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PubMed1991

[The long-term results in orthodontic closure of a gap in the anterior teeth--the functional status].

In a follow-up study, the functional and occlusal status of patients after orthodontic space closure of missing incisors is compared with those who were not orthodontically treated. The investigation involved a method of instrument registration of TMJ function. The findings show that occlusion of our former patients in various mandibular positions is slightly different from ideal occlusal concept and we found no increased functional risk in this kind of treatment. In cases with missing incisors, orthodontic space closure that avoids prosthetic procedures should be taken into consideration.

Adult↗

PubMed1990

[The experiences of adult patients with their orthodontic treatment].

Own experience with an orthodontic treatment stimulated us to interview patients out of retention about four topics concerning their opinion and experience: 1. Reasons for treatment, 2. doubts about treatment, 3. troubles during treatment, 4. attitude to the result of treatment. 50 adults, former patients of the Department of Orthodontics at the Erlangen-Nürnberg University, responded our questionnaire. Aesthetics range first in the patient's desires for treatment. Severe doubts about treatment rarely occurred before treatment. The occurrence of particular complaints cannot be predicted and does not show a characteristic distribution. Pain, induced by treatment generally was underrated. For unpredictable severe pain may occur, one might consider to review the treatment goals critically after the patient's own experience with orthodontic treatment.

Adult↗

PubMed1996

The Orthosystem--a new implant system for orthodontic anchorage in the palate.

The present report describes the design and first clinical experiences of a newly developed endosseous orthodontic implant anchor system (Orthosystem, Institut Straumann, Waldenburg, Switzerland) for palatal anchorage. The 1-piece fixture made of titanium consists of a screw-type endosseous implant body (sandblasted, acid-etched, diameter 3.3 mm, lengths: 4 and 6 mm), a cylindrical polished transmucosal neck and an abutment. Clamp-caps provide attachment of square commercially available orthodontic wires (0.032 x 0.032 inch, SS) to the abutment (transpalatal bars). In a pilot study 1 fixture (implant body length: 6 mm) was inserted into the midsagittal anterior palatal region in each of 6 adult patients with Angle class II malocclusion (distocclusion 7 to 8 mm, overjet: approximately 9 mm). The treatment plan included extraction of the first maxillary premolars and retraction of the anterior teeth based on maximum anchorage of the posterior teeth without using compliance-dependent anchorage aids (headgear, class II elastics). Due to the design of the fixture only 1 simple surgical procedure was required for insertion (nonsubmerged method, 1-stage surgery). Accordingly the need for surgical exposure of the abutment for connection and wire insertion was eliminated. Thus, inconvenience to patients was reduced to a minimum. The patients are now at varying active treatment stages. The course of treatment of the most advanced case is described. Evaluation of the clinical and radiological findings after 12 months of treatment (3 months implant healing, 9 months active orthodontic treatment which is equal to the implant loading period) revealed no implant mobility/dislocation, favourable peri-implant soft tissue conditions, no marked mesial movement (approximately 0.5 mm) of the implant/transpalatal bar supported posterior teeth, and 8 mm retraction of the anterior teeth. Retrieval of the fixture and post-operative wound healing were uncomplicated. In the treatment of this case, no compliance-dependent extraoral anchorage was used, and the well aligned mandibular dentition was not bonded provide anchorage support (class II elastics).

Adolescent↗

PubMed1997

Lüscher colour test in orthodontic patients. Practicability for compliance assessment?

The Lüscher colour test has been repeatedly recommended as a tool for the prediction of orthodontic treatment course and patient cooperation despite its scientific shortcomings. A series of studies involving patients aged 9 to 16 years undergoing treatment with removable appliances at various orthodontic practices and at one university clinic provided no evidence of systematic correlations between Lüscher test colour preferences and cooperation with appliance wear. There was only slight consistency in colour preferences in a re-test conducted a few months after baseline measurements. Statistical evaluation of specific hypotheses and exploratory analysis of the global potential of the test provided no support for generalizable and useful correlations between colour preferences and patient compliance. Therefore the Lüscher test cannot be generally recommended for the rating of patient compliance in the clinical orthodontic practice.

Adolescent↗

PubMed2000

Relationship between patient discomfort, appliance acceptance and compliance in orthodontic therapy.

