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PubMed2001

Restorative and orthodontic treatment of maxillary peg incisors: a clinical report.

This clinical report describes a combination treatment approach to an esthetic defect that resulted from diastemata and peg-shaped lateral incisors. Minor tooth movement was achieved through the use of a removable orthodontic appliance and orthodontic rubber band, and full-coverage PFM crowns were placed on the lateral incisors. These complementary orthodontic and restorative procedures successfully corrected the defect.

Adult↗
PubMed2002

Lingual forced eruption orthodontic technique: clinical considerations for patient selection and clinical report.

Lingual forced eruption is a treatment modality that minimizes esthetic impairment during orthodontic treatment. Use of this technique can enhance the acceptance of orthodontic treatment by adult patients and minimize unnecessary compromises in the treatment planning of submerged roots. In this clinical report, a treatment modality for forced eruption therapy is described, clinical considerations for patient selection are identified, and the advantages and limits of the lingual orthodontic technique are discussed.

Crown Lengthening↗
PubMed2003

Occlusal status in orthodontically treated and untreated adolescents.

In order to evaluate the outcome of orthodontic care, all available 16-year-old adolescents (n = 138) living within the catchment area of one Finnish health center were invited for a clinical examination. A total of 126 adolescents participated, corresponding to 79% of the whole age cohort. Of these, 47% had been treated orthodontically, 2% were still wearing appliances, and 51% were untreated. In 80% of cases, a non-extraction treatment was carried out. All occlusions were evaluated using a recently developed occlusal morphology and functional index (OMFI) based on assessment of 6 morphological and 4 functional traits which are classified applying an acceptable-non-acceptable dichotomy. The occlusal status in untreated individuals was used as a second reference in comparisons between the treated and untreated occlusions. The morphological criteria for an acceptable occlusion were met by 42% of the participants and the functional criteria by 64%. Although the treated occlusions failed to meet the criteria of morphological acceptability more often than the untreated ones (73% vs 40%), the proportions of non-acceptable occlusions were fairly high among untreated occlusions. The main reasons for non-acceptability were the failure of the canine relationship, overbite, and protrusion movement to fulfill the criteria of acceptability. Only 19% of the adolescents had occlusions classified as acceptable, both morphologically and functionally. In the evaluated health center, the allocation of resources resulted in a high coverage of orthodontic care. However, our results indicate that the general occlusal status in the examined age cohort did not reach an optimal level.

Adolescent↗
PubMed2002

Quantitative approach for the prediction of tooth movement during orthodontic treatment.

The orthodontic treatment is aimed to displace and/or rotate the teeth to obtain the functionally correct occlusion and the best aesthetics and consists in applying forces and/or couples to tooth crowns. The applied loads are generated by the elastic recovery of metallic wires linked to the tooth crowns by brackets. These loads generate a stress state into the periodontal ligament and hence, in the alveolar bone, causing the bone remodeling responsible for the tooth movement. The orthodontic appliance is usually designed on the basis of the clinical experience of the orthodontist. In this work, a quantitative approach for the prediction of the tooth movement is presented that has been developed as a first step to build up a computer tool to aid the orthodontist in designing the orthodontic appliance. The model calculates the tooth movement through time with respect to a fixed Cartesian frame located in the middle of the dental arch. The user interface panel has been designed to allow the orthodontist to manage the standard geometrical references and parameters usually adopted to design the treatment. Simulations of specific cases are reported for which the parameters of the model are selected in order to reproduce forecasts of tooth movement matching data published in experimental works.

Animals↗
PubMed1994

Use of an adhesive resin for bonding orthodontic brackets.

