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PubMed2001

Quality of life and its importance in orthodontics.

Over the last 10-15 years, the terms quality of life (QOL) and health-related quality of life (HRQL) have been seen increasingly in medical literature. Much of the orthodontic treatment that is undertaken is justified on the basis of improving health-related quality of life. With this in mind, studying HRQL in orthodontic patients has the potential to provide information about treatment needs and outcomes, and may also facilitate improved care. Clinicians should therefore be aware of some of the ways in which health-related quality of life may be assessed. The first part of this review article looks at the general concepts of health-related quality of life, whilst the second section focuses on dentistry and orthodontics.

Attitude to Health↗
PubMed2001

Functional occlusion: II. The role of articulators in orthodontics.

Opinion is divided on whether there is a place for the use of semi-adjustable dental articulators in orthodontics. In this review we explore the validity and reproducibility of the techniques involved in mounting study models on a semi-adjustable dental articulator. We also look at the role of articulated study models in orthodontic diagnosis and treatment planning, in the finishing stages of orthodontics and in planning for orthognathic surgery. We report that each of the many stages involved in mounting study models on a semi-adjustable articulator is a potential source of error and that only if the technique is carried out with a high degree of accuracy is it worth the additional chairside time.

Dental Articulators↗
PubMed1989

Incidence of filled surfaces from 10-18 years of age in an orthodontically treated and untreated group in Norway.

The present study was conducted to examine the incidence and location of filled surfaces from 10-18 years of age in individuals subjected to and not subjected to treatment with fixed orthodontic appliances. Each group comprised 65 individuals. About 5 years had elapsed since the appliances were removed. No statistically significant difference in filled surfaces was found between the groups at age 10 to 18. The incidence in filled surfaces from 10-18 years was 6.34 in the orthodontic group, and 7.22 in the untreated group. The difference was not statistically significant. The distribution of fillings in the dentition in the two groups showed no significant differences. Most of the fillings were recorded in the fissures of the molars. In the first molars most of the fillings in the fissures were already present at the age of 10. It was concluded that in individuals with relatively low caries activity, the present fluoride regimes are sufficient to prevent any excess caries lesion development requiring filling during or after orthodontic therapy.

Adolescent↗
PubMed1989

Occupational health problems and adverse patient reactions in orthodontics.

The purpose of the present investigation was to study the nature and frequency of adverse reactions to materials and procedures among orthodontists and their patients. A questionnaire about this topic was mailed to practicing members of the Norwegian Orthodontic Society, of which 137 (about 75%) responded together with 127 chairside assistants. About half of the orthodontic personnel had experienced adverse reactions. The majority of the problems were dermatoses, comprising dryness, redness, itching, thickening, reduced tactile sensitivity, fissuring, soreness/desquamation and pain of hands and fingers. The residual were respiratory reactions, eye reactions or reactions of a general nature. Many of the dermatoses were of moderate severity, attributed to (seasonal) air/ventilation associated problems. Other frequent causes were hand washing procedures, work involving composites and acrylics (orthodontists), or work involving model materials, alcoholic disinfectants, latex gloves, alignates etc. (assistants). For both groups the most severe dermatological reactions were associated with unspecified allergies, acrylics and composites. Non-dermatological reactions also reflected the different working pattern and exposure to materials in orthodontics; acrylic monomer topping the list. The orthodontists had observed 425 patients with dermal reactions and 67 patients with intraoral/systemic reactions, indicating a prevalence of about 1 per cent. Dermal reactions included redness, eczema, itching and fissuring in facial, neck or perioral areas, mostly attributed to metallic parts of extraoral appliances, with some exceptions (elastics, neck pillows, head caps). Intraoral reactions consisted of redness, soreness and swelling of the oral mucosa, gingiva and/or lips and were associated with metal brackets, labial wires, bonding procedures or acrylic appliances.

Adolescent↗
PubMed1981

The combined surgical and orthodontic treatment of mandibular prognathism.

Patients with severe mandibular prognathism are best managed with a combined orthodontic-surgical approach. In our patients, the orthodontic treatment consisted of six to eighteen months of presurgical preparation, which in some patients may accentuate the dental deformity. This is done to provide two well-aligned dental arches that will fit accurately at surgery. The surgical procedure used was an oblique subcondylar osteotomy. This was followed by six to eight months of orthodontic treatment to complete dental alignment. Thirty patients were treated using this combined approach, with excellent results and few complications.

Adolescent↗
PubMed2000

Interdental distraction osteogenesis and rapid orthodontic tooth movement: a novel approach to approximate a wide alveolar cleft or bony defect.

