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At least 1,261 records · Page 70Linked to original sources
PubMed2001

The time-factor in orthodontics: what influences the duration of treatments in National Health Service practices?

UNLABELLED: This study aimed to elucidate factors associated with duration of orthodontic treatment. METHODS: Retrospective analysis of a systematic 2% sample of cases completed in National Health Service practices in England and Wales. Records were collected during 1991. Characteristics of practitioners, patients, malocclusions, treatment variables and outcomes were evaluated. Data were submitted to multivariate analysis, with Log10 Time in Treatment as the dependent variable. RESULTS: Data were available for 1506 cases. The (geometric) mean time in treatment was 13 months. A model was found that explained 41% of the variance. Factors found to increase duration were fixed appliances, multiple stages in the treatments, premolar extractions, and correction of antero-posterior buccal occlusion. Age, buccal segment malocclusion, DHC (Dental Health Component of the Index of Orthodontic Treatment Need) grade 5 and orthodontically qualified practitioners were also associated with slightly longer treatments. CONCLUSIONS: Whilst briefer treatments may be attractive to purchasers, providers and recipients, it should be remembered that thorough treatment, and treatment of more complex malocclusions, tends to take longer. Economic pressures on practitioners to produce high turnovers of cases may be counterproductive in the quest for better outcomes.

Adolescent↗
PubMed1992

[Orthodontic and surgical aspects of cleft palate treatment].

The growth pattern of the face in cleft lip and palate patients is determined by intrinsic, functional and iatrogenic factors. Probably the iatrogenic factors are the most important. Orthodontic and orthognatic aspects of cleft palate treatment are described, being divided in five stages: 1. presurgical orthopedic treatment prior to lipclosure; 2. early orthopedic treatment of maxillary hypoplasia; 3. reconstruction of the alveolar cleft with bonegrafting and/or orthodontic treatment; 4. orthodontic treatment and 5. combined surgical/orthodontic treatment.

Adult↗
PubMed2002

[The dry skull model in orthodontics].

Orthodontic therapy aims to displace teeth by means of orthodontic appliances. Forces, applied on the teeth, induce remodeling of the alveolar process in upper and lower jaw resulting in a new position of the teeth into both jaws. In this publication an attempt has been made to test a model (dry skull model) which could provide a better understanding of the effect of force application on tooth and bone displacement. Initial tooth displacement (microscopical), right after force application, could give an indication for the longitudinal tooth displacement to be expected. Variables as the point of force application, the amount and direction of the force and the localisation of the centre of resistance are determining factors for the final tooth displacement. This study attempts to forecast the longitudinal tooth displacement by evaluating the initial displacement on the dry skull. Initial tooth displacement has been measured by means of laser measuring techniques (holography, speckle interferometry and laser reflection technique). These techniques are non-invasive (non-destructive testing) and permit the measurement of small tooth and bone displacements varying between 0.5 and 15 microns. According to the results of the animal studies, it became obvious that initial tooth and bone displacements are indicative for the longitudinal effect of the same sort of force application on a short time basis (5 to 8 weeks). The final conclusion is that initial tooth displacement measured on a dry skull has a predictive value for the longitudinal effect of orthodontic force application. Moreover, the creation of a finite element model looks very promising in this respect. More research is needed to test the finite element model further and to make it useful for testing the effect of force application on skull and tooth structures of a patient.

Animals↗
PubMed2002

Determinants of costs of orthodontic treatment in the Finnish public health service.