To date, most successful bonding agents used in orthodontics rely on mechanical retention to both the enamel and bracket base. Chemical adhesion to enamel as seen with glass ionomer cements, and to the silanated base of ceramic brackets have been tried. Recent developments in resin formulation have led to the production of adhesive diacrylate resins capable of forming adhesive bonds to certain metals including stainless steel. The aim of this experiment was to compare such a resin, Panavia EX, with a more conventional 'no-mix' orthodontic bonding resin. Two different base retention mechanisms were used, and the effect of rebonding and differing environmental conditions were also investigated. The results indicated that Panavia EX could produce greater bond strengths than the more conventional bonding resin. Of the two base retention systems tested, braised mesh bases gave consistently greater bond strengths than the cast base, although no base/resin specificity could be detected. Re-using the same brackets showed rebound strengths to be significantly lower than initial bond strength although the results indicated the adhesive resin was still able to bond more effectively to these used brackets than the conventional resin. Environment had the greatest effect on bond strength, such that following environmental exposure there was no significant difference between the two resins. This latter factor, and in particular the more complex bonding technique required for the adhesive resin, means that Panavia EX cannot be recommended for orthodontic use in its present form.

Acrylic Resins↗
PubMed1996

Tissue response to space closure in monkeys: a comparison of orthodontic magnets and superelastic coil springs.

Interest in using magnets for generating orthodontic forces started with the widespread availability of rare earth magnetic alloys. In vivo studies have indicated that a static magnetic field and/or corrosion products from the magnetic materials may induce biological effects when in close contact with cells or tissues. In the clinical situation, orthodontic magnets are often situated some distance away from the gingiva and bone. Consequently, the previously observed biological effects may not be found in an experimental situation mimicking the clinical setting. Thus, the present experimental study was undertaken to test this hypothesis using commercially available cobalt-samarium magnets for orthodontic treatment in comparison to treatment with Sentalloy closed coil springs with respect to possible side effects on alveolar bone growth, gingival epithelial thickness as well as rate of space closure. Corrosion of the uncovered areas of the magnets was already evident after 6 weeks. No statistical differences were found between the magnet and coil spring specimens with respect to rate of space closure, bone formation or epithelial thickness. The only two variables that differed significantly between magnet and coil spring specimens was that there were more resorption and more tetracycline labelled osteocyte lacunae under the magnets. In conclusion, although some marginal statistical differences were found between the magnet and coil spring specimens with respect to cell and tissue reactions, the near lack of cell and tissue effects of the magnets in the present clinical experimental situation compared to previous studies in which the magnets were positioned in close contact with the tissue under study, indicate limited adverse clinical effects.

Alveolar Process↗
PubMed1999

Palatal bone support for orthodontic implant anchorage--a clinical and radiological study.

When maximal anchorage is required during orthodontic treatment, additional aids are often needed to support the anchoring teeth. While intra-oral aids may be limited in their anchorage potential, extra-oral anchoring aids are often rejected by the patients. Endosseous implants may therefore be a valuable alternative for stable intra-oral anchorage. However, the possibility of using conventional implants is insufficient, e.g. for treating purely orthodontic patients with full dentition or where extraction sites are to be closed. Therefore, the mid-sagittal area of the palate is an alternative insertion site for the placement of implants for orthodontic anchorage. The limited bone height in this area inspired this comparison between bone thickness in the implantation site as verified by probing during the implantation of Straumann Ortho-system implants, and thickness as measured on the lateral cephalogram. The results suggest that vertical bone support is at least 2 mm higher than apparent on the cephalogram. In none of 12 patients was a perforation to the nasal cavity found. However, in five subjects the implant projected into the nasal cavity on the post-operative cephalogram. These results were supported by the study of the projections of palate and wires in wire-marked skulls where the wires were placed bilaterally on the nasal floor and on the nasal crest. It is therefore concluded that the mid-sagittal area of the palate lends sufficient bony support for the implantation of small implants (4-6 mm endosseous length, diameter 3.3 mm).

Adolescent↗
PubMed1999

Motivation for and satisfaction with orthodontic-surgical treatment: a retrospective study of 28 patients.

