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Orthodontic therapy with fixed appliances bears a high risk of plaque accumulation, resulting in demineralization and new carious lesions. Rather than treat incipient lesions in orthodontic patients, most general dental practitioners decide to await future developments. A new concept for comprehensive restorative and endodontic treatment is presented, and its orthodontic implications are discussed.
Patient home care during orthodontic treatment is often less than ideal. For those patients who routinely let plaque accumulate around orthodontic appliances, there can be white or stained areas of decalcification around the bonded appliances. Management of this esthetic problem can be accomplished in several ways depending on the severity of the defect. This paper describes the very conservative technique of microabrasion which works well in removing superficial markings caused by decalcification. In a sample of 98 decalcified teeth from 20 patients with orthodontic decalcifications and various other unesthetic stains, microabrasion removed most or all of the disfiguring marks on 78.5 percent of the teeth evaluated. At least some improvement was noted 96.9 percent of the time. These results were statistically significant (P > .01). It seems appropriate to employ this technique prior to initiating more aggressive cosmetic dentistry such as resin bonding, Class V restorations, or labial veneers.
Orthodontics is an elective dental procedure generally believed to involve pain. In certain individuals, the pain caused by orthodontic tooth movement can be a major negative component of the entire therapy. Clinicians who are aware of this fact can attempt to prevent pain rather than ameliorate it once it is present and help make the experience a more positive one for the patient. Orthodontic forces should be kept at suitable levels and care taken to prevent trauma due to hyperocclusion. In procedures suspected to cause significant painful stimuli (such as forcing bands on unseparated teeth, removal of fixed expanders, initial placement of archwires, or lingual arches), or in particularly sensitive patients, the use of analgesics may be indicated. These agents should be taken prior to the procedure and for a minimum of 24 hours following the procedure. Acetaminophen is recommended in young children, while nonsteroidal anti-inflammatory agents are indicated in older patients.
The surface roughness of orthodontic wires is an essential factor that determines the effectiveness of arch guided tooth movement. Using the nondestructive technique of laser specular reflectance, the surface roughness of 11 nickel titanium orthodontic wires and a standard steel as well as a beta-titanium wire was measured. The results were compared with the results from surface profilometry. The smoothest wire, standard steel Hi-T, has an optical roughness of 0.10 microns, while the roughness from profilometry reached a value of 0.06 microns. The titanium molybdenum wire has an optical as well as a profilometric roughness of about 0.20 microns, while the roughness of the NiTi wires ranges from 0.10 microns to 1.30 microns. As the surface roughness not only influences the effectiveness of sliding mechanics, but also the corrosion behaviour and aesthetics, the manufacturers of orthodontic wires are asked to improve the surface quality of their products.
PURPOSE: Proper well-organized orthodontic treatment planning for special needs patients quantifies such needs with a valid screening method to determine priority treatment. The aim of this study was to determine the orthodontic treatment needs of mentally handicapped children in Ibadan, Nigeria. METHODS: The sample consisted of 124 mentally handicapped children, 68 boys and 56 girls who were 6 to 18 years old with mean age of 14.5 +/- 1.5 years, drawn from 7 special centers/schools in the city. RESULTS: Less than 42% had normal or minor malocclusions needing slight or no treatment; 17% had definite malocclusions with treatment elective; 9% had severe malocclusions and treatment highly desirable; 32% had very severe or handicapping malocclusions with treatment considered mandatory. Significant gender differences were found in the mean dental aesthetic index (DAI) scores (P < .05) and significant association noted (P < .05) between severe mental retardation and DAI scores deserving treatment. CONCLUSIONS: There were considerable orthodontic treatment needs among the study population with a reasonable percentage deserving treatment in publicly funded programs.
A single-blind, cross-over study design was used to evaluate the effectiveness of four different manual toothbrushes and to determine whether patient toothbrush preference is directly related to plaque control in patients with fixed orthodontic appliances. The brushes evaluated were Orthodontic Oral-B, Oral-B Advantage 30, Colgate Precision and Aquafresh. Forty-six subjects, aged 11 to 27, undergoing fixed orthodontic treatment were screened and recruited with parental consent. Subjects were randomly allocated into four groups. All subjects had their teeth scaled and polished at week 0. Baseline recordings of PI and GI were done four weeks later and the first toothbrush was given. After using the toothbrush for a period of 2 weeks the PI and GI were again recorded and teeth were again scaled and polished. A period of four weeks elapsed before new baseline recordings were done and the sequence followed as described for the first toothbrush. This was done until all subjects had used all four toothbrushes. At the end of the clinical trial, each subject was asked which toothbrushes they preferred. PI and GI values were relatively low at baseline as well as after the use of the toothbrushes. General linear model procedure showed no statistical difference between the Mean Plaque Index (MPI) before and after use of each toothbrush as well as the Difference in Mean Plaque Index (DMPI). There was a slight difference in the Difference in Mean Gingival Index (DMGI) between the Colgate Precision and Aquafresh toothbrush. For all the other comparisons general linear model procedure showed no difference between the Mean Gingival Index before and after use of each brush. There was no correlation between the toothbrush preferred by the patient and oral cleanliness as measured by DMPI and DMGI.