Factors affecting the costs of children's free orthodontic treatment were studied from patient records of a random sample of 193 successfully treated orthodontic patients, aged 7-14 years at the start of the treatment. They were treated by orthodontic specialists in the health centers of the cities of Joensuu, Oulu, and Vaasa. The statistical analysis was done using advanced regression analysis, two-tailed t-test and chi-square test. The results indicated that the number of appliances used, the patients' ages at the start of treatment, the number of missed appointments, differences between health centers, and the change in PAR (Peer Assessment Rating) Index scores accounted for 78.7% of the variations in treatment costs. The number of appliances used was the most important factor in the regression (R2 = 0.657). The costs of treatment were lowest in one-stage treatments started in the permanent dentition, and were highest in two-stage treatments started in the mixed dentition. Significant differences were found in treatment patterns and costs between the three health centers, reflecting low concern for cost-efficiency aspects.

Adolescent↗
PubMed2002

Comparison of orthodontic treatment outcomes in educational and private practice settings.

An accredited graduate orthodontic program provides advanced specialty education to meet standards of care mandated by the ADA, including both didactic and clinical components with defined outcome measures. To quantify these measures, the quality of care provided by graduate orthodontic students was compared to that of orthodontists in private practice. The quality of care was studied in two different delivery settings in the Columbus, Ohio, area-private practice orthodontists (PPO) and the OSU graduate orthodontic clinic (GOC). The Peer Assessment Rating (PAR) Occlusal Index was used as a measure of malocclusion severity and post-treatment occlusal outcome. Quality of care was measured using post-treatment PAR, percent PAR reduction, and treatment duration. At baseline, no differences were seen in the gender and pre-PAR scores of patients treated by the PPO and GOC, but statistically significant differences were seen in patients' pre-treatment age, race, and starting dentition. When the post-treatment occlusal results were compared, no statistically significant differences were seen in post-PAR scores and percent PAR reduction between the PPO and GOC. A statistically significant difference was seen in treatment duration (p = 0.002), which was longer in the PPO even after controlling for confounding factors such as pre-treatment age, gender, race, starting dentition, and treatment stages. Our conclusion is that there was no statistically significant difference in the occlusal outcome between the PPO and GOC, but there was a significant difference in the treatment duration.

Analysis of Variance↗
PubMed2002

Case report: orthodontic separators as periodontal ligatures in periodontal bone loss.

Periodontal destruction due to subgingival elastic bands was first reported in the dental literature nearly 130 years ago, and has involved over 20 cases. Destruction due to orthodontic separators used during fixed appliance therapy is a less common occurrence. A case report is presented which illustrates the severe periodontal destruction, which can occur when separators are misused. The subsequent treatment of this problem is also described. Emphasis is placed on the correct use of these orthodontic adjuncts and, appropriate monitoring of the gingival health of orthodontic patients.

Adolescent↗
PubMed2002

Orthodontic treatment of palatally impacted maxillary canines.

The aim of this study was to determine the feasibility of treating children with impacted maxillary canines by orthodontic treatment alone. The subjects were 28 children (mean age: 13.5 years, range 11.4-16.1 years) with between them 32 palatally impacted canines. The overlying primary canines were extracted between 0 and 42 months before the start of appliance treatment to open space in the arches for the impacted teeth. No other surgical procedures were carried out prior to the start of appliance treatment. Appliance treatment was deferred for at least six months if an impacted canine was the main reason for treatment, otherwise treatment was commenced according to the needs of the patient. In 94% of the cases, the severity of impaction lessened following extraction of the overlying primary canines and orthodontic treatment. The deepest impactions tended to occur in the oldest children. The majority (75%) of the canines emerged following orthodontic treatment to create space for them in the arch; the remainder were surgically exposed. Appliance treatment tended to take longer in children with the deepest impactions. It is concluded that fixed appliance treatment to create space for a palatally impacted canine is an effective management option for children with impacted maxillary canines.

Adolescent↗
PubMedDate not supplied

A prospective study of the risk factors associated with failure of mini-implants used for orthodontic anchorage.

