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PubMed1998

Apical root resorption during orthodontic treatment of patients with multiple aplasia: a study of maxillary incisors.

The aim of this study was to evaluate the risk of root resorption during orthodontic treatment of patients with aplasia, and to analyse the relative importance of some anamnestic and treatment variables. The subjects comprised 68 orthodontically treated patients with 1-16 congenitally missing teeth. The age of the patients was 11-20 years (mean 15 years). All patients were treated with fixed edgewise appliances. The purpose of the orthodontic treatment varied: to create optimal conditions for prosthetic restorations or osseointegrated implants, or to achieve aesthetic and functional alignment of teeth in less severe cases. The degree of root resorption was assessed before and after treatment from intra-oral radiographs of the maxillary incisors using a scale of 0-4. In all, 186 maxillary incisors were evaluated. The degree of apical root resorption was significantly greater in cases of multiple aplasia (4-16 missing teeth) than in those with only one to three missing teeth. Root form, treatment time with rectangular wires and intermaxillary elastics, and total treatment time were significantly related to root resorption. Discriminant analysis disclosed that the following variables were the most important determinants of root resorption: number of missing teeth, root form, and time with rectangular archwires and intermaxillary elastics. It is concluded that there is a high risk of apical root resorption during orthodontic treatment in patients with multiple aplasia (four or more teeth), in particular in teeth with an abnormal root form and lengthy treatment with elastics and rectangular archwires.

Adolescent↗
PubMed1999

Residual need in orthodontically untreated 16-20-year-olds from areas with different treatment rates.

Knowledge concerning residual orthodontic need among individuals who have passed the age at which orthodontic treatment is normally provided, is important in the discussion of guidelines for the provision of care. The purpose of the present study was to examine and compare orthodontic need (objective and subjective) in cohorts of orthodontically untreated individuals from areas with various treatment rates. A total of 250 individuals, aged 16-20 years, comprised four samples representing cohorts from areas in Norway with low, medium, and high treatment rates. The occlusion was assessed according to a treatment need index (NOTI) from clinical and radiographic records, and dental cast measurements. Attitudes were assessed from questionnaires addressing satisfaction with dental arrangement, desire for treatment, and value placed upon well-aligned teeth. A significant decrease in occurrence of normative need (P < 0.001) and reported dissatisfaction (P < 0.05) was observed in samples representing increasing treatment rates. Dissatisfaction was completely eliminated among individuals from the high treatment rate area. Although a significant association between severity of malocclusion and desire for treatment existed within samples, this was not reflected in a corresponding trend for a decrease in desire across the samples. Well-aligned teeth seemed to be taken for granted among individuals from the area with a high treatment rate. From the present observations, a 'correct' level of treatment provision could not be identified.

Adolescent↗
PubMed2003

Orthodontic treatment need in Latvia.

Measuring the prevalence of malocclusion and treatment need in a population is useful for the planning of orthodontic services. In addition, knowledge concerning the attitudes of patients to malocclusion is becoming increasingly important in orthodontics. Without a satisfactory estimate of the need and demand for treatment it is difficult to develop and organize a meaningful service. The aims of this investigation were to estimate the need for orthodontic treatment in 12-13-year-old school children in urban and rural schools in Latvia. Five hundred and four school children aged 12-13 years were examined using the Index of Complexity, Outcome and Need (ICON). The children were invited to complete a questionnaire about treatment need and their appearance. The survey was carried out in four urban and five rural school settings. There were no statistically significant differences in treatment need between rural and urban settings or between boys and girls. However, there was a difference in ICON scores between Riga and Daugavpils, with a greater need for treatment in Daugavpils. Individual responses to questionnaires illustrated a correlation between individuals who expressed dissatisfaction with the arrangement of their teeth and treatment need according to the ICON score. The overall prevalence of individuals needing orthodontic treatment in Latvia was 35.3 per cent, but this figure masked considerable variation between schools. For example, a greater need was found in Daugavpils than in Riga. This difference is not fully explained but could be due to genetics, the individuals in Daugavpils being mainly of Russian origin. The individuals' perception of the arrangement of teeth and the need for treatment correlated significantly with the ICON score.

Adolescent↗
PubMed2005

Self-perceived orthodontic treatment need and culturally related differences among adolescents in Sweden.