The closure of a wide alveolar cleft and fistula in cleft patients and the reconstruction of a maxillary dentoalveolar defect in traumatic patients are challenging for both orthodontists and surgeons. This is due to the difficulty in achieving complete closure by using local attached gingiva and the great volume of bone required for the graft. In this article, the authors propose using interdental distraction osteogenesis to create a segment of new alveolar bone and attached gingiva for the complete approximation of a wide alveolar cleft/fistula and the reconstruction of a maxillary dentoalveolar defect. They performed this procedure on one patient with a traumatic maxillary dentoalveolar defect and 10 patients with unilateral or bilateral cleft lips and palates who had varied dentoalveolar clefts/fistulas. Interdental and maxillary osteotomies were performed on one side of the dental arch by the cleft or defect. After a latency period of 3 days, the osteotomized distal segment of the dental arch was then distracted and transported toward the cleft or defect by using a toothborne intraoral distraction device. The alveoli and gingivae on both ends of the cleft or defect were approximated after distraction osteogenesis. The need for extensive alveolar bone grafting was eliminated. A segment of new edentulous alveolus and attached gingiva was created interdentally at a site distant to the cleft or defect. In the cleft patients, teeth were moved orthodontically into the regenerate (newly formed alveolar bone) dental crowding 1 week after distraction. The orthodontic tooth movement was rapidly completed in 3 months, and the edentulous space was eliminated. Interdental distraction osteogenesis minimizes an alveolar cleft/fistula and helps reconstruct a maxillary dentoalveolar defect by approximating the native alveoli and gingivae; it also creates new alveolar bone and gingiva for rapid orthodontic tooth movement.

Alveolar Process↗
PubMed1995

Mechanical response to functional and therapeutic loading of a retromolar endosseous implant used for orthodontic anchorage to mesially translate mandibular molars.

Three finite element models were created to investigate the potential of rigid osseous fixation (osseointegration) for orthodontic anchorage: a mandible without an implant; a mandible with an implant; and a mandible and implant with a superimposed orthodontic load. Force was applied to different locations and the stresses were computed. The mechanical stress distributions adjacent to the implant were not affected by different biting forces, hence only one case needed to be analyzed. The stresses adjacent to the bone-implant interface changed drastically due to implantation, with major changes occurring on the buccal and mesiobuccal sides. A strong, concordant gradient for intraosseous stress and bone remodeling rate was observed that reflects a mismatch in the moduli of elasticity between the implant and the supporting bone. These results suggest important clinical implications. Osseointegration of symmetrically threaded titanium implants appears to be maintained by a sustained elevation of the mechanical stresses that continuously stimulate the bone remodeling activity within 1 mm of the implant surface. It is unlikely that a rigidly fixed (osseointegrated) implant will lose integration due to an orthodontic load superimposed on normal function.

Alveolar Process↗
PubMed2003

A long-term retrospective outcome assessment of facial growth, secondary surgical need, and maxillary lateral incisor status in a surgical-orthodontic protocol for complete clefts.

In 1965, the cleft palate team at Children's Memorial Hospital embarked on a new surgical-orthodontic protocol in the habilitation of newborn complete cleft lip and palate cases. It brought the orthodontic effort into focus at birth and in planned sequence to correspond with the surgical procedures of lip closure, maxillary alveolar stabilization by means of an autogenous graft of the authors' design, and complete palate closure, all within the first year of life. The purpose of this investigation is threefold: first, to review the authors' previous publications and assess growth, secondary surgical need, and lateral incisor status of teeth adjacent to the cleft in a series of patients who have all followed a precise, early surgical/orthodontic protocol; second, to compare these cases with other collaborative studies wherein this protocol was not used; and third, to report on an additional 82 cases with regard to secondary surgical need and the status of teeth adjacent to the cleft. Methods of assessment have included cephalometric radiography, periapical and occlusal dental radiography, computer-assisted tomography, plaster cast analysis, and intraoral and extraoral photography. The authors have demonstrated, along with other collaborative studies, that there is growth as good as other similar samples wherein there was no primary osteoplasty. In addition, the authors found their incidence of orthognathic surgery to be 18.29 percent; pharyngoplasty, 3.65 percent; and oronasal fistulas requiring surgical closure, 29.27 percent. In the case of unilateral complete clefts, 53.13 percent of those lateral incisors present adjacent to the cleft area were usable, and in bilateral cases, 57.77 percent were usable. The authors remain convinced after more than 35 years of following this successful protocol that early maxillary orthopedics and their technique of primary osteoplasty in planned sequence with lip and palate closure can produce a more favorable alignment of maxillary growth potential and, with comprehensive orthodontic treatment, can lead to teeth in a better overall occlusion than if these procedures had not been undertaken.