OBJECTIVE: To investigate the relapse of incisor alignment after orthodontic treatment and possible factors which may related to its stability. METHODS: 72 finished cases with full records selected from orthodontic clinic of Peking University School of Stomatology composed the sample. The follow-up lateral head films and study casts were taken at least 2 years after orthodontic treatment. The cephalograms were measured by computerized program and the study casts measured by caliper. RESULTS: The upper Irregularity Index decreased from (11.5 +/- 5.02) mm before treatment to (2.01 +/- 1.39) mm after treatment and then increased to (3.46 +/- 1.69) mm in the follow-up stage. The lower Irregularity Index decreased from (7.24 +/- 44.35) mm before treatment to (1.75 +/- 1.04) mm after treatment and then increased to (3.39 +/- 1.78) mm in the follow-up stage. The changes are significant statistically. The changes of jaw in the sagittal and vertical directions as well as the related changes of the position of lower incisors, the decrease of the lower canine arch width, Bolton Index and sex all have statistically significant relation with the changes of the lower Irregularity Index after retention. CONCLUSIONS: Compared with lower arch, the alignment in upper arch is more stable in the follow-up stage. The results suggest that some possible factors may have correlations with the change of lower arch crowding during the follow-up stage.
OBJECTIVE: To observe the effects of orthodontic treatment on the changes of condylar position in Class division 2 deep-bite patients. METHODS: 11 patients with Class division 2 deep-bite malocclusion were orthodontically treated, the changes of condylar position were evaluated by means of 3D-CT and Sam-diagnostic articulator. RESULTS: With the increase of inclination of upper incisors and opening bite, there were statistically significant changes of condylar longitudinal distance and condylar height in both sides, and retruded contact position-intercuspal position(RCP-ICP) discrepancy was significantly reduced. CONCLUSION: The condylar position in division 2 deep-bite patients could be orthodontically changed, moving anterior-inferiorly and approaching RCP.
OBJECTIVE: To observe the clinical effect on the treatment of traumatic intrusion of upper anterior teeth using orthodontic extrusion combined with fixation. METHODS: 24 cases, 27 teeth included, were treated by means of orthodontic extrusion combined with composite-resin split fixation. The clinical effect of 2-year-period was recorded. RESULTS: After the treatment of 27 selected teeth (16 immature teeth,11 mature teeth),11 teeth achieved the standard of success,16 teeth achieved the standard of efficiency, none of them was failing. CONCLUSION: Orthodontic extrusion combined with composite-resin split fixation is an active and atraumatic method in the treatment of traumatic intrusion of upper anterior teeth, and the effect is ideal.
After clarifying the role and significance of the European Federations of Orthodontic Specialists Associations (EFOSA), the results of a recent survey on the situation of the Speciality of Orthodontics in Europe are presented. Among the many items included are the recognition and availability of orthodontic specialists, their training, their working conditions, the height of the charged fees and the present insurance and refunding systems.
In this article a young, still growing female patient with a Class II division 1 malocclusion and a short mandible is presented. She was treated with functional and fixed orthodontic appliances. During orthodontic treatment with fixed appliances, mandibular lengthening by means of the intra oral distraction technique was used to correct the jaw relation. The orthodontic treatment could be finished successfully after lengthening of the mandible. The results are presented. In the discussion some alternatives for mandibular distraction are mentioned. It was concluded, that intra oral mandibular distraction is useful and successful, in selected cases.
This study was designed to compare the occlusions of 24- to 59-month-old children who used orthodontic or conventional pacifiers to the occlusions of a group of controls who had no sucking habits. Information on the habits was collected by parental questionnaires. Ninety-five children were examined for malocclusions involving overbite, overjet, canine, and molar relationships, and posterior crossbites. Users of orthodontic pacifiers had statistically significantly greater overjets, and there was a significantly higher proportion of subjects with open bite in the conventional pacifier group. There was a trend toward a greater number of subjects in the control and orthodontic pacifier group with overbites less than or equal to 50%. These differences were not clinically significant, however. There appeared to be only minor differences between the occlusions of the two pacifier groups.
