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PubMed1989

[Orthodontic treatment of adults].

Orthodontic treatment of adults has become an integral part of orthodontic routine. Adults can only be treated with fixed appliances. The amount of force and the resulting moments need careful calculation. The factors listed below distinguish orthodontic treatment of adults from that in juveniles: (1) Preceding periodontal treatment is a sine qua non. It should also accompy orthodontic treatment. (2) A growth effect can no longer be expected. (3) Bite opening can only be achieved by intrusion and torque of incisors. (4) Skeletal disharmonies invariably need surgical correction. (5) Treatment time is considerably longer. (6) Motivation of adult patients is much higher. (7) Therefore, oral hygiene is not a problem. (8) The cosmetic appearance is an important factor, which is best taken care of by ceramic or lingual brackets. (9) Final adjustment of occlusion should be done with gnathologic positioners. (10) Adult treatment should only be done by orthodontists trained and experienced in modern fixed appliance use.

Adult↗
PubMed1989

[Cariologic aspects of orthodontic treatment].

An almost linear correlation between plaque accumulation and caries lesion development has been demonstrated in orthodontic patients. Nevertheless, the present fluoride agents and regimens are sufficient to prevent lesion development to such an extent that filling therapy is not required. An increased prevalence of white spot demineralization on the buccal surfaces in orthodontically treated individuals may on the other hand represent an aesthetic problem. Fig 5 summarizes a series of experiments on the effect of fluoride on lesion development during treatment with fixed orthodontic appliances. Whereas daily rinsing with a neutral fluoride solution (0.2% NaF) inhibits lesion development by about 60%, a fluoride solution (0.6% F) at pH 1.9 inhibits lesion development completely under the same experimental conditions. The hypothesis is that the acidic fluoride solution induces an acid resistant layer of calcium fluoride-like material on the enamel surface and/or a large depot of fluoride for release during cariogenic challenges. A fluoride solution at low pH may be recommended for prevention of lesion development during treatment with fixed orthodontic appliances.

Dental Caries↗
PubMed1996

Orthodontic retention.

This article briefly describes several factors that should be considered during orthodontic retention. These factors may influence occlusal stability following the completion of the active phase of orthodontic therapy. Orthodontic retention is an important part of orthodontic treatment. It should always be considered and included in the initial stages of treatment planning, rather than added on at the end of treatment as an after-thought.

Humans↗
PubMed1998

Signs and symptoms of temporomandibular disorders in 19-year-old individuals who have undergone orthodontic treatment.

Fifty-five per cent of the 1554 19-year old subjects in Halmstad, Sweden, born in 1975, have received orthodontic treatment. Among these, 520 have been treated by specialists (specialist group) and 340 by general practitioners after consultation with specialists (consultation group). The aims were to study the prevalence of signs and symptoms of temporomandibular disorders (TMD) in these two groups on a long-term basis, to identify any possible difference between the groups, and to compare the results with those from a previously presented epidemiological study (control group). From the population of orthodontically treated subjects, a sample was randomly selected to represent the two groups, and 260 subjects agreed to attend for investigation, the participation rate being 77%. The investigation consisted of a questionnaire and clinical examination focusing on function and dysfunction of the masticatory system. Severe signs and symptoms of TMD were rare, the prevalence did not differ significantly between the two orthodontic groups, and the results were similar in the control group. The prevalence of several signs and symptoms was more common in females than in males. No significant correlation between TMD signs and symptoms and occlusal contact recordings was found. It was concluded that the vast majority of the 19-year old individuals who had undergone orthodontic treatment had well-functioning masticatory systems, and severe signs and symptoms of TMD were rare.

Adult↗
PubMed2000

Influence of economic restraints and reduced specialist resources on delivery and quality of orthodontic care.

In 1993 and 1994, economic restrictions were introduced in the County of Ostergötland. The aim of this study was to investigate the influence on delivery and quality of orthodontic care, i.e. any subsequent change in number of patients receiving orthodontic treatment both by General Public Dental Service (GPDS) and by specialist clinic, the choice of appliance, and treatment outcomes, and also any changes in the total number of appliance treatments by general practitioners. Records were examined for 236 and 213 patients registered in 1994 and 1997, respectively, at an orthodontic clinic in the western district of Ostergötland. The total number of appliance treatments by general practitioners was estimated. The number of patients receiving initial treatment by a general practitioner and subsequently by an orthodontist, was relatively unchanged during the period. Quad helix predominated in both 1994 and 1997. The best treatment outcomes were achieved by quad helix and maxillary removable appliances, and the poorest by activators and headgear. In conclusion the total number of appliance treatments by general practitioners decreased as well as treatments requiring patient compliance over an extended period, findings which might be a consequence of the coincident economic restriction.