Adolescent↗
PubMed1991

Measurements of dental cast profile and three-dimensional tooth movement during orthodontic treatment.

We have developed a system for measuring three-dimensional profiles of dental casts and three-dimensional tooth movement during orthodontic treatment. The profile measurement is based on the triangulation method which detects a laser sport on a cast using an image sensor. The system is computer-controlled and designed to achieve the depth and lateral resolutions of 0.05 and 0.1 mm, respectively, within a depth range of 25 mm. We have applied our system to measuring three-dimensional movement of teeth, including rotations, during orthodontic treatment. The movements have been obtained by means of three-dimensional registration of tooth profiles using a computer between casts serially taken at different stages of the treatment. Measurements over periods of 41 to 190 days on patients have revealed that this technique is capable of quantifying the difference in movements due to orthodontic therapeutics.

Computer Graphics↗
PubMed1983

Longitudinal evaluation of a system for self-monitoring plaque control effectiveness in orthodontic patients.

This study was undertaken to determine the effectiveness of the Plaklite as an adjunct to plaque control instruction in orthodontic patients. 24 subjects, aged 9-14, who were to receive full banded Edgewise orthodontic appliances, were divided randomly into 3 groups. The first group was a control and did not receive structured plaque control instructions. The second group received plaque control instructions using the modified Bass brushing technique with no disclosant. The third group received a similar type of plaque control instructions supplemented with instructions in the use of a Plaklite to self-assess the effectiveness of plaque control. Both plaque control groups received monthly reinforcement of their initial instructions for the first 5 months of orthodontic treatment. The Plaque Index and Gingivitis Index were utilized to assess plaque and gingival inflammation before and after banding, and at 6-week intervals for the first 9 months of treatment. These indices were recorded single blind. The results indicated that plaque and gingivitis scores progressively increased during the test period for the control group. Also those subjects who received a plaque control program which included the Plaklite had a more sustained improvement in plaque and gingivitis scores for the test period than the group receiving plaque control instructions only.

Adolescent↗
PubMed2006

An efficacy and safety analysis of a chlorhexidine chewing gum in young orthodontic patients.

AIM: The objective of the present study was to investigate the impact of a chlorhexidine (CHX) chewing gum in teenage orthodontic patients on plaque levels, gingival bleeding tendency and tooth staining. MATERIALS AND METHODS: A randomized-controlled, double-blind, parallel study was conducted on 31 teenagers in fixed orthodontic therapy. Subjects of the CHX gum group were asked to continue their oral hygiene procedures in conjunction with chewing two pieces of a 5 mg CHX-containing chewing gum for 10 min. twice a day for 3 months. Subjects of the placebo gum group received the same instructions; however, using a CHX-free chewing gum. Plaque levels, gingival bleeding on probing and tooth staining were monitored at baseline and subsequently after 1-3 months. RESULTS: Plaque levels significantly decreased from baseline at lingual/palatal sites in the placebo gum group. In the CHX gum group, a similar, yet non-significant trend was observed. At buccal sites, plaque levels remained unaffected in both groups. Gingival bleeding tendency significantly decreased in both groups, predominantly at lingual/palatal sites. There were no significant between-group differences in any of the efficacy parameters at any time point. However, the increase in staining was nearly five times higher in the CHX gum group. CONCLUSIONS: There seems to be no indication for a CHX chewing gum in teenage orthodontic patients when used as an adjunct to normal oral hygiene practices.

Adolescent↗
PubMed1975

Estimates of orthodontic treatment need in Danish schoolchildren.

Orthodontic treatment need has been assessed on the basis of complete orthodontic records in a random sample of 293 Danish children aged 13-17 years by a group of postgraduate orthodontic students and by three orthodontists. The estimates of treatment need ranged from 45% to 61%. Interexaminer agreement in pairs was observed in 77%-92% (mean 83%) of the cases. Uniformity in four individual assessments was reached in 69% of the cases: 38% were considered in need of treatment and 31% were considered not to present such need; conversely, 31% gave rise to disagreement. It is argued that, at present, the orthodontist's subjective estimate of treatment need probably constitutes a more realistic approach to the problem of assigning treatment priority than the various indices of malocclusion.

Adolescent↗
PubMed1978

Need of orthodontic treatment in 7-year-old Finnish children.

