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PubMed1984

Long-term effect of orthodontic treatment on crestal alveolar bone levels.

It was the purpose of the present study to evaluate crestal alveolar bone levels in individuals (Study group, n = 104) who had completed orthodontic treatment at least 10 years previously and compare the findings with adults who had untreated malocclusions (Control group, n = 76). Crestal alveolar bone levels were determined on both bitewing and periapical radiographs by direct measurement from the cemento-enamel junction to the alveolar crest. Data from the individual tooth surface measurements were subjected to analyses of variance partitioned on group (Study vs Control), radiographic method, tooth type, dental arch and surface location. There was no significant difference between crestal alveolar bone levels between the study and control group. A Group/Tooth/Surface interaction occurred for the distal surface of molars. The alveolar crest level was significantly less in the orthodontically treated group. Examination of the numerical data suggested that the measured dimension was low relative to normal values, and this effect may have been related to tooth intrusion during orthodontic treatment. It was concluded that orthodontic treatment during adolescence had no detrimental long-term effect upon crestal alveolar bone levels.

Adult↗
PubMed1996

Periodontal and microbiological changes associated with the placement of orthodontic appliances. A review.

This review examines specific aspects of orthodontic treatment and periodontal health, namely the effects of orthodontic banded attachments on periodontal disease and more specifically the microflora found around the gingival margins. This review highlights critical developments in orthodontic techniques and microbiological advances which have helped clarify the interrelationships between orthodontic appliances and periodontal disease. Suggestions as to how these may be modified are made, as well as targeting specific areas for research.

Bacteria↗
PubMed2004

Combined bone grafting and orthodontic treatment of an iatrogenic periodontal defect: a case report with clinical reentry.

BACKGROUND: This case report discusses the treatment of an iatrogenic periodontal defect caused by an inadequate orthodontic appliance in a 9-year-old girl. METHODS: The multidisciplinary approach to this case consisted of periodontal treatment using a bone grafting technique to restore the 10 mm bone dehiscence. Three months later orthodontic treatment was initiated to straighten and level the central incisors. Six months later mucogingival surgery was performed to cover 2 to 3 mm gingival recession. RESULTS: The bony defects were completely filled and the 10 mm dehiscence was reduced to 4 mm. The connective tissue graft resulted in a complete coverage of the recessions and a thickening of the keratinized gingiva. The patient is still undergoing orthodontic treatment. So far, straightening of the upper central incisors and closure of the diastema are satisfactory. CONCLUSIONS: Inadequate orthodontic appliances can cause iatrogenic periodontal defects. A multidisciplinary approach in a well-defined sequence can restore lost periodontal tissue, thus achieving comfort, function, and esthetics.

Bone Transplantation↗
PubMed2006

Guided bone regeneration of a pronounced gingivo-alveolar cleft due to orthodontic space closure.

BACKGROUND: Gingival invagination is a relatively common occurrence following orthodontic closure of extraction sites. The present paper reports a combined periodontal and orthodontic treatment in a patient with a severe gingivo-alveolar cleft due to orthodontic closure of maxillary central incisor extraction space. METHODS: A definite interdental gingival cleft, extending 8 mm into the alveolar bone, required the correction of the gingival deformity as a first step, followed by guided bone regeneration (GBR). The GBR approach included the emptying of the incisive foramen to approximately 5 mm in depth followed by the insertion of bioabsorbable hydroxyapatite and covering with a bioabsorbable barrier membrane. Six months afterward, the orthodontic therapy was resumed. RESULTS: Radiographs and clinical examination 4 years after the completion of therapy indicates functionally and aesthetically satisfactory and stable results. CONCLUSION: The present paper illustrates an additional application for the guided bone regeneration technique.

Adolescent↗
PubMed1999

An electromyogram study on mandibular movement in unilateral cleft lip and palate patients before and after orthodontic treatment.