The aim of this investigation was to compare Swedish and immigrant groups of 12- and 13-year-old boys and girls with respect to: (1) self-perceived need for and attitude to orthodontic treatment, (2) attitude to own teeth and general appearance, (3) behaviour pattern and psychosocial functioning, and (4) self-perceived need for orthodontic treatment in relation to psychosocial functioning. The subjects comprised 508 students, aged 12 and 13 years, living in Sweden, who were grouped according to nationality: (A) both parents born in Sweden (139 girls and 131 boys); at least one parent born in: (B) eastern Europe (27 girls and 34 boys); (C) Asia (66 girls and 61 boys) and (D) other countries (23 girls and 27 boys). Each student answered a questionnaire in the classroom. The questions concerned demographic data, self-perceived treatment need, attitude to orthodontic treatment, own teeth and general appearance, behaviour pattern and psychosocial functioning. The results showed that, on average, 20 per cent of the students had a self-perceived treatment need, more girls than boys, 24 per cent of Swedes (A), 12 per cent from eastern Europe (B), 18 per cent from Asia (C) and 14 per cent from other countries (D). Seventy-two per cent of the Swedish students were prepared to undergo fixed appliance therapy, compared with 58 per cent of immigrant students. Nine per cent of the Swedish students considered their general appearance to be less favourable compared with 7 per cent of their peers (not significant). While some differences in behaviour pattern were observed, these did not seem to influence the well-being of the subjects. The conclusion is that perceived orthodontic treatment need is lower in immigrant students than in Swedish students.

Adolescent↗
PubMed2005

Towards a comprehensive model for the study of compliance in orthodontics.

The aims of the present study were to explore methods used by Dutch orthodontists in daily practice to estimate and stimulate patient compliance, and to develop a theoretical model of compliance. A questionnaire, containing 38 items, was distributed among participants at the annual congress of the Dutch Society of Orthodontists in September 2002. The items concerned the need for and the level of patient adherence during orthodontic treatment, modes of estimating and stimulating compliance, and perceived reasons for non-compliance. Based on this pilot study and on an extensive literature search, a model for future research was developed in which concepts related to compliance in orthodontics were systematically organized. Of the 88 orthodontists who attended the congress, 51 responded (mean age 47 years, 22 per cent females). The respondents considered compliance to be of vital importance for a successful treatment result. Most patients were regarded as moderate compliers. The respondents believed that a lack of awareness of dental problems, a lack of motivation to co-operate, and personal problems were the main reasons for non-compliance. Only indirect methods were used to estimate compliance. It was concluded that Dutch orthodontists used subjective methods to measure compliance in daily practice, and that a theoretical model was needed to be able to examine compliance in orthodontics in a more systematic way. A multiple assessment of compliance, using a variety of research methods, seems to be the most appropriate way at present to ensure accuracy in measuring levels of patient compliance in orthodontics.

Adolescent↗
PubMed2006

Changes in the physical properties of human premolar cementum after application of 4 weeks of controlled orthodontic forces.

This study was performed to assess the relationship between the magnitude of orthodontic force and physical properties of individual human cementum, and to identify the sites that may be predisposed to root resorption. The findings may assist in relating physical properties of dental root cementum and its susceptibility to root resorption. Sixteen maxillary first premolar teeth were selected in eight orthodontic patients (three males and five females), mean age 14.8 years (range 11.2-17.5 years), requiring first premolar extractions. In each patient, a light orthodontic force of 25 cN was applied buccally using a sectional archwire on the first premolar on one side, while a heavy force of 225 cN was applied to the contralateral side. The teeth were extracted 4 weeks after initial force application. Hardness and elastic modulus were measured on the buccal and the lingual surfaces of the cementum at the cervical, middle, and apical third of the root. The results showed that the mean hardness and elastic modulus of cementum in the light force group were greater than in the heavy force group at all positions. There were highly significant differences in both hardness and elastic modulus between the heavy and light force groups (P < 0.01). The mean hardness and elastic modulus of cementum gradually decreased from the cervical to the apical regions for buccal as well as lingual surfaces in both groups. There was, however, an insignificant difference between hardness and elastic modulus on the buccal surface compared with the lingual surface (P < 0.05). It was concluded that the hardness and elastic modulus of cementum were affected by the application of orthodontics forces.

Adolescent↗
PubMed1998

Toothbrushing forces in children with fixed orthodontic appliances.