Activator Appliances↗
PubMed1994

Surgical treatment of mandibular prognathism in collaboration with orthodontic treatment in Korea.

Mandibular prognathism is defined by John Hunter as follows: "The lower jaw projecting too far forward so that the foreteeth pass before those of the upper jaw, therefore disfigurement and malocclusion are two of the main facial characteristics." Other distinguishing features are the coexistence of class III malocclusion, incomplete closure of lip, deviation of the midline, and decrease of labiomental fold. Generally, the functional occlusal relationship and balanced facial harmony cannot be obtained by surgical or orthodontic treatment alone. Its success depends on careful conjoint, supplementary diagnostic, and treatment planning. As a cardinal principle the authors made the following combined surgical and orthodontic treatment plans: (1) Orthodontic treatment relocates and decompensates the malpositioned teeth (remove the masking effect of teeth) and, therefore, skeletal deformity is exposed maximally. (2) Surgical treatment eliminates the maximally exposed skeletal defect. Therefore, dramatic facial balance and functional occlusal relationship are obtained. Treatment planning includes the pre- and postoperative orthodontic treatment, lateral cephalometric prediction tracing (LCPT), and model surgery with dental cast. The authors made it easy with the use of an acrylic dental wafer to coordinate exact occlusal relationship after surgery. We treated mandibular prognathism by using Dautrey's modification of the sagittal split ramus osteotomy (SSRO) (10 cases) and intraoral vertical ramus osteotomy (IVRO) (5 cases) and sometimes additional genioplasty (2 cases). IVRO was used in those cases where (1) the amount of setback was more than 10 mm and (2) where there was a flat gonial angle.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Cooperation of adolescents in orthodontic treatment.

Cooperation of 39 adolescents with orthodontic treatment was examined 8-10 months into treatment and again at completion. Early in treatment, parental attitudes served as the best predictors of cooperation. By the end of active treatment, however, the adolescent patients' own cognitions were the most salient predictors of cooperation. Prior to beginning orthodontic treatment, subjects and their parents completed a battery of psychosocial and orthodontic-specific measures. Results of stepwise multiple regression analyses showed that only the Parent Positive Attitude Toward Braces measure significantly predicted orthodontic cooperation early in treatment, while External-Powerful Others (Professionals) attributions of control, External-Chance attributions of control, and the initial assessment of cooperation significantly predicted cooperation over longer periods of time.

Adolescent↗
PubMed1989

[Correlations of orthodontics and periodontics].

Periodontics and orthodontics are correlated with one other in many ways. For instance, periodontal conditions have to be considered in the orthodontic treatment of adults, special orthodontic measures are taken to enhance a periodontal treatment, and when periodontal surgery is performed for the prevention of relapse or the disimpaction of teeth. Dental practitioners working in the field of orthodontics should have a sound understanding of the biology and pathology of the periodontium in order to avoid causing periodontal lesions, or when lesions are present, how best to determine prognosis and differential treatment.

Adult↗
PubMed1992

[The orthodontic treatment needs of young adults. An epidemiological study of recruits].

In an epidemiological study of 370 recruits, the need for orthodontic treatment was investigated. Subjects who had previously received orthodontic treatment (n = 135) were compared with untreated subjects (n = 234). An unequivocal need for orthodontic treatment was ascertained in 50% of the recruits. Differences between previously treated subjects and untreated subjects were not Some 60% of the orthodontic measures had been carried out by an orthodontist, and 40% by a nonspecialist dentist. The results of treatment were generally unsatisfactory, although the success rate achieved by the orthodontists did appear somewhat higher than that seen with nonspecialist dentists.

Adolescent↗
PubMed1989

[The effects of functional diagnostic measures on orthodontic planning and therapy].

Patients with significant functional disorders were pretreated with a relaxation splint before planning orthodontic treatment. The orthodontic diagnostic procedures were completed with extensive clinical and instrumental examinations of function (articular diagnosis and axiography) before and after the pretreatment. The studies show that the pretreatment for patients with TMJ disorders is necessary for the differential diagnosis. Furthermore, this may become necessary in order to determine the individual acceptable therapeutic mandibular position. In most cases, the axiography was found to be of minor relevance for the orthodontic therapeutic plan. If the functional improvement is intended to have a stable and causal basis, then an extensive clinical and instrumental functional examination (for the determination of a reproducible mandibular reference position) is crucial at least in TMJ-disordered patients for planning and carrying out orthodontic treatment.

Adolescent↗
PubMed1994

[Endosseous titanium implants as orthodontic anchoring elements. Experimental studies and clinical application].