Motivation for starting treatment and satisfaction with treatment results were evaluated on the basis of replies to a 14-item questionnaire and clinical examination of 28 orthognathic patients from 6 months to 2 years after treatment. The most common reasons for seeking professional help were problems in biting and chewing (68 per cent). Another major reason was dissatisfaction with facial appearance (36 per cent). Many patients also complained of temporomandibular joint symptoms (32 per cent) and headache (32 per cent). Women (8/19) were more often dissatisfied with their facial appearance than men (2/9), but the difference was not statistically significant. In agreement with earlier studies, the results of orthognathic treatment fulfilled the expectations of almost every patient. Nearly 100 per cent of the patients (27/28) were satisfied with treatment results, although 40 per cent experienced some degree of numbness in the lips and/or jaw 1 year post-operatively. The most satisfied patients were those who stated temporomandibular disorders as the main reason for seeking treatment and whose PAR-index had improved greatly. The majority of the patients experienced the orthodontic treatment as painful and as the most unpleasant part of the whole treatment, but all the patients were satisfied with the pre-treatment information they were given on orthodontics. Orthodontic-surgical therapy should be of a high professional standard technically, but the psychological aspects are equally important in the treatment protocol. The professionals should make efforts to understand the patient's motivations for and expectations of treatment. Patients should be well prepared for surgery and supported for a long time after to help them to adjust to post-surgical changes.

Adolescent↗
PubMed2000

Stress relaxation and recovery behaviour of composite orthodontic archwires in bending.

The viscoelastic behaviour of prototype composite orthodontic archwires was evaluated using a bend stress relaxation test. Archwires having 10 different volume fractions of reinforcement were subjected to constant bending radii in a water bath at 37 degrees C for time periods of up to 90 days. The wires were subsequently released and left unconstrained for the same testing conditions. Creep-induced changes in the unconstrained bending radii of the wires were measured at specific times during both phases (stress relaxation and recovery) of the test. The statistical analysis showed that stress relaxation behaviour was strongly correlated with the archwire reinforcement level. The final relaxation varied, with decreasing reinforcement, from 2 to 8 per cent. Archwire recovery was not correlated with reinforcement level, and revealed a final viscous loss of only 1 per cent. The relaxed elastic moduli in bending of the composite wires were similar to the elastic moduli in bending of several conventional orthodontic archwire materials. Losses that were associated with the viscoelastic behaviour varied with decreasing reinforcement level from 1.2 to 1.7 GPa. Because these modulus losses were minimal, each archwire retained sufficient resilience to be applicable to the early and intermediate stages of orthodontic treatment.

Analysis of Variance↗
PubMed2003

Quantifying enamel demineralization from teeth with orthodontic brackets--a comparison of two methods. Part 1: repeatability and agreement.

The aim of this investigation was to compare the repeatability of measuring enamel demineralization surrounding an orthodontic bracket using two techniques: computerized image analysis from digitally converted photographic slides and quantitative light-induced fluorescence (QLF). Fifteen human molars were halved and shaped to look like incisors. The teeth were individually numbered and orthodontic brackets bonded to the buccal surface. The crowns were covered with acid resistant varnish, except for windows approximately 1.5 x 3 mm adjacent to the gingival, occlusal, mesial, and distal edges of the bracket. The windows were variously exposed to a demineralizing gel for 0, 3, 7, or 14 days, and the acid resistant varnish was removed. Standardized photographic slides and QLF images of the teeth were taken. These were repeated after 1 week. The slides were converted to grey scale digital format and analysed using Image-Pro Plus 3.0. The QLF images were stored, processed, and analysed using customized software. All images were recoded for blind analysis. The four surfaces of the bracket were inspected and only areas of suspected demineralization were analysed. This was repeated after 1 week. The limits of agreement and mean difference between repeat readings of the area of demineralization were similar for both techniques (-0.04 +/- 0.43 for photographs and -0.10 +/- 0.63 for QLF). Mean grey level (photographs) and mean loss of fluorescence from that area (deltaF) (QLF) showed acceptable limits of agreement. The Intra Class Correlation (ICC) was below 0.81 for the measurement of area from QLF, suggesting that random error needs to be reduced. There was evidence of systematic bias for the repeat readings of the grey levels from the photographs (P < 0.001). Enamel demineralization surrounding an orthodontic bracket can be measured reproducibly using these two techniques.

Bias↗
PubMed2004

Axiographic findings in patients undergoing orthodontic treatment with and without premolar extractions.

