addition, the objective was to evaluate the electromagnetic field's effects on bony physiology and metabolism and to search for possible systemic side effects. Laterally directed orthodontic force was applied to the maxillary central incisors of a sample of 40 young male, Hartley guinea pigs (20 experimental, 20 control) by means of a standardized intraoral coil spring inserted under constricting pressure into holes drilled in the guinea pigs' two maxillary central incisors. During the experimental period, the guinea pigs were placed in specially constructed, plastic animal holders with their heads positioned in an area of uniform electromagnetic field. Control animals were placed in similar plastic holders that did not carry the electrical apparatus. The application of a pulsed electromagnetic field to the experimental animals significantly increased both the rate and final amount of orthodontic tooth movement observed over the 10-day experimental period. The experimental animals also demonstrated histologic evidence of significantly greater amounts of bone and matrix deposited in the area of tension between the orthodontically moved maxillary incisors. This increase in cellular activity was also reflected by the presence of significantly greater numbers of osteoclasts in the alveolar bone surrounding the maxillary incisors of the experimental animals. After a 10-day exposure to pulsed electromagnetic field, minor changes in serologic parameters relating to protein metabolism and muscle activity were noted. The results of this study suggest that it is possible to increase the rate of orthodontic tooth movement and bone deposition through the application of a noninvasive, pulsed electromagnetic field.

Alveolar Process↗
PubMed1989

Periodontal implications of orthodontic treatment in adults with reduced or normal periodontal tissues versus those of adolescents.

This longitudinal study monitored periodontal status in 20 adults and 20 adolescents undergoing fixed orthodontic treatment. Ten adults had generalized periodontitis and received periodontal treatment, including periodontal surgery, before orthodontic treatment. They also received periodontal maintenance at 3-month intervals during orthodontic treatment. The other 10 adults had normal periodontal tissues. Neither these latter adults nor the adolescents received periodontal maintenance during orthodontic treatment. Periodontal status was determined (1) at six standard sites before fixed appliances were placed (baseline), (2) at 1, 3, 6, 9, 12, and 18 months after appliances had been placed, and (3) 1, 3, 6, and 12 months after appliances had been removed. At each of these visits, these sites were assessed for plaque index, gingival index, bleeding tendency, and pocket depth. Loss of attachment between baseline and 3 months after appliances were removed and tooth loss were also determined. Complete data were obtained for 15 adolescents and 14 adults. During orthodontic treatment the adolescent group showed significantly more (p less than 0.05) periodontal inflammation and supragingival plaque than the adults; after appliances were removed, this pattern was no longer statistically significant. For loss of attachment, there were no significant differences among adolescents, adults with normal periodontal tissues, or adults with reduced but healthy periodontal tissues who had undergone treatment for periodontal disease. For tooth loss, three nonstudy site teeth with pockets deeper than 6 mm and/or furcation involvements were lost because of periodontal abscesses in the adult group treated for periodontal disease.

Adolescent↗
PubMed1993

Facial keys to orthodontic diagnosis and treatment planning. Part I.

The purpose of this article is twofold (1) to present an organized, comprehensive clinical facial analysis and (2) to discuss the soft tissue changes associated with orthodontic and surgical treatments of malocclusion. Facial examination leads to avoidance of potential orthodontic and surgical facial balance decline and enhances diagnosis, treatment planning, treatment, and quality of results. Patients are examined in natural head position, centric relation, and relaxed lip posture. Nineteen key facial traits are analyzed. By examining the patient in this format, reliable facial-skeletal traits can be recorded that enhance all aspects of care. Orthodontics and surgery used to correct the bite alter facial traits; alteration should reverse negative traits and maintain positive traits. This cannot be achieved without a complete understanding of the face before treatment. Tooth movement (orthodontic or surgical) used to correct the bite can negatively impact facial esthetics, especially if pretreatment esthetics are not defined before treatment. Treating the bite based on model analysis or on osseous cephalometric standards without examination of the face is not adequate. Three questions are asked regarding the 19 facial traits before treatment: (1) What is the quality of the existing facial traits? (2) How will orthodontic tooth movement to correct the bite affect the existing traits (positively or negatively)? (3) How will surgical bone movement to correct the bite affect the existing traits (positively or negatively)? This article is for orthodontists, and yet, much surgical information is included. This is intentional. We only treat what we are educated to see. The more we see, the better the treatment we render our patients.

Cephalometry↗
PubMed1993

Periodontal tissue response to orthodontic movement of teeth with infrabony pockets.

The aim of this study was to evaluate the effect of orthodontic tooth movement on the level of the connective tissue attachment in sites with infrabony pockets. The experiment was carried out in four beagle dogs. The second and fourth premolars were extracted. After healing, angular bony defects were prepared at the mesial aspect of the third premolars. The exposed root surface was scaled and planed, and a notch was prepared at the bottom of the defect. Plaque-collecting cotton floss ligatures were placed around the neck of the teeth and maintained in situ for 3 weeks, followed by an additional 2 months of plaque accumulation before the orthodontic tooth movement was initiated. In each dog, one premolar was moved away from the angular bony defect and one premolar into and through the angular bony defect. The maxillary third premolars served as control teeth and were not subjected to orthodontic tooth movement. After orthodontic treatment (5 to 6 months), the teeth were stabilized for a period of 2 months before biopsy sampling. Clinical, radiographic, and histologic evaluations revealed that it was possible to establish and maintain an infrabony pocket with a subcrestal, plaque-induced inflammatory lesion during the entire course of the study. While the control teeth had maintained their attachment levels, all but one of the orthodontically moved teeth showed additional loss of attachment.(ABSTRACT TRUNCATED AT 250 WORDS)

Alveolar Process↗
PubMed2004

Orthodontic treatment with growth hormone therapy in a girl of short stature.