The aim of this investigation was to determine whether toothbrushing forces are influenced by wearing fixed orthodontic appliances. Thirty children, (10 males, 20 females) with planned fixed appliance therapy and aged 10-15 years, were recruited to the study. No subject had previously worn an orthodontic appliance. At baseline, each subject brushed their teeth in their usual way, unsupervised. The toothbrush used was a purpose-designed electronic instrument that measured the force applied to the brush and transmitted force data by radio to a remote PC. After toothbrushing, subjects had orthodontic brackets fitted. Toothbrushing was repeated at 2 and 14 weeks after baseline, and brushing forces recorded. There were no significant differences between the measurements made at baseline and those made at 2 and 14 weeks. There were no differences between males and females in the forces used at any time point. It was concluded that toothbrushing forces are unaffected by placing fixed orthodontic appliances in children. The brushing forces recorded were comparable with those previously found by other investigators.

Adolescent↗
PubMed2000

A survey of perceived problems in orthodontic education in 23 European countries.

This paper reports on a survey of perceived problems in the provision of orthodontic education at the stages of undergraduate, postgraduate, and continuing professional education (CPE) in 23 European countries in 1997. A questionnaire, together with an explanatory letter, was mailed to all members of the EUROQUAL II BIOMED project. Answers were validated during a meeting of project participants and by further correspondence, when necessary. The topics covered in the questionnaire were adequacy of funding, numbers of orthodontic teachers, availability of equipment, regulations, training centres, numbers of orthodontists, availability of books, journals, and information technology. Completed questionnaires were returned by orthodontists from all 23 countries. Respondents from seven countries did not answer all questions. Respondents reported a perceived almost universal lack of adequate funding for postgraduate orthodontic training (from 18 out of 20 countries) and, to a lesser extent, at undergraduate (13 out of 20 countries) and CPE levels (17 out of 21 countries). Respondents from 12 of the 20 countries reported adequate numbers of qualified teachers at undergraduate level, but only seven out of 18 at postgraduate level and eight out of 19 for CPE. Lack of suitable equipment was reported as a more frequent problem by central and eastern European countries (six out of 20 countries at undergraduate level, eight out of 20 countries at postgraduate level, and 12 out of 19 at CPE level). Too few or too many regulations were only perceived to be a problem by the respondent from one country out of 19 at undergraduate level, by seven out of 19 at postgraduate level, and by eight out of 16 at CPE level). Lack of training centres was more frequently reported as a problem by respondents from central and eastern European countries, but was generally not perceived as a problem by respondents from west European countries. Respondents from seven countries reported a lack of training centres for CPE. Respondents from six countries reported that they perceived there to be too many orthodontists at postgraduate level, from seven countries that there were an appropriate number, and from seven that there were too few. A lack of books, journals, and information technology was reported to be a problem by respondents from four out of 19 countries at undergraduate level, eight out of 20 at postgraduate level, and 10 out of 20 at CPE level. At both undergraduate and postgraduate level, the majority of respondents from central and eastern European countries reported problems with books, journals, and information technology. The results of the survey confirmed many anecdotal impressions and provided an extremely useful background against which to formulate quality guidelines for orthodontic education in Europe.

Dental Equipment↗
PubMed2003

Idiopathic gingival hyperplasia and orthodontic treatment: a case report.

There are many reasons for gingival hyperplasia. Mostly, proper oral hygiene is sufficient to achieve normal healthy gingiva. In some situations, however, gingival hyperplasia is drug-induced or can be a manifestation of a genetic disorder. In the latter, it may exist as an isolated abnormality or as part of a syndrome. If orthodontic treatment is needed in patients with gingival hyperplasia, both orthodontic and periodontal aspects need to be considered. Extreme hereditary gingival fibromatosis was periodontally treated, by removal of all gingival excess using flaps and gingivectomies. After a follow-up period, the orthodontic treatment started with fixed appliances. Monthly periodontal check-ups (scaling and polishing) were scheduled to control the gingival inflammation. After the orthodontic treatment, permanent retention was applied, once more followed by a complete gingivectomy in both maxilla and mandible. One of the most important keys to successful treatment of hyperplasia patients is the cooperation between the periodontist and the orthodontist.

Adolescent↗
PubMed2003

Orthodontic treatment need and self-perception of 11-16-year-old Saudi Arabian children with a sensory impairment attending special schools.