Mechanical axiography was performed on 49 (37 female, 12 male) patients prior to orthodontic treatment, after removal of the fixed appliance, and at the end of retention. Twenty-five subjects (mean age 12.8 years) underwent orthodontic treatment without premolar extractions (group 1) and 24 subjects (mean age 13.5 years) with premolar extractions (group 2). The axiographic tracings of the protrusive movements were analysed using a digitizer and specially designed software. A statistically significant increase (P < 0.05) in the values for horizontal condylar inclination (HCI) was found for both groups over the entire observation period. Group 1 showed a higher increase (P < 0.05) between the beginning of treatment and removal of the brackets, and group 2 between bracket removal and the end of retention. At the end of retention, a similar increase in HCI values was found for both groups. Over the observation period, the frequency of pathological axiographic findings decreased, which seems to be a positive effect of orthodontic treatment.

Adolescent↗
PubMed2005

Evolution of flexural rigidity according to the cross-sectional dimension of a superelastic nickel titanium orthodontic wire.

The choice of the most suitable orthodontic wire for each stage of treatment requires estimation of the forces generated. In theory, the selection of wire sequences should initially utilize a lower flexural rigidity; thus clinicians use smaller round cross-sectional dimension wires to generate lighter forces during the preliminary alignment stage. This assessment is true for conventional alloys, but not necessarily for superelastic nickel titanium (NiTi). In this case, the flexural rigidity dependence on cross-sectional dimension differs from the linear elasticity prediction because of the martensitic transformation process. It decreases with increasing deflection and this phenomenon is accentuated in the unloading process. This behaviour should lead us to consider differently the biomechanical approach to orthodontic treatment. The present study compared bending in 10 archwires made from NiTi orthodontics alloy of two cross-sectional dimensions. The results were based on microstructural and mechanical investigations. With conventional alloys, the flexural rigidity was constant for each wire and increased largely with the cross-sectional dimension for the same strain. With NiTi alloys, the flexural rigidity is not constant and the influence of size was not as important as it should be. This result can be explained by the non-constant elastic modulus during the martensite transformation process. Thus, in some cases, treatment can begin with full-size (rectangular) wires that nearly fill the bracket slot with a force application deemed to be physiologically desirable for tooth movement and compatible with patient comfort.

Dental Alloys↗
PubMed2006

Galvanic corrosion between orthodontic wires and brackets in fluoride mouthwashes.

The aim of this investigation was to determine the influence of fluoride in certain mouthwashes on the risk of corrosion through galvanic coupling of orthodontic wires and brackets. Two titanium alloy wires, nickel-titanium (NiTi) and copper-nickel-titanium (CuNiTi), and the three most commonly used brackets, titanium (Ti), iron-chromium-nickel (FeCrNi) and cobalt-chromium (CoCr), were tested in a reference solution of Fusayama-Meyer artificial saliva and in two commercially available fluoride (250 ppm) mouthwashes, Elmex and Meridol. Corrosion resistance was assessed by inductively coupled plasma-atomic emission spectrometry (ICP-MS), analysis of released metal ions, and a scanning electron microscope (SEM) study of the metal surfaces after immersion of different wire-bracket pairs in the test solutions. The study was completed by an electrochemical analysis. Meridol mouthwash, which contains stannous fluoride, was the solution in which the NiTi wires coupled with the different brackets showed the highest corrosion risk, while in Elmex mouthwash, which contains sodium fluoride, the CuNiTi wires presented the highest corrosion risk. Such corrosion has two consequences: deterioration in mechanical performance of the wire-bracket system, which would negatively affect the final aesthetic result, and the risk of local allergic reactions caused by released Ni ions. The results suggest that mouthwashes should be prescribed according to the orthodontic materials used. A new type of mouthwash for use during orthodontic therapy could be an interesting development in this field.

Corrosion↗
PubMed2006

Tapered orthodontic miniscrews induce bone-screw cohesion following immediate loading.