PURPOSE: The aim of this prospective clinical study was to assess the risk factors associated with failure of mini-implants used for orthodontic anchorage. MATERIALS AND METHODS: A total of 140 mini-implants in 44 patients, including 48 miniplates and 92 freestanding miniscrews, were examined in the study. A variety of orthodontic loads were applied. The majority of implants were placed in the posterior maxilla (104/140), and the next most common location was the posterior mandible (34/140). RESULTS: A cumulative survival rate of 89% (125/140) was found by Kaplan-Meier analysis. There was no significant difference in the survival rate between miniplates and freestanding miniscrews, but miniplates were used in more hazardous situations. The Cox proportional-hazards regression model identified anatomic location and peri-implant soft tissue character as 2 independent prognostic indicators. The estimated relative risk of implant failure in the posterior mandible was 1.101 (95% confidence interval, 0.942 to 1.301; P = .046). The risk ratio of failure for implants surrounded by nonkeratinized mucosa was 1.117 (95% confidence interval, 0.899 to 1.405; P = .026). DISCUSSION AND CONCLUSION: The results confirmed the effectiveness of orthodontic mini-implants, but in certain situations adjustment of the treatment plan or modifications in the technique of implant placement may lead to improved success rates.

Adolescent↗
PubMed2005

[Orthodontics: interface between biology and biomechanics].

As far as craniofacial development is concerned, the orthodontist is mainly interested in growth of the jaws, craniofacial growth patterns and physiologic backgrounds of bone remodelling after tooth displacement. In biomechanics, the principle "action is equal to reaction" is one of the most important issues to deal with. The art in orthodontics is to distribute the reaction forces or to use them on purpose in an attempt to achieve one of the treatment goals. Reaction forces can be neutralized intra-orally. In this respect the location of the center of resistance of the tooth or a group of teeth needs to be defined carefully in order to have a good understanding of the biomechanical principles of tooth displacement. The action forces can be neutralized extra-orally. When no reaction forces on other teeth are applied, there will be no side effects of the reaction forces on other teeth. Research on the biomechanical principles of the headgear does offer some clinical information. Recently in orthodontics, the use of implants has been introduced. It can be used to neutralize reaction forces intra-orally. Moreover, the implants can be used primarily as anchorage during orthodontic tooth movement and later on to replace missing teeth. Recent animal studies at our department have shown that non-axial loading of implants with forces higher than 5 Newton can be used.

Biomechanical Phenomena↗
PubMedDate not supplied

Gingival enlargement and resolution during and after orthodontic treatment.

Gingival enlargement (GE) is a condition that commonly develops during orthodontic treatment. Thirty adolescent subjects with clinically significant GE were analyzed at pre-orthodontic treatment (T1), when the appliances were removed (T2), and 3 to 12 months after (T3). The mean GE decreased from T2 to T3, but was significantly higher on T3 than T1 (p<.05). It may be concluded that complete resolution of GE developed during orthodontic treatment is not always attained after removal of the fixed appliances.

Adolescent↗
PubMed2005

[Evaluating the integrated force induced by high quality magnet and elastics in orthodontic fixed appliance].

PURPOSE: To investigate the stability and effective working distance of integrated forces induced by high quality magnet and elastics in orthodontic fixed appliance. METHODS: N48 NdFeB magnets resembling brackets in size and volume were combined with 1/8, 3/16, 1/4, and 3/8 inch orthodontic elastics respectively to induce integrated forces that had super-long working distance. Magnetic, elastic, and integrated forces were tested by universal material test system and curves of the forces were draw. The characteristics of integrated forces, complementary effects of magnetic and elastic forces, and the proportion between elastic and magnetic forces in integrated forces at different extension distances were analyzed. Unpaired t test was used to analyze the differences between integrated and elastic forces. RESULTS: With the increase of the extension distance, the magnitude of the magnetic forces decreased significantly and the elastic forces increased in a liner manner, while the integrated forces were stable and changed mildly. Four kinds of integrated forces achieved 86 g, 138 g, 163 g, and 192 g stable forces within super-long distance respectively. Magnetic forces accounted for 34.94%-93.98% of the integrated force at 3 mm distance, 12.60%-37.89% at 6 mm distance, and only 2.69%-5.98% at 12 mm distance. The differences between four integrated forces and elastic forces at 3 mm (P<0.01), 6 mm (P<0.01), and 9 mm distance (P<0.05) were significant. CONCLUSION: Integrated forces composed of magnetic and elastic forces were a new ideal stable orthodontic force with super-long working distance.