Orthodontic treatment is occasionally a discomfort to patients, due to pain or functional restrictions. In this context, several retrospectively planned studies were performed in the 1980s, but correlations between different aspects of patient discomfort were not investigated. The present study aimed at examining and structuring the psychogenic dimensions of patient discomfort. Furthermore, the impact of the patient's attitude on the intensity of discomfort was to be evaluated in addition to the influences of appliance therapy. The study was performed with 67 patients aged from 9 to 32 years. Prior to insertion of a new appliance, psychogenic scales reflecting their attitude towards orthodontic therapy were submitted to them. They were instructed to keep a discomfort log during the first 7 days after insertion. After 6 months they were given lists for retrospective assessment of discomfort and an appliance-acceptance scale to be filled in. At the same time, the respective orthodontist assessed his patient's compliance on a cooperation scale. The factor analysis revealed 3 levels of patient discomfort: feelings of tension, functional restrictions and aversion to wearing an orthodontic appliance in public. Appliance acceptance after 6 months could be predicted from the attitude towards treatment and the experienced discomfort. Patient compliance also correlated with these factors, so that causal flow diagrams of the investigated variables could be produced. Giving detailed information on any discomfort occurring and explaining how to reduce or eliminate it are vital factors in good treatment cooperation.

Adolescent↗

PubMed2000

Influence of orthodontic appliances on myofunctional therapy.

Various removable and fixed orthodontic appliances were rated by interview and questionnaire by 42 myofunctional therapists in the Hamburg area with respect to their influence during myofunctional therapy. The Nance holding arch was given the most negative rating of all appliances covering the palate area. For the active plate, marking the rest position of the tongue by roughening the acrylic surface or by reproducing the palatal relief was considered beneficial. The quadhelix expansion device and Hyrax palatal expander were rated as unfavorable because of their positioning in the palatal area. Among the functional appliances, Fränkel's function regulator was given the best rating. Regular fixed appliances (brackets, bands) were not considered a disturbance. Habit reminders (plates and spurs) were given a very negative rating by ca. 80% of the therapists because they disturbed the myofunctional exercises and led to adaptive dysfunctions. Since many patients with dysfunction of the orofacial musculature undergo simultaneous myofunctional and orthodontic therapy, treatment planning and choice of orthodontic appliances should be carefully coordinated.

Attitude of Health Personnel↗

PubMed2003

Orthodontic findings in the deciduous and early mixed dentition--inferences for a preventive strategy.

AIM AND METHOD: The aim of the present epidemiologic study was to obtain representative basic data on the frequency, extent and age-dependence of malocclusions in the deciduous and early mixed dentition. The developmental tendencies of specific malocclusions were investigated from the aspect of orthodontic prevention. The collective comprised 8,864 preschool and school-aged children, of whom 1,225 were in the deciduous dentition (mean age 4.5 years) and 7,639 in the mixed dentition (mean age 8.9 years). The orthodontic data were clinically assessed as sagittal, transversal, or vertical single-arch and occlusal findings. In addition, the malocclusions were classified according to their primary symptoms. Early infantile habits, tongue dysfunctions, speech defects and incompetent lip closure were registered separately. RESULTS: 57% of the children were found to have malocclusions, with the frequency rising statistically significantly in dependence on age from the deciduous to the mixed dentition (p < or = 0.001). The mean extent of excessive overjet increased significantly from the deciduous to the mixed dentition. Crossbite with mandibular midline discrepancies were observed significantly more frequently in the deciduous dentition. Although the frequency of anterior open bite underwent a significant decline from the deciduous to the mixed dentition, open bite was the malocclusion most frequently associated with dysfunction in both groups. The significant increase in traumatic deep bite in the mixed dentition indicates an unfavorable developmental tendency in this anomaly until after the eruption of the permanent incisors. CONCLUSION: The need for preventive orthodontic therapy and for the intensified application of interceptive and early treatment measures is stressed in view of the high number of malalignments and malocclusions in the deciduous and mixed dentition and the tendency for some forms of malocclusion to deteriorate as the dentition develops.

Adolescent↗

PubMed2005

A comparison of the periodontal health of patients during treatment with the Invisalign system and with fixed orthodontic appliances.