The purpose of the investigation was to determine the need of orthodontic treatment in 7-year-old Finnish children. The series consisted of 200 Finnish children, 100 girls and 100 boys. With regard to the main lines of occlusion a close agreement was observed between the prevalence of malocclusion in this and other. Scandinavian series. The need of orthodontic treatment was assessed using a treatment scale for the age group concerned. No treatment was required in 42% of the children, while 23.5% were in immediate need of orthodontic treatment. In 34.5% it was considered necessary to follow the occlusal development.

Child↗
PubMed1978

Orthodontic examination of 2,301 Danish children aged 9-10 years in a community dental service.

Orthodontic therapy in the Danish Child Dental Health Service is offered according to patient need. In general, systematic screenings of children in specific age groups are carried out to insure uniformity in selection of patients for orthodontic treatment. The screening described in this investigation was carried out among 2,301 3rd grade schoolchildren in order to diagnose symptoms of malocclusion at an early stage with regard to tooth formation, the aim being to evaluate the need for orthodontic observation, prophylactic measures or therapy. Each examination took approximately 3-4 min.

Child↗
PubMed1991

Malocclusion and orthodontic treatment need of 15-74-year-old Dutch adults.

In 1986 a nationwide dental survey was performed in the Netherlands. This article describes the prevalence of dentofacial anomalies in the age group 15-74 yr, as well as the subjective and objective need for orthodontic treatment. The main findings were: severe crowding in the mandible was found in approximately 15%; an Angle Class II situation was seen in 28%; a maxillary overjet of greater than 5 mm was found in 23%; orthodontic treatment had or was being performed in approximately 25%; 45% of orthodontic treatment was carried out by a general practitioner; using professionally defined need, 39% of the population required treatment whereas only 14% of the people felt that this treatment was necessary.

Adolescent↗
PubMed1994

Perceived, desired, and normatively determined orthodontic treatment needs in male US Army recruits.

This study assessed perceived, desired, and normative need for orthodontic care in a systematic random sample of 576 male enlisted Army recruits at one Army post in fall 1990. Perceived and desired need were collected using a pretested questionnaire. Normative need was assessed on all participants by one dentist using the Treatment Priority Index. Results show 16.3% of enlisted male Army recruits have severe or handicapping malocclusions, yet only one-third desire corrective treatment. Preference for orthodontic care is strongly influenced by the recruit's education level. We recommend that military health policymakers consider expanding access to adult orthodontic care for active duty military personnel to keep pace with its widening acceptance by the general public and to keep the military health benefits package competitive with those of civilian employers.

Adolescent↗
PubMed1998

Orthodontic treatment need prior to treatment and 5 years postretention.

OBJECTIVES: To assess orthodontic treatment need prior to treatment and 5 years postretention in a large university sample. METHODS: A random sample of 920 patients (400 male and 520 females) from the Department of Orthodontics and Oral Biology, University of Nijmegen, the Netherlands, were included in this study. Dental casts were evaluated using the Index of Orthodontic Treatment Need (IOTN) at the pretreatment (TP) and 5-year postretention stages (T5). The mean age at TP was 12.2+/-3.0 years and at T5 21.6+/-3.1 years. At TP and T5 the aesthetic component (AC) and the dental health component (DHC) were assessed. The difference between TP and T5 was compared for males and females and tested by the t-test. The changes in AC, DHC and treatment need categories were described at TP and at T5. RESULTS: On the basis of combined AC and DHC treatment need categories, 83% of the patients fell into the "Definite need" category prior to treatment and 10% of the treated patients were categorised as having "Definite need" 5 years postretention. No significant differences were found between males and females for the change in AC and DHC between TP and T5. CONCLUSIONS: The results indicate that the policy used in the department for patient selection gives priority to patients with a high treatment need. The results also provide a general impression of treatment outcome utilising the IOTN to analyse the change in the treatment need categories.

Adolescent↗
PubMed1994

Stomatitis or systemically-induced contact dermatitis from metal wire in orthodontic materials.

5 patients with dermatitis or stomatitis related to the use of orthodontic appliances are described. All the patients were patch tested with the European standard series. One had a ++ reaction to potassium dichromate, one a ++ reaction to nickel, and the remaining 3 no positive patch tests. 3 of the patients had recurrent vesicular hand eczema, which flared after oral challenge with 1 of the metals used in their orthodontic appliances. 2 of these 3 patients had negative patch tests. The dermatitis of 4 of the 5 patients cleared completely upon the removal of their metal orthodontic appliances or their replacement with appliances made of acrylics.

Adolescent↗