The purpose of this study is to investigate masticatory muscle function in subjects with unilateral cleft lip and palate compared with normal occlusion and the extents of improvement before and after orthodontic treatment. Subjects were twenty pretreatment patients, thirty posttreatment patients and ten controls. Electromyograms were recorded from their masticatory muscles during masticatory movement and tapping movement. Reduction of duration/stroke ratio (D/S) was observed in electromyograms obtained during masticatory movement after orthodontic treatment. The reduction was especially notable in the masseter muscle. In spite of a significant reduction in coefficient of variation (CV) values, a significant difference between the posttreatment group and the control group indicated some persisting irregularity in masticatory movement. Electromyograms taken during tapping movement showed no change in latency in the posttreatment group, but duration of the silent period (SP) was shortened and SP appearance increased. The findings outlined above reveal electromyographically clear improvements in masticatory muscle functions and jaw reflex mechanisms after orthodontic treatment. Nevertheless, parameters for subjects with cleft lip and palate still differed from those for controls with normal occlusion. The influence of plastic surgery in subjects with the defects discussed here causes maxillary retrusion, which in turn results in skeletal malocclusion. Orthodontic treatment should be designed to compensate this dentally and alveolarly. This design and the need to improve masticatory functions would contribute to eliminate the extreme difficulty of the therapeutic process.

Adolescent↗
PubMed2001

The Nd-YAG laser is useful in prevention of dental caries during orthodontic treatment.

Plaque control during the course of orthodontic treatment is not an easy task, and dental caries are not an unlikely complication. We examined the possibility of controlling dental caries with Nd-YAG laser irradiation in orthodontic patients. As a preliminary experiment, we used the Nd-YAG laser to irradiate an extracted tooth and then left it to soak in lactic acid. The decay of the tooth was evaluated with a scanning electron microscope (SEM); tooth decay was inhibited by the action of the laser. Twenty patients undergoing orthodontic treatment for early decalcification of the teeth (white spot lesions) were selected, and photographs were taken of their oral cavities. White spot lesions on the four incisors and two canines of the maxilla were traced on tracing paper, and their areas were calculated by computer. Ten of the patients received laser treatment and acidulated phosphate fluoride solution (APF); the other ten acted as the control group. Between 11 and 12 months later, we photographed the oral cavity as we had previously; the white spot lesions were again traced and their areas calculated. The changes in the areas of the white spots of the laser-irradiated and control groups showed the following increases: laser-irradiated group, 1.41 times; controls, 2.87 times. The difference was statistically significant. These results demonstrate that Nd-YAG laser irradiation with application of APF acts as an effective method of caries control during orthodontic treatment.

Acidulated Phosphate Fluoride↗
PubMed1998

Orthodontic treatment of an adult male after bilateral condylectomy of the mandible for injuries sustained in a traffic accident.

In recent years there have been many reports on studies related to the temporomandibular joint (TMJ) in orthodontic treatment, but an adequate system of diagnosis and treatment has yet to be established, and they often cause considerable difficulty clinically. The patient in this case report sustained generalized contusions, a cerebral concussion, a midline fracture of the mandibular corpus, and bilateral fractures of the condylar process of the mandible when he fell asleep while driving a car and collided with a truck. Because non-surgical reduction was impossible, mandibular condylectomy was performed, and when orthodontic treatment was attempted to improve the open bite that persisted as a sequela of the accident, the favorable results were obtained, as described below. 1. The open bite was corrected by the orthodontic treatment, and the impairment that remained as a sequela resolved. 2. The mandibular condyles were removed during surgical reduction, and the mouth opening disturbance, the TMJ pain, and the TMJ noise resolved. The patient was able to go about his everyday life unimpaired, with hardly any awareness of limitation of jaw movement, and this situation remained unchanged even after the orthodontic treatment was performed.

Accidents, Traffic↗
PubMed2002

[An analysis of mandibular movements before and after a surgical orthodontic treatment].