Part 1 of this study, which deals with experimental use of titanium implants in animals (Brånemark, dimension 10 x 3.75 mm), examines the long-term orthodontic application of force on the quantity of peri-implant and paraimplant bone and on direct bone contact (in %) at the implant surface. In the experiment 6 premolars (P3 mandible/maxilla and P4 mandible) were extracted from each of 2 foxhounds. After 12 weeks each dog received 6 implants (P3 and P4 areas). After the implants had healed for 25 weeks, the fixtures in the P3 areas were used as anchoring elements (test implants) for P2 distalization over a period of 26 weeks (continuous force applied: approximately 2 N). The implants in the P4 area served as the control group. Histological analysis revealed in the test implants (mandible) in comparison to the control implants (mandible) the following differences: broader cortical bone; wider peri-implant bone casing; denser, partly sclerotic spongiosa (pressure side); and thicker trabecula (tension side). Fluorescence microscopy revealed that these findings were the result of distinct lamellar bone apposition during the force application phase. In comparison, far less lamellar apposition was found in the test implants (maxilla). The mean percentage of direct bone contact at the implant surface was: Control implants (mandible, n = 4): 40.5%; test implants (mandible, n = 4): 51.6%; and test implants (maxilla, n = 4): 42.4%. Part 2, the clinical portion of the study, presents the suitability and feasibility of using endosseous implants as orthodontic anchoring elements, first, for orthodontic-prosthetic anchoring, and, second, for orthodontic anchoring only. Further, the significance of these aspects in relation to the implant site, to implant dimension, and to the type of implant anchoring are recorded.

Animals↗
PubMed1996

Need and desire for orthodontic (re-)treatment in 35-year-old Norwegians.

Long-term outcome of orthodontic care systems may be studied by examining malocclusion and treatment need in groups of treated and untreated adults. The objective of the present work was to investigate the professionally defined need as well as the need perceived by the individuals in an attempt to study the outcome of orthodontic services. The material comprised data from 111 individuals collected from a random sample of 35-year-olds from Oslo, Norway. From a clinical examination and measurements on dental study casts, the subjects were classified into either of 4 levels of need according to the Need for Orthodontic Treatment Index (NOTI) used by the Norwegian Health Insurance System. Perceived need for treatment was analyzed from responses to questions about satisfaction with dental appearance and desire for orthodontic treatment presented in a questionnaire. Satisfaction with dental appearance was recorded in 85% and 92% of untreated and previously treated, respectively. Desire for treatment was expressed by 19% of the untreated and 3% of the treated individuals. Occlusal anomalies were present among both the treated and untreated subjects, and the clinical significance of the malocclusion traits observed is discussed.

Adult↗
PubMed1995

[The psychosocial aspects in orthodontically treated and untreated adults with similar, clearly visible tooth malalignments].

A study was undertaken to compare the psychosocial aspects of orthodontic treatment or non-treatment of female adults, 25 of whom underwent treatment and 25 of whom did not, with similar, visible malocclusion. Interviews, for which 52 standardized questions were prepared in collaboration with a graduate psychologist, served as the methodological basis of the study. The results of the study indicate that in relation to the aesthetic aspects of orthodontic treatment, the treated group showed a high degree of sensitivity and self perception. Following orthodontic treatment members of this group exhibited a highly significant improvement in their subjective perception of the aesthetic aspects of their dental and facial appearance. In spite of the differences observed in the 2 groups, it nevertheless remains difficult to draw general conclusions or to recommend guidelines which would cover all cases. When the question is to orthodontically treat or not treat female adults, the answer rests with the individual patient.

Adult↗
PubMed1992

[A contribution to the controversial discussion on a preoperative orthodontic treatment for infants with unilateral cheilognathopalatoschisis].

A longitudinal study of 39 casts of pre-operative orthodontically treated unilateral cleft lip and palate children from birth to palate operation was carried out with a special coordinate measuring technique to quantify changes in the maxilla. A significant reduction in width of the alveolar cleft was found. The anterior alveolar arch width remained constant, while the posterior region slightly increased. These results seem to justify treatment with the infant appliance. After measuring casts from 39 preoperatively treated and casts from 62 untreated patients prior to lip operation, a comparison of the mathematical average values between the two groups revealed few differences. This can be explained by referring to the original morphological findings and the different measurements during the preoperative orthodontic treatment, which lead to different changes in segment position prior to lip operation. In a cross section examination this difference could not be found. A sub-classification of the subject matter in primary and secondary clefts revealed that between both types clear differences in the resulting parameters can be observed. This leaves the question, whether the width of the cleft palate is caused by tissue deficiency or by an embedded tongue. Furthermore, how will the orthodontic appliance therapy influence the growth? A greater dislocation of the segments in secondary clefts may be expected in cases where the rest position of the tongue appears caudal. Improved measuring methods to record cleft morphology and more emphasis on the study of soft tissue reactions may help to understand the differing results after preoperative or orthodontic treatment.