OBJECTIVE: Evaluation of the periodontal health in patients during treatment with either fixed orthodontic appliances or the Invisalign system. STUDY DESIGN: The study was designed as a concomitant trial. The evaluation of the patients started in February 2002 and was completed in August 2003. PATIENTS AND METHODS: Thirty consecutive patients each with fixed orthodontic appliances and with aligners were examined at three consecutive control visits for their periodontal condition. All individuals were part of the clientele of the Department of Orthodontics and Dentofacial Orthopedics of the Charité Berlin. The parameters evaluated were the modified Gingival Index, modified Plaque Index, modified Papillary Bleeding Index, and sulcus probing depth. The first three indices were recorded alternatively buccally and lingually in all permanent teeth from central incisor to first molar: buccally in the maxillary right and the mandibular left quadrants, lingually in the maxillary left and mandibular right quadrants. The sulcus depth was measured in four areas: mesially and distally, lingually and buccally in the 1st molar and the 1st premolar of each quadrant. Each control visit was concluded with a detailed, individualized oral hygiene instruction. RESULTS: The modified Plaque Index was significantly lower in the Invisalign group overall. On the other hand, the periodontal condition of the two samples was nearly identical. CONCLUSION: Periodontal health is not jeopardized, even though the Invisalign system aligners cover all the teeth and the keratinized gingiva in part. This could be attributed to the fact that aligners are removable and thus allow unimpeded oral hygiene.

Adolescent↗

PubMed2006

Orthodontic springs and auxiliary appliances: assessment of magnetic field interactions associated with 1.5 T and 3 T magnetic resonance systems.

The objective of this paper is to evaluate magnetic field interactions at 1.5 and 3 T for 20 orthodontic devices used for fixed orthodontic therapy. Twenty springs and auxiliary parts made from varying ferromagnetic alloys were tested for magnetic field interactions in the static magnetic field at 1.5 and 3 T. Magnetic translational force F(z) (in millinewtons) was evaluated by determining the deflection angle beta [American Society for Testing and Materials (ASTM standard test method)]. Magnetic-field-induced rotational force F(rot) was qualitatively determined using a five-point scale. beta was found to be >45 degrees in 13(15) devices at 1.5(3) T and translational force F(z) exceeded gravitational force F(g) on the particular object [F(z) 10.17-261.4 mN (10.72-566.4 mN) at 1.5(3) T]. F(z) was found to be up to 24.1(47.5)-fold higher than F(g) at 1.5(3) T. Corresponding to this, F(rot) on the objects was shown to be high at both field strengths (> or = +3). Three objects (at 1.5 T) and one object (at 3 T) showed deflection angles <45 degrees , but F(rot) was found to be > or = +3 at both field strengths. For the remaining objects, beta was below 45 degrees and torque measurements ranged from 0 to +2. Of 20 objects investigated for magnetic field interactions at 1.5(3) T, 13(15) were unsafe in magnetic resonance (MR), based on the ASTM criteria of F(z). The implications of these results for orthodontic patients undergoing MRI are discussed.

Electromagnetic Fields↗

PubMed1975

The surgical uncovering and orthodontic positioning of unerupted maxillary canines.

1. The presence of the maxillary canine is vital to the function and esthetics of the dental complex. The availability of this tooth must be carefully considered during an orthodontic diagnosis. Lack of space is the most common cause of canine impaction. Other contributing factors are that this tooth has the longest period of developmenent and that it is bigger longer, and travels farther while erupting than any other tooth. 2. Proper management of unerupted canines is a challenge to the dental practitioner. Maxillary canines are found impacted to both the buccal and the lingual. Palatal impactions are much more common than labial impactions, but, of the two, labial impactions are more difficult to manage. 3. An appropriate surgical procedure which opens to the crowns of unerupted teeth is a key to uneventful orthodontic positioning of these teeth. Packing the follicular space with baseplate gutta-percha and keeping the crown open to the oral cavity with surgical WondrPak is an effective method of making the tooth erupt into the oral cavity. 4. Modern preformed bands and improved cements make the placement of attachment on malposed teeth relatively easy. Direct bonding techniques are also of value in the management of unerupted teeth. 5. It is practical to move teeth orthodontically from seemingly impossible positions into ideal alignment. Such teeth will function normally, and no evidence will be left of their original position or of their having been moved over long distances.

Cuspid↗

PubMed1984

Computer based methodology for construction of orthodontic arch wire templates.