By the surgical orthodontic treatment for the patient who has a malocclusion, scaffold reverse occlusion, it is considered that remarkable change of maxillofacial form in the oro-facial region affects the stomatognathic functions. The purpose of this study was to analyze stomatognathic functions during border-movements and masticatory movements before and after surgical orthodontic treatment. The lateral border movements were analyzed regarding the symmetry of both sides and the change of angle of balancing condylar path. The masticatory movements were analyzed during opening and closing phases. We also analyzed cross patterns. In consequence, the lateral border movements were extended after the surgical orthodontic treatment, and the symmetries of the border-movement were improved. The angle of balancing condylar path did not show a large change in the sagittal plane by a remarkable change of the anterior guidances during lateral movements. However, the balancing condylar path in the horizontal and frontal plane had a tendency to change. The cross patterns of the masticatory movements tended to decrease after the surgical orthodontic treatment, and each of the opening phase and the closing phase tended to separated independently, i.e. each movement became stable. It was also suggested that the occlusal relationships of the upper and lower jaw including occlusal contacts had particular effect on the stomatognathic functions.

Adult↗
PubMed1975

Index for need of orthodontic treatment.

The demands placed on an index for evaluating the need of orthodontic treatment are described. An index designed by the Swedish Medical Health Board is discussed against the background of the above mentioned demands. A new index for the need of orthodontic treatment is presented. It consists of a morphological part in which essential abnormalities are recorded and allotted points according to their severity. The index also has a functional part in which selected functional disorders of the masticatory system as well as occlusal disharmonies are recorded and allotted points. The reasons are given for the choice of the various features included in the index. Practical instructions for the use of the index are given. The new index for need of orthodontic treatment was tried under clinical conditions in two series of children, aged 6--16 years. The variation between the recordings by the same examiner on two occassions was studied by double determinations. With but few exceptions no systematic errors were found between the double determinations. The precision of the new index for need of treatment was found to be the same as of that given by the Swedish Medical Health Board. No systematic differences were found between recordings made by orthodontists and inexperienced examiners. The accidental error of the method was of the same order for orthodontists as for inexperienced examiners. Comparison of recordings made by four orthodontists showed systematic errors between the recordings of functional but not of morphological deviations. Ranking of the children according to the need of orthodontic treatment as judged with the new index differed from that obtained with the system of the Swedish Medical Health Board. The new index attached more importance to functional deviations. This was the main requirement in the construction of the new index.

Adolescent↗
PubMed1998

Study on hydroxyapatite-coated titanium implants used as orthodontic anchorage--an experimental investigation of implant stability and peri-implant neck tissue in dogs.

OBJECTIVE: Hydroxyapatite-coated titanium endosseous implants as orthodontic anchorage were studied. METHODS: These implants, installed in the mandibles of two dogs, were loaded with the orthodontic force of 150 g for 3 months. The stability of the implant and peri-implant neck tissue were investigated with radiograph and index evaluation. RESULTS: No implants were mobile, loosened or dislocated at the 3-month follow-up. The soft tissue around the cervical part of the implants had slight inflammation because of poor oral hygiene and stimulation of residual foods attached to the stainless steel spring. However, no resorption of marginal alveolar bone was found under sustained orthodontic force. CONCLUSIONS: The HA-coated titanium implant can be used as anchorage for short-term orthodontic treatment.

Alveolar Bone Loss↗
PubMed1975

[Aims and methods of treatment in orthodontics].

The scope and the forms of treatment in orthodontics. On the occasion of the Symposium of the Society of Orthopaedic Stomatology of the German Democratic Republic at Reinhardsbrunn (Thuringia) from April 8 to 11, 1974, questions concerning the scope and the forms of treatment in orthodontics were dealt with in the framework of the main subject "The Effectiveness of Orthodontic Treatment in Adolescents". The present contribution was the discussion basis on the first day of the meeting. It is possible to substantiate the extent of normal biological, dentometric and cephalometric variations. The form of treatment should be an individual one, respecting the most favourable moment for treatment and well-tried therapeutical methods. Modifiable biological parameters should be adepted to unchangeable morphological and functional conditions. Broad-based, prevention-oriented orthodontics should be adhered to.