Cleft Lip↗
PubMed2001

Orthodontic treatment--yes or no? A difficult decision in some cases. A contribution to the discussion.

Reasons for orthodontic treatment are discussed on the basis of 1. evidence-based knowledge from the literature, 2. viewpoints based on clinical experience, 3. case presentations. Viewpoints regarding prophylactic aspects of orthodontic treatment in relation to oral health are critically evaluated. The clinically based experience that dentofacial esthetics is the main reason for most patients requesting orthodontic treatment is also well documented in the literature. Against this background, psychosocial aspects as an indication for orthodontic treatment deserve greater recognition.

Adolescent↗
PubMed2003

Distribution of the cement film beneath the orthodontic band: a morphometric in vitro study.

BACKGROUND: During orthodontic treatment with a multiband appliance, enamel decalcifications and periodontal irritation may occur due to inevitable plaque retention. Besides the band itself, non-cemented gaps between tooth and band constitute a problem that has not yet been investigated from quantitative aspects. MATERIALS AND METHODS: In this in vitro study, the cement distribution beneath the orthodontic band was investigated on 48 identical transparent resin replicas of upper molars and lower molars, respectively. The replicas with the cemented orthodontic bands were divided into buccal, distal, oral, and mesial segments so that the inner surfaces of the bands could undergo morphometric analysis for areas not covered with cement. Two different molar bands (Dentaform Snap by Dentaurum, Ispringen, Germany, and "Washbon" by Ormco, Orange, CA, USA), and two glass-ionomer cements (OptiBand by Ormco and Ultra Band-Lok Blue by GAC, Gräfelfing, Germany) were used. In this way, 8 test series with twelve specimens each were performed. RESULTS: Not one cement-band combination was without defects in the cement film, with poorer cement flow properties being observed at the upper than at the lower molars. In general, fewer defects were recorded in the occlusal than in the cervical areas. Overall, the buccal surfaces yielded the best results, and the mesial surfaces the poorest. CONCLUSIONS: Since defects in the cement film have so far been unavoidable, the indication for orthodontic treatment with a multiband appliance must continue to be strict. Unless accompanying professional prophylactic care coupled with optimal oral hygiene is ensured, multiband appliances should be used with great caution.

Composite Resins↗
PubMed2006

Distraction osteogenesis of ankylosed front teeth with subsequent orthodontic fine adjustment.

OBJECTIVE: Conventional therapeutic approaches to correct ankylosed anterior teeth in infraposition require compromises involving esthetics and function. The combined approach of distraction and early orthodontic fine adjustment, not yet established as a routine, promises better results concerning the bone conditions and gingival development. CASE HISTORIES: Both female patients had suffered a trauma to the front teeth during early mixed dentition resulting in ankylosed central incisors in infraposition. At the ages of 14 years and 2 months and 15 years and 2 months, respectively, we carried out segment distraction by means of a bone-supported internal distractor followed by orthodontic fine adjustment after having shortened the consolidation phase. Both ankylosed front teeth could be successfully aligned, leading to an increase in bone and harmonization of the gingival margin in the dental arch. At ten and 14 months after the conclusion of treatment, we observed only few deviations in the dental situation compared to posttherapeutic findings. CONCLUSION: From a functional and esthetic point of view, therapy involving combined orthodontics and surgery is superior to conventional therapy. Orthodontic fine adjustment should be considered as a continuation of the distraction procedure.

Child↗
PubMed1976

Cause and prevention of injuries to teeth and supporting structures during orthodontic treatment.

The present investigations have shown that, although there are definite risks in undertaking orthodontic treatment with fixed appliances, such treatment need not cause any appreciable damage when accepted orthodontic principles are followed in cooperative patients with good oral hygiene and regular fluoride treatment. On the other hand, when these principles are neglected, the damage may be considerable and the benefits from orthodontic treatment questionable. Progressively increasing evidence from preventive dentistry that the bacterial plaque is the single most important causative factor in periodontal breakdown, and is important also in causing dental caries, opens unique possibilities for the orthodontist and his auxiliary personnel with simple means to increase their patient's oral hygiene awareness. This would not only reduce the prevalence and severity of iatrogenic damage, but would increase the long-term benefits of the orthodontic therapy. Orthodontists may thus provide young adults with an improved esthetic facial appearance, a perfectly functioning occlusion, and the desire, interest, and possibilities of maintaining the dentition in this condition for all or most of their lives (Figs. 3 to 5, 12, and 13).

Dental Bonding↗