Composite veneers, crowns, and adhesive bridges also can be a part of interdisciplinary therapy, namely, cooperation between orthodontics and prosthodontics. This study sought to systematically analyze patients treated orthodontically and prosthodontically with permanent teeth from a long-term point of view (three years). Forty-nine composite veneers, crowns, and adhesive bridges were inserted on the anterior teeth of 20 patients as a part of reshaping and reorientation of teeth after orthodontic therapy. The results indicated that composite resin restoration, including fiber-reinforcement restoration, is the treatment of choice in anterior dentition.
OBJECTIVE: Combined orthodontic-periodontal treatment with supracrestal fiberotomy was undergone on the periodontal patients with anterior displacement of incisors. Evaluate of the changes before and after treatment. METHODS: Periodontal indices, periapical x-ray analysis, and model analysis were used for investigating the changes of alveolar bone height and periodontal health by orthodontic treatment following supracrestal fiberotomy of anterior displaced incisors on periodontal patients. RESULTS: Alveolar bone height was increase by 1.2 mm in fiberotomy patients. The overjet was reduced from 7.0 mm to 2.0 mm, while the overbite was decreased from 4.0 mm to 2.0 mm, and the periodontal health maintained as well. CONCLUSION: Combined orthodontic periodontal treatment with supracrestal fiberotomy could correct the malpositioned teeth, and improve the periodontium conditions and gain the crest bone.
After clarifying the role and significance of the European Federations of Orthodontic Specialists Associations (EFOSA), the results of a recent survey examining the situation of the Speciality of Orthodontics in Europe are presented. Among the many items included are the recognition and availability of orthodontic specialists, their training, and working conditions, the fees charged, and the present insurance and refunding systems.
OBJECTIVE: To compare soft-tissue morphology changes by cephalometric measurements between extraction and non-extraction orthodontic treatment in borderline cases. METHODS: The samples consisted of 33 cases selected as borderline cases by 5 orthodontic specialists. They were divided into 21 extraction cases (including 13 four first premolar extraction cases and 8 four second premolar extraction cases) and 12 non-extraction cases by checking patients' treatment records. Conventional cephalometric analysis was made to compare soft tissue structures before and after orthodontic treatments and the same comparison was made between two different extraction patterns. RESULTS: No statistical difference was found in pretreatment soft-tissue morphology between extraction and non-extraction groups divided from borderline cases. The PosBs/FH of the four first premolars extraction group was smaller than that of non-extraction group, and the Ns-Sn-Pos of the four first premolars extraction group was smaller than that of four second premolar extraction group. None of the post-treatment soft-tissue measures showed significant statistical differences between four first premolars extraction group and non-extraction group, but there were 6 items showed significant statistical differences between four second premolars extraction group and non-extraction group. Compared with extraction and non-extraction treatments, the most significant soft-tissue changes were: PosBs/FH, LL-SnPos, and Bs-EP . CONCLUSION: Although pre-treatment soft-tissue morphology of second premolar extraction group was close to that of non-extraction group, the post-treatment soft-tissue morphology of first premolar extraction group became closer to that of non-extraction group. Compared with non-extraction treatment, the more significant changes caused by extraction treatment were located in the lower lip and chin, but not the upper lips.
AIM: Significant delay in tooth eruption may be observed in many orthodontic patients. This delay may lead to complications, such as devitalization, ankylosis, external root resorption, injury to the adjacent teeth, and mucogingival problems. These complications may result in prolonged treatment time, esthetic deformities, damage to the periodontal tissues, and tooth loss. This report investigates the special considerations needed in treating such cases. METHODS: Combined orthodontic and surgical treatment can be used in managing teeth exhibiting significant delay in eruption. RESULTS: A high rate of success can be achieved in terms of esthetics, occlusion, and periodontal health. CONCLUSION: Nontraumatic surgery, adequate control of gingival inflammation, and use of minimal orthodontic forces may ensure a higher percentage of success and prevention of problems associated with teeth exhibiting significant delay in eruption.
AIM: To determine the influence of chromium and nickel concentrations in saliva and their effects on gingival tissues during orthodontic treatment. METHODS: Twenty orthodontic patients (10 males and 