AIM: To determine the self-perception and need for orthodontic treatment in young sensory [visual (VI) and hearing (HI)] impaired children attending special schools in Riyadh, Saudi Arabia. Also, to determine if gender and social class background influence the rating and self-perception of malocclusion among the children. LOCATION: Riyadh, Saudi Arabia. DESIGN: A prospective study on orthodontic treatment need in sensory impaired children. SUBJECTS: Seventy-seven VI, 210 HI, and 494 control (C) children aged 11-16 years. METHOD: The aesthetic component (AC) of the Index of Orthodontic Treatment Need (IOTN) was determined using the standard 10 pictures for the C group and HI with a modified version (tactile graphic) for VI. The dental health component (DHC) and AC of IOTN were used to allocate each child to no need, borderline need and definite need for treatment subgroups. RESULTS: Sixty-five per cent of VI, 21.8 per cent HI, and 18.7 per cent of the C were perceived to be in need of orthodontic treatment. However, 55.8 VI, 43 per cent HI and 34 per cent C were rated for treatment need based upon the AC. The difference between the examiner and the child's rating of treatment need was found to be statistically significant among the HI and control children (P < 0.001). CONCLUSION: The VI children who were scored for treatment by the examiner as having need for treatment had similar perceptions of their treatment need irrespective of their social background. Male VI children had a higher DHC score, but both VI and HI males had a higher normative and self-perceived need based on AC.

Adolescent↗
PubMed2003

Current products and practice section: religious, cultural, and ethical dilemmas in orthodontics.

There are potential religious, cultural and ethical dilemmas facing patients who are undergoing orthodontic treatment. Opinions were collected from religious and cultural leaders, as well as from non-religious groups who take an ethical standpoint on certain medical or dental treatment. Factors relating to ingredients in orthodontic products, timing of orthodontic appointments, and the effects of religious fasting are all discussed. It is important to recognize all patients' opinions and beliefs when planning and undertaking orthodontic treatment.

Cultural Diversity↗
PubMed1989

Comparison of two orthodontical techniques for the correction of lingual deviation of upper incisors in the dog.

Two different orthodontic treatments were applied to dogs exhibiting lingual deviation of maxillary incisors. Two dogs were treated by means of an orthodontic device consisting of an acrylic plate fitted with a counteracting spring. The results were disappointing. These animals and two other dogs were treated with Schwarz's orthodontic device. After 3 to 4 months of treatment, lingual malposition of incisors was successfully corrected. Orthodontic therapy induced problems were unimportant and with collaborating owners could be easily overcome.

Animals↗
PubMed1987

Clinical and microbiological effects of fixed orthodontic appliances.

The purpose of this clinical and microbiological study was to evaluate longitudinally the changes occurring in the subgingival microbiota in children following the placement of orthodontic bands in the absence of a prophylactic oral hygiene program. A total of 12 children in the age between 10 and 15 years were selected for the study. The experimental group (E) consisted of 6 subjects scheduled for orthodontic treatment including the placement of fixed appliances. They were seen 1 week before and just prior to the placement of orthodontic bands. The control group (C) involved 6 children in the maintenance phase of orthodontic therapy in which removable retainers were used. All subjects were examined at 3-5 week intervals for a period of 4 months. At each examination, microbiological subgingival plaque samples were collected by means of sterile paper points. Plaque and gingival index scores as well as pocket probing depth at the site of sampling were determined. The microbiological samples were processed using continuous anaerobic culturing techniques and were plated on non-selective and selective media. Differential counts and biochemical characterization of isolates were performed according to the methods described by Kornman and Loesche. Following tooth-banding, an increase in pocket probing depth was observed, while the P1I and GI scores remained unaffected. A statistically significant increase from baseline values (p less than 0.05) was found for the %s of black-pigmented bacteroides, the B. intermedius and A. odontolyticus species, concomitantly with a decrease of the anaerobe/facultative bacteria ratio in the experimental, but not the control sites.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Conservative management of a combined endodontic-orthodontic lesion.

Pulp injury may occur during orthodontic tooth movement particularly in previously traumatized teeth. Therefore the management of such cases requires specific therapeutic considerations. An extensive periradicular lesion was detected in an orthodontically treated maxillary incisor with an uncertain history of a previous traumatic incident. Conservative endodontic therapy resolved the periradicular lesion thus enabling the orthodontic treatment to continue uneventfully. It is essential to closely monitor the patients undergoing orthodontic treatment and those who are in retention, particularly if a history of trauma is suspected.

Adolescent↗
PubMed1997

Delayed endodontic and orthodontic treatment of cross-bite occurring after luxation injury in permanent incisor teeth.

A case is presented in which combined endodontic and orthodontic therapy was performed in traumatically injured teeth 12 months after an accident. Calcium hydroxide treatment was used to halt any possible resorption during orthodontic treatment. The teeth were repositioned in a desirable manner without any complication by orthodontic treatment. Root canal obturation was accomplished after the completion of active orthodontic treatment. Recall examination 12 months after completion of root canal treatment showed clinical and radiographic evidence of healing.