Dental Stress Analysis↗
PubMed2005

Orthodontic approach for patients with severe periodontal disease.

Although comprehensive orthodontic treatment cannot preclude the possibility of periodontal disease developing later, it can be a useful part of the overall treatment plan for a patient who already has periodontal involvement. A careful clinical examination must determine the patient's dental health status, including any existing destruction or deficiencies of the teeth and their support, as well as the patient's ability to achieve and maintain good overall oral hygiene. Two major criteria should be considered in the treatment of these patients: (1) the patient should be seen frequently for periodontal maintenance and (2) minimal orthodontic forces should be applied. Segmented archwires could be used for the treatment mechanics. After treatment, splinting of the teeth is necessary both short- and long-term. With this orthodontic approach, both dental esthetics and function improve and can be maintained. A male patient, 50 years of age, with severe periodontal involvement was referred to the authors' clinic, from the periodontal department, for treatment. The mandibular incisors were intruded by using segmental archwires. At the end of treatment, permanent retention was required due to the severe bone loss.

Cephalometry↗
PubMed2005

Levels of t-PA and PAI-2 in gingival crevicular fluid during orthodontic tooth movement in adults.

BACKGROUND: The regulation of plasminogen activation is a key element in controlling proteolytic events in the extracellular matrix. OBJECTIVE: The aim of this study was to investigate gingival crevicular fluid (GCF) levels of tissue plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI -2) during orthodontic tooth movement in adults. METHODS: Five male subjects (Mean age: 22.5 +/- 2.8 years) and five female subjects (Mean age: 23.4 +/- 3.9 years) were used. Each subject had one upper canine retracted into an extraction space. The contralateral and opposing canines, which were not moved, served as controls. GCF was collected at the distal cervical margins of the experimental and control teeth 0, 1, 24, and 168 hours after a retracting force was placed. GCF levels of t-PA and PAI-2 were determined by commercially available ELISA kits. RESULTS: After 24 hours of tooth movement the levels of t-PA and PAI-2 in the GCF were significantly higher from the experimental canines compared with the control teeth. There were no significant experimental-control differences at 0, 1, and 168 hours. There were no differences in the total protein levels up to 168 hours after orthodontic tooth movement. CONCLUSIONS: These results indicate that the amounts of t-PA and PAI-2 in the GCF increase with orthodontic tooth movement, and suggest that such increases may be involved in extracellular matrix degradation in response to mechanical stress. Failure to detect elevated levels of t-PA and PAI-2 at 168 hours was attributed to decay of the force retracting the canines.

Adult↗
PubMedDate not supplied

Parents' satisfaction with their child's orthodontic care: a comparison of orthodontists and pediatric dentists.

PURPOSE: The purpose of this study was to compare the quality of orthodontic care between orthodontists and pediatric dentists when measured by parental satisfaction. METHODS: Six pediatric dentists and 5 orthodontists participated in the study. Quality of care was measured using the peer assessment rating (PAR) occlusal index, treatment duration, and parental satisfaction. Parental satisfaction was evaluated using a 25-item questionnaire measuring 3 dimensions: (1) treatment process; (2) psychosocial effects of treatment; and (3) treatment outcomes. The questionnaire items were scored on a scale of "strongly disagree" to "strongly agree." RESULTS: At baseline, no differences were seen in the gender, starting dentition, and permanent teeth extractions of patients treated by the orthodontist and pediatric dentists. Statistically significant differences were seen in patients': (1) pretreatment age; (2) race; (3) primary teeth extractions; (4) treatment stages; and (5) pre-PAR scores. No statistically significant differences between orthodontists and pediatric dentists were observed regarding overall parental satisfaction or the dimensions of satisfaction. These results did not change after controlling for potential confounding factors such as patient's age, gender, starting dentition, treatment stage, extraction recommendations, pre-PAR score, treatment duration, and percentage PAR reduction. CONCLUSIONS: The quality of orthodontic care, when measured by parental satisfaction, was similar between orthodontists and pediatric dentists. This indicates that, as far as parents are concerned, pediatric dentists performed orthodontic treatment to the same high standard as orthodontists.