This paper presents the details and logic of two Fortran computer programs. The program, BRACKET, is designed to evaluate the constant relationship among teeth and orthodontic brackets to which an arch wire is adapted. The program, WIRE, is used to initially fit brackets to teeth using the constants derived in BRACKETS, based upon a series of orthogonal transformations. Subsequently, an orthodontic arch wire is fitted through the brackets, and the results are displayed using computer graphics. It is anticipated that the system would be useful in the orthodontic clinical setting as an aid in arch wire formation. The graphics produce a template which incorporates essential points to consider in arch wire formation, namely, perimeter length, lateral widths, symmetry, and appropriate arch form for the patient.

Computers↗

PubMed1986

Comparative range of orthodontic wires.

ADA specification No. 32 for determining the range (elastic limit) of orthodontic wires uses the bending of a wire section treated as a cantilever beam. An alternative method for defining the range of orthodontic wires proposed by Waters (1981) is to wrap wire sections around mandrels of varying diameters and measure the deformation imparted after unwrapping. Four brass mandrels with a total of 46 test diameters ranging from 3.5 to 60.0 mm were used in this study. Wire sections 9 cm in length were rolled on the mandrel with a hand lathe. The mandrel cross section required to produce a predetermined amount of deformation (2 mm arc height for a 5 cm chord) was defined as the yield diameter for that particular wire. No individual wire was tested twice so as to avoid introduction of strain history. Test samples of 488 different orthodontic wires supplied by nine commercial distributors were evaluated (a total of 4,747 samples). Stainless steel wires of identical dimensions had a large variation in range, depending on the state of strain hardening and heat treatment. For example, 0.020 inch round wire had yield diameters ranging from 22.8 mm for Australian special plus orange (TP Laboratories) to 42.9 mm for Nubryte gold (G.A.C. International). Chromium cobalt wires had less range than stainless steel before heat treatment, but increased greatly in range after heat treatment. Nitinol (Unitek) had the greatest range of all wires tested (yield diameter of 8.7 mm for 0.016 inch Nitinol). Multistranded stainless steel wires had yield diameters between 9.0 and 14.0 mm.

Alloys↗

PubMed1989

Perception of discomfort by patients undergoing orthodontic treatment.

The purpose of this study was to determine the perception of discomfort over time by a group of 70 patients undergoing orthodontic treatment. Patients who were selected for comprehensive orthodontic treatment completed questionnaires before insertion of separators and initial arch wires and after placement at 4 hours, 24 hours, and 7 days. The level of discomfort during these time periods was assessed by a visual analogue scale. The results showed a significant increase in the level of discomfort after insertion of either separators or arch wires at 4 hours and 24 hours, but not at 7 days. No significant difference was found in the level of discomfort of patients more than 16 years of age compared with those 16 years and under. No significant difference in discomfort was found between the sexes. These results are useful in relating expectations of discomfort to patients who undergo orthodontic treatment.

Adolescent↗

PubMed1989

Effect of rotary electric toothbrush versus manual toothbrush on periodontal status during orthodontic treatment.

Adolescents with fixed orthodontic appliances frequently have increased levels of plaque accumulation and gingivitis. The purpose of this study was to determine whether a rotary electric toothbrush would be more effective than conventional toothbrushing in maintaining periodontal health in these patients. Forty adolescent patients were divided into equal groups matched for sex and age. Before and during placement of orthodontic appliances, one group was instructed in use of the rotary electric toothbrush and the other in the use of a conventional toothbrush; these instructions were reinforced at monthly visits thereafter. Baseline clinical assessments of Plaque Index, Gingival Index, and bleeding tendency were made on six standard teeth before appliances were placed. assessments were repeated at 1, 3, 6, 9, 12, and 18 months after appliances were placed. Intragroup and intergroup differences were tested by a two-way analysis of variance. At baseline there were no significant differences between the two groups for any study variable. During the 18-month study period, however, plaque accumulation and gingivitis increased significantly over baseline levels in the control group (p less than 0.01) but remained stable in the group using the rotary electric toothbrush. In addition, the control group showed significantly greater plaque (p less than 0.01), gingival inflammation (p less than 0.001), and gingival bleeding on probing (p less than 0.001) than did the treatment group from the 1- to 18-month examinations. These data suggest that the rotary electric toothbrush is more effective than conventional toothbrushes for removing plaque and controlling gingivitis in adolescents during orthodontic treatment with fixed appliances.

Child↗

PubMed1991

A statistical assessment of orthodontic practices, product usage, and the development of skin lesions.