Adult↗
PubMed2004

The efficacy of a fluoride varnish in reducing enamel demineralization adjacent to orthodontic brackets: an in vitro study.

OBJECTIVES: To test the hypothesis that fluoride varnish is effective in reducing demineralization (white spot) lesions adjacent to bonded orthodontic brackets. DESIGN: Two similar samples of extracted bovine incisors, with bonded orthodontic brackets, were separated into an experimental group (fluoride varnish was applied) and control group (no fluoride varnish) to examine the preventive effects of fluoride varnish. SETTING AND SAMPLE POPULATION: The dental clinic of the State University of Maringá--UEM (Maringá, Paraná, Brazil). Thirty-eight extracted bovine incisors with bonded orthodontic brackets. EXPERIMENTAL VARIABLE: Fluoride varnish was applied topically to half of the sample of extracted bovine teeth. No varnish was applied to the other half. OUTCOME MEASURE: The depths of enamel demineralization (white spot) lesions were measured from polarized light microscopy images using image analysis software. RESULTS: The teeth in both the experimental and control groups had been exposed to a cariogenic environment twice a day for 35 days. Those teeth that had been treated with two applications of fluoride varnish (one at the outset and another 15 days later) demonstrated about 38% less mean lesion depth than teeth where no varnish had been applied. CONCLUSION: Orthodontists may wish to consider the application of fluoride varnish during fixed orthodontic therapy to help reduce the development of enamel white spot lesions.

Animals↗
PubMed1998

Let them eat cake: the struggle between form and substance in orthodontic clinical investigation.

Events of the past decade or so argue that there is little support in the literature for much of the specialty's treatment portfolio. The resulting call for 'evidence-based' treatment (not to mention the obvious intellectual bankruptcy of much of the clinical literature) has prompted many to argue that the randomized clinical trial (RCT) represents the future of orthodontic clinical investigation. The RCT, after all, is medicine's gold standard; what more is there to say? A popular, but ultimately divisive, corollary of this mimicry is the smug tendency to discount all other sources of data. In the face of a need for information, this attitude is also a wasteful conceit: in the end, the RCT can be applied only to a very narrow spectrum of orthodontic questions. Randomization implies equal susceptibility. Any prospective participant would have to be informed of this equality as part of the informed consent process. Unfortunately, it would be nearly impossible to enroll fully-informed subjects into any study whose alternatives are of markedly different morbidity: extraction versus non-extraction or orthodontics versus surgery. Thus, when measured against the most vexing clinical questions, the orthodontic RCT is almost by definition an amusing diversion--expensive, but relatively trivial in scope. Like it or not, it seems reasonable to conclude that most of the specialty's comparative clinical data will have to be generated by way of non-randomized designs in which care is taken to minimize the various known sources of bias. There probably is no other way.

Clinical Trials as Topic↗
PubMed1995

A follow-up study of radiographic findings in the mandibular condyles of orthodontically treated patients and associations with TMD.

Our earlier studies have shown that some radiographic structural findings in the mandibular condyles are more common in orthodontically treated populations than in normal populations. To test the hypothesis that these findings are stable, we studied condylar findings in panoramic radiographs longitudinally in 39 subjects and in 39 sex- and age-matched controls. The subjects had condylar findings at the end of orthodontic treatment at about 15 years of age; no such findings were seen in the controls. The subjects and controls were re-examined radiographically about 12 years after the posttreatment radiographic examination. We also tested the hypothesis that radiographic condylar findings are associated with temporomandibular disorders (TMD). No statistically significant differences were found between subjects and controls in terms of reported subjective TMD symptoms. Clinically, the subjects had temporomandibular joint (TMJ) crepitation significantly more frequently (27%) than controls (8%) (p < 0.05). Crepitation correlated with some reported symptoms and clinical signs, suggesting that osteoarthrosis might have been an important etiological factor for TMD in the present subjects. At the follow-up examination, radiographic condylar findings were seen in 25 subjects and in four controls (p < 0.001). The condylar findings varied greatly between the time of orthodontic treatment and follow-up in the subjects. The findings had become more severe in 49% of the subjects, more often in females than in males (p < 0.05), whereas in 28% of the subjects the condylar findings had disappeared. Although the radiographic findings after orthodontic treatment fluctuated with age, in most adolescents with changes in their condyles, these findings remained constant or became more severe.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