Adolescent↗
PubMedDate not supplied

Early healing events following placement of a palatal subperiosteal orthodontic anchor: a pilot study.

PURPOSE: The aim of this report was to describe the initial 8-month healing events of 8 consecutive cases of placement of an onplant device for orthodontic anchorage and to report the results of a questionnaire evaluating subjective patient experience. METHODS: At 2 weeks and at 4 and 8 months after placement of the device, presence or absence of exposure of the device, mobility using gentle finger palpation, and signs of possible inflammation were evaluated. At 8 months, the inflammatory status of the tissue-abutment interface was determined from presence or absence of bleeding and/or suppuration on probing. Patients' experience of pain, discomfort, and acceptance of the treatment were evaluated by the use of visual analog scales. RESULTS: In 7 of the 8 patients, the device became stable and could be used for orthodontic anchorage. In 1 case, infection occurred, and the device was removed. At the 8-month time point, none of the 7 successful devices showed any plaque or any bleeding or suppuration on stimulation with a periodontal probe. Most patients reported little pain/discomfort from the various treatment procedures and indicated that they felt that opting for the onplant treatment had been the right choice. CONCLUSION: The results of this pilot study suggest that placement of the onplant can lead to uneventful healing and stability of the device. Further studies with larger numbers of subjects are necessary to substantiate these findings and to determine the usefulness of this device for orthodontic anchorage.

Adolescent↗
PubMed1990

Orthodontic education and practice in Canada: perceptions of the profession as shown in a recent survey.

A questionnaire survey concerning the training and practice of orthodontics was mailed to 20 per cent of the licensed dentists and to dental specialists in the provinces of Ontario, Manitoba, Alberta, and British Columbia between March and August of 1987. The response rate was 49.4 per cent. Many dentists and orthodontists who completed the survey reported declines in patient load during the past three years. Dental schools are perceived to be providing inadequate orthodontic training, in both the undergraduate dental curriculum and in the area of continuing education. A desire for an increase in time, quality, and applications was expressed. Between 20.1 and 34.2 per cent of fully-banded orthodontic cases are being treated by general practitioners.

Alberta↗
PubMed1989

[Interrelationships between orthodontics and periodontics].

It has been known that orthodontic appliances have been a local etiologic factor contributing to periodontal problems. Properly executed tooth movement should be accompanied by a more favorable periodontal response rather than an adverse reaction. Today guiding the patient's orthodontic therapy with fixed and removable appliances requires a sophisticated knowledge of the periodontium. The purpose of this article is to describe several interrelationships between orthodontics and periodontics and to highlight frequent problem areas.

Humans↗
PubMed1989

[Two case reports of orthodontic treatment using mini-bracket (Smile bracket)].

The orthodontic treatment has become simple since the straight arch wire technique was introduced. From then onwards, various improvements have been made on this new method. One of them was to make a bracket small in size. The result was that the effect of wire become more excellent because of the distance between two brackets being changed longer by this small bracket and the disgraceful feeling of patients with bracket was reduced by this one. We call this one mini-bracket. This author has applied it clinically and has gotten good results. And so, the author summarizes the orthodontic points of two case reports of orthodontic treatment using the straight arch wire technique with mini-bracket.

Adolescent↗