Activator Appliances↗
PubMed1999

Smoking patterns in adolescent orthodontic patients and school children.

Smoking is known to be widely practised by young adults and teenagers, a fact that is of immediate importance to the orthodontic profession as it is now well accepted that smokers have poorer periodontal health than non-smokers. The aim of the present study was to determine the level of smoking in teenage orthodontic patients and compare it with that in the general teenage population and, further, to examine how these smoking habits are influenced by the subjects' attitudes. Patients were surveyed as to their smoking habits and attitudes. All were between 10 and 18 years of age and undergoing active fixed-appliance therapy. The same survey was distributed to a local primary (elementary) school and local secondary (high) schools. Of the 729 school respondents, 29 per cent were classified as smokers; of the 333 respondents in the orthodontic group, 11 per cent were classified as smokers. Although the level of smoking amongst orthodontic patients appears to be lower than that for the general adolescent population, significant numbers of patients smoke on a regular basis, and a small proportion of these is under 13 years of age. Because they have regular contact over a number of years with their adolescent patients, orthodontists are in a favourable position to reinforce non-smoking behavior.

Adolescent↗
PubMed2000

Prevalence of malocclusion and orthodontic treatment need in 10-year-old New Zealand children.

The need for orthodontic treatment was determined in a random sample of 10-year-old Dunedin, New Zealand schoolchildren using the Dental Aesthetic Index (DAI); an index based on the social acceptability of dental appearance. When absent or unerupted teeth were disregarded, orthodontic treatment was considered to be "mandatory" for one-third of the children. The remaining children were almost equally divided into the three other treatment-need groups: "highly desirable", "elective", and "not necessary". The majority of the children had crowding and spacing in at least one incisor segment, and a molar occlusion other than Angle Class I. In this predominately mixed-dentition sample, more children were considered to need orthodontic treatment than older children in studies using the DAI. This raises some questions about the suitability of the DAI as a tool to assess orthodontic treatment need in mixed-dentition samples.

Chi-Square Distribution↗
PubMedDate not supplied

Associated orthodontic, surgical and hematological management of Cooley s anemia. Report of a case.

Cooley s anaemia or b-thalassaemia or mediterranean anaemia is a blood disease characterised by malformation of the skull and long bones, which confers a typical appearance on the patient. The complete development of facial abnormalities can be prevented by an intensive blood transfusion programme or by bone-marrow-transplantation. At the present time these therapeutic strategies would be able to help these patients grow and develop, live a prolonged life and avoid bad surgical RESULTS. The aim of this study was to evaluate the feasibility of orthodontic and maxillofacial surgical corrective treatment associated with an appropriate transfusion therapy in a b-thalassemic patient. The patient enrolled in the study was affected by major b-thalassemia and diagnosis was performed as an infant. She was referred to our centre at puberty for dento-maxillofacial disorders. Clinical, haematological and radiographic evaluation permitted a complete diagnosis. She received a combined haematological, orthodontic and maxillofacial surgical treatment. Controls for evaluating the statement of results obtained were performed at different times after the end of the therapy and have shown that the therapeutic objectives had been achieved and maintained. At the present time, complete diagnostic and therapeutic haematological strategies cannot be carried out on a large scale, especially in countries where health resources are limited. This objective reason, associated with possible low patient compliance, explains why we still encounter severe facial deformities resulting from erythroid hyperplasia. Our results suggest that this facial disfigurement requires surgical and orthodontic correction by consolidated surgical-orthodontic techniques performed according to the appropriate anaemia therapy. Although this is a preliminary study, initial encouraging results show no relapse three years after the end of the therapy.

Adolescent↗
PubMed2001

The relationship between normative orthodontic treatment need and measures of consumer perception.