The purpose of this article is to review the characteristics of craniofacial morphology in children of short stature and the effects of human growth hormone (HGH) therapy on the craniofacial complex. Changes in body height, facial growth, and dental maturity of a 9-year-old girl who received HGH therapy during orthodontic treatment were observed. Orthodontists need to understand the skeletal characteristics of the craniofacial complex of short-stature patients before beginning orthodontic treatment and consider how the differences between chronologic and skeletal ages affect the timing and method of orthodontic treatment. If short-stature children are undergoing HGH therapy, its cranioskeletal effect should be considered; if possible, it is better to delay orthodontic treatment until HGH is finished. However, if orthodontic treatment is performed, the following should be considered: (1) HGH therapy affects the growth of the mandible more than the growth of the maxilla, (2) the amount and pattern of growth during HGH administration are unpredictable, and (3) HGH therapy rarely affects dental maturity.

Adolescent↗
PubMed2005

Peri-implant bone response to orthodontic loading: Part 1. A histomorphometric study of the effects of implant surface design.

INTRODUCTION: Bone response to orthodontic loading was compared histomorphometrically around 2 different types of osseointegrated implants (porous surfaced and machined threaded) to determine their suitability for orthodontic anchorage. METHODS: Five beagles each received 3 implants of each design in contralateral mandibular locations. After a 6-week initial healing period, abutments were placed, and, 1 week later, the 2 mesial implants on each side were orthodontically loaded for 22 weeks. All implants remained osseointegrated throughout orthodontic loading except for 1 threaded implant that loosened. Light miscroscopy and back-scattered scanning electron microscopy were used to compare responses around the 2 implant designs. RESULTS: Porous-surfaced implants had higher marginal bone levels (P +/- .025) and less relative implant displacement than threaded implants. CONCLUSIONS: Differences in implant surface design can lead to differences in peri-implant bone height and bone-to-implant contact. Porous-surfaced implants might be successful as orthodontic anchorage units.

Alveolar Process↗
PubMed2005

Peri-implant bone response to orthodontic loading: Part 2. Implant surface geometry and its effect on regional bone remodeling.

INTRODUCTION: Bone response to orthodontic loading was compared around 2 different types of osseointegrated implants (porous surfaced and machined threaded) to determine the effect of implant surface geometry on regional bone remodeling. METHODS: Five beagles each received 3 implants of each design in contralateral mandibular extraction sites. After a 6-week initial healing period, abutments were placed, and, 1 week later, the 2 mesial implants on each side were orthodontically loaded for 22 weeks. All implants remained osseointegrated throughout orthodontic loading except for 1 threaded implant that loosened. Back-scattered scanning electron microscopy and fluorochrome bone labeling techniques were used to compare responses around the 2 types of implants. RESULTS: The loaded, porous-surfaced implants had significantly higher marginal bone levels and greater bone-to-implant contact than did the machined-threaded implants. CONCLUSIONS: Significant differences in peri-implant bone remodeling and bone formation in response to controlled orthodontic loading were observed for the 2 implant designs. Short, porous-surfaced implants might be more effective for orthodontic applications than machine-threaded implants.

Alveolar Process↗
PubMed2006

Orthodontic tooth movement after inhibition of cyclooxygenase-2.

INTRODUCTION: The purpose of this study was to compare the effects of a conventional nonsteroidal anti-inflammatory drug, diclofenac (Voltaren [Novartis, Barcelona, Spain]), and a specific cyclooxygenase-2 (COX-2) inhibitor, rofecoxib (Vioxx [MSD, Madrid, Spain]), on the inhibition of dental movement induced with a coil-spring orthodontic apparatus in rats. METHODS: Tooth movement was measured on the lateral cranial teleradiographs of 42 male Wistar rats in 6 experimental groups: (1) 50-g coil spring and 2 rofecoxib injections of 1 mg per kilogram of body weight; (2) similar orthodontic procedure and 2 diclofenac injections of 10 mg per kilogram of body weight; (3) the same orthodontic treatment and 0.9% saline-solution injections; and (4), (5), and (6) 100-g coil appliance and the same pharmacological treatment as 1, 2, and 3, respectively. RESULTS: The difference in tooth movement, measured in the control animals after 10 days of 50 or 100 g of orthodontic force application, was not statistically significant. Reduction in tooth movement in 50-g traction groups reached statistically significant differences; both rofecoxib or diclofenac were effective in inhibiting dental movement. The comparison of the 3 groups treated with 100 g of force also reached statistical significance. Both rofecoxib and diclofenac significantly inhibited dental movement, partially in the case of rofecoxib and totally in the case of diclofenac. Nevertheless, no statistically significant difference was found between the effects of rofecoxib and diclofenac. CONCLUSIONS: There is no substantial advantage in using selective COX-2 inhibitors compared with nonspecific COX inhibitors to avoid interference with tooth movement during orthodontic treatment in rats.

Animals↗