The aim of this study was to investigate the initial stability of tapered orthodontic miniscrews (T-type screws) after placement, the necessity of a healing period, and the propriety of immediate loading. Twenty male Wistar rats with a mean age of 20 weeks were divided into two groups. In the immediate-loading groups, straight orthodontic miniscrews (S-type screws) and T-type screws (five rats each) underwent experimental traction force for 2 weeks (W) immediately after placement. In the healing groups (S- and T-type, five rats each), force was applied for 2 W after a 6-W healing period. The right tibia in each rat was identified as the test limb, while the left tibia in each rat was used as the control group, and underwent no experimental force during the experimental period. The screw-to-bone contact was observed histologically and the bone-screw contact ratio was calculated. Scheffe's test was performed to compare the bone-screw contact ratio in each group using statistical software package (SPSS 8.0 for Windows). In the control group, the bone-screw contact ratio improved from 34.8 +/- 16.0 to 74.8 +/- 12.0 per cent with S-type screws in proportion to the experimental period (2 to 8 W, respectively). With the T-type screws in the test group, there was no significant difference between the immediate-loading and healing groups. In the immediate-loading group, the bone-screw contact ratio with T-type screws was significantly greater (82.3 +/- 15.0 per cent) than with the S-type screws (33.3 +/- 11.8 per cent; P < 0.05), suggesting that T-type screws can be used for orthodontic anchorage immediately after placement.

Animals↗
PubMed2000

Hazards of orthodontics appliances and the oropharynx.

Occasionally orthodontic appliances or parts of orthodontic appliances have caused problems with either the airway or the gastrointestinal tract. The type of appliances that have caused problems and their clinical management are discussed. A case is described in which an upper removable appliance with inadequate retention became lodged in a patient's pharynx lacerating the palatine tonsils. Suggestions are made to try and avoid the problems that were encountered in this case and others reported in the literature in patients undergoing orthodontic treatment.

Airway Obstruction↗
PubMed2005

An evaluation of resonance frequency analysis for the determination of the primary stability of orthodontic palatal implants. A study in human cadavers.

BACKGROUND: The primary stability of short orthodontic implants is important for anchorage. METHODS: For this study 14 cadaveric human heads were used. The stability of orthodontic implants (Straumann) with lengths of 4 and 6 mm and different localization (palatal suture or paramedially) were evaluated. The implants with length of 6 mm were only placed in the suture and primary stability was non-invasively determined with the resonance frequency (Osstell). The invasive method for the analysis of the morphometric parameters of the implant/bone contact was carried out by means of histological and radiological examinations. RESULTS: The 6 mm implants have significant better primary stability in the palatal suture as 4 mm implants paramedially (P<0.05). No differences were found between 6 and 4 mm implants in the palatal suture and between 4 mm implants in palatal suture to paramedially. The histological and radiological results demonstrate the ability to measure the implant stability by investigation of the bone offer and density around the implant. Bone structure, especially the pore size in the trabecular bone and the precision of placement may influence the stability. CONCLUSION: This study shows that the short implant gives sufficient bone fixation, independently of placement. The quality of implantation and bone structure are more important than the length of the orthodontic implant.

Bone Density↗
PubMed1992

Force-distance relation and properties of repelling Sm-Co5 magnets in orthodontic clinical use: an experimental model.

In recent years, magnets and magnetic forces have been suggested as an alternative to traditional orthodontic devices such as elastics, springs and wires. The purpose of this study was to analyze the reliability and the output of forces for prefabricated orthodontic repelling Sm-Co5 magnets and the force conditions for the magnets after 5 months of maximal loading. The test-machine consisted of a jig where the tested pair of repelling magnets was mounted close to the clinical situation. With a cylindrical strain gauge transducer, a micrometer screw, a bridge-amplifier, and a Mingograph jet recorder, force-distance diagrams were constructed. The force-distance diagrams showed that the force-distance curve was hyperbolic and that the mean force when the magnetic pole faces were almost in contact with each other was 214.9 g, SD 13.42 g. The variation of magnetic force between different Sm-Co5 magnets was 6-9%. The difference in force before and after 5 months of maximal loading of the magnets was not significant. The test results indicate that with proper handling of the forces according to the new force diagrams, the system is reliable for orthodontic use.

Cobalt↗