AIM: The first aim was to investigate whether there was an association between normative (clinician measured) orthodontic treatment need and the following consumer values, 1) child self-perceived aesthetic need, 2) child self-esteem, 3) oral aesthetic subjective impact score (OASIS). The secondary aim was to investigate whether there was an association between child self-esteem and 1) child self-perceived aesthetic need 2) OASIS. STUDY TYPE: Prospective, cross-sectional. SAMPLE: A random sample of 439, 11-12 year-old children was selected from schools in Greater Manchester. METHOD: Normative and child self-perceived orthodontic treatment need were measured using the Index of Orthodontic Treatment Need (IOTN). The subjects completed questionnaires to measure their self-esteem (Piers Harris) and OASIS score. RESULTS: Children with higher normative IOTN scores had more negative psycho-social impact from their malocclusion (P<0.001). However, there was no association between clinician IOTN grades and child self-esteem. Clinician and child-rated IOTN aesthetic component (IOTN AC) grades were statistically significantly different (P<0.05). Higher child self-esteem scores were associated with lower child rated IOTN AC grades (P<0.05) and lower OASIS scores (P<0.001). CONCLUSIONS: Only one of the consumer measures studies (OASIS) reflected normative/clinician IOTN grades. A high child self-esteem appears to be related to their self-perceived malocclusion and its psycho-social impact. It is still important to have additional information derived from consumer based measures rather than rely solely on normative measures of need. It remains to be seen whether these factors subsequently influence demand and uptake of orthodontic treatment.

Attitude to Health↗
PubMed2001

Facial aesthetics in orthodontics.

Current trends in orthodontic care emphasise alternatives to the extraction of premolars, despite a lack of support from the refereed literature for many of the non-extraction treatments. Anecdotal reports published in non peer-reviewed journals have called into question the aesthetic effects of extraction treatment. As calls for evidence-based treatments increase throughout dentistry, reports on the effects--both positive and negative--of different orthodontic options have appeared in growing numbers. Given the results of a variety of reports in the peer-reviewed literature, it may be concluded that orthodontic treatment involving extractions can produce improved aesthetics for many patients who have some combination of crowding and protrusion. However, careful diagnosis followed by evidence-based treatment decisions should be the accepted clinical norm as the specialty of Orthodontics embarks on its second century.

Esthetics↗
PubMed2001

Orthodontic treatment need in Jordanian school children.

OBJECTIVE: To assess the need for orthodontic treatment among Jordanian school children. RESEARCH DESIGN: The vehicle of this study was the dental health component (DHC) of the index of orthodontic treatment need (IOTN). The examinations were carried out using mouth mirrors and stainless steel rulers. No more than 30 school children were examined at one time to prevent examiner fatigue. SETTING: Clinical examinations were carried out on the school premises under natural lighting. PARTICIPANTS: 320 10th grade school children aged 14 to 17 years were selected at random to represent the four main areas of Amman as divided by the Ministry of Education in Jordan. MAIN OUTCOME MEASURES: A 'definite need' for orthodontic treatment was recorded if the patient fell into grades four and five of the IOTN, while grade 3 represented 'borderline need' and grades 2 and 1 'no need' for treatment. RESULTS: A 'definite need' for treatment was recorded in 28% of children and 22% had 'border line' need on dental health grounds. Three main occlusal features were responsible for allocating children into the former category; severe displacements of more than 4 mm (45%), increased overjet of greater than 6 mm but less than or equal to 9 mm (22%) and impeded eruption of teeth (24%). CONCLUSIONS: This study has shown that 28% of Amman school children were in need of orthodontic treatment for dental health reasons.

Adolescent↗
PubMed2001

Orthodontically assisted restorative dentistry.

As treatment expectations of dental patients continue to escalate we, as restorative dentists, must provide an interdisciplinary treatment approach to ensure optimum results for our patients. In recent years the disciplines of periodontics, endodontics and oral surgery have continued to develop closer working relationships with the field of restorative dentistry. Unfortunately, this is not the common relationship that exists with the discipline of orthodontics. Most orthodontic therapy is directed at the treatment of malocclusion and is conducted with limited or no input from the restorative dentist. Orthodontics offers countless ways of assisting the restorative dentist in achieving treatment goals. Several of these orthodontic opportunities to enhance the restorative treatment plan are reviewed.

Dental Occlusion↗