Recently there has been great interest in skin lesions on the hands of orthodontic personnel who are exposed to a wide variety of metals, bonding agents, and other materials. Thus this 1985 national survey of 448 Canadian orthodontists (response rate 49%) was undertaken to examine orthodontic practice activities, bonding agent and wire product use, and prevalence of skin lesions on the hands and their possible association with these products. About 13% of the 213 responding orthodontists and at least one other staff member in 18% of the orthodontic practices reported the occurrence of hand lesions (reactions) over the preceding 3 years typical of exposure to dental materials. In nearly one fourth of the offices, at least one person was affected. Regarding product use. Concise, Mono-Lok, and Endur bonding agents and stainless steel, Nitinol, and Elgiloy wires were used most often. The orthodontists reported frequent involvement in bonding activities and infrequent use of gloves. Of all the individual and combined materials and practice characteristics and activities tested singly and multivariately for statistical association with hand lesions, only the orthodontists' use of Mono-Lok, gloves, and the activity of frequently cleaning excess bonding agent were statistically related to the lesions. Multiple logistic regression suggested that the statistical effects of Mono-Lok use and removal of excess bonding agent were independent; thus removal of excess agent may have consequences for lesion development separate from Mono-Lok use.

Bisphenol A-Glycidyl Methacrylate↗

PubMed1992

Variations in bracket placement in the preadjusted orthodontic appliance.

This study was conducted to determine the accuracy of bracket placement with the direct bonded technique. Ten orthodontic faculty members bonded a preadjusted orthodontic appliance on models of five cases of malocclusion in a simulated clinical situation (mannequin). A total of 50 sets of models served as the population of the study. Photographs of the models were measured to determine vertical and angular discrepancies in position between adjacent bracket pairs from a constructed reference line. Variations are evaluated with respect to the classification of malocclusion, specific tooth type, and intra/inter operator differences. A mean of 0.34 mm for the vertical discrepancies and a mean of 5.54 degrees for the angular discrepancies are found in placement of the orthodontic brackets.

Analysis of Variance↗

PubMed1992

The orthodontic management of congenitally absent maxillary lateral incisors and second premolars: a case report.

The orthodontic management of congenitally missing maxillary lateral incisors and second premolars is the subject of this case report. The primary orthodontic consideration was the maintenance of facial esthetics in a 12-year-old boy while consolidating, aligning, and coordinating the dental arches. The maxillary canines were orthodontically positioned in the lateral incisor spaces. The maxillary posterior teeth, including the deciduous second molars, were protracted to esthetic positions where they could function without interferences. The stability of the occlusion depends on the longevity of the maxillary deciduous second molar roots, which did not resorb during active tooth movement.

Anodontia↗

PubMed2004

Do miniscrews remain stationary under orthodontic forces?

Miniscrews have been used in recent years for anchorage in orthodontic treatment. However, it is not clear whether the miniscrews are absolutely stationary or move when force is applied. Sixteen adult patients with miniscrews (diameter = 2 mm, length = 17 mm) as the maxillary anchorage were included in this study. Miniscrews were inserted on the maxillary zygomatic buttress as a direct anchorage for en masse anterior retraction. Nickel-titanium closed-coil springs were placed for the retraction 2 weeks after insertion of the miniscrews. Cephalometric radiographs were taken immediately before force application (T1) and 9 months later (T2). The cephalometric tracings at T1 and T2 were superimposed for the overall best fit on the structures of the maxilla, cranial base, and cranial vault to determine any movement of the miniscrews. The miniscrews were also evaluated clinically for their mobility (0: no movement, 1: < or =0.5 mm, 2: 0.5-1.0 mm, 3: >1.0 mm). The mobility of all miniscrews was 0 at T1 and T2. On average, the miniscrews tipped forward significantly, by 0.4 mm at the screw head. The miniscrews were extruded and tipped forward (-1.0 to 1.5 mm) in 7 of the 16 patients. Miniscrews are a stable anchorage but do not remain absolutely stationary throughout orthodontic loading. They might move according to the orthodontic loading in some patients. To prevent miniscrews hitting any vital organs because of displacement, it is recommended that they be placed in a non-tooth-bearing area that has no foramen, major nerves, or blood vessel pathways, or in a tooth-bearing area allowing 2 mm of safety clearance between the miniscrew and dental root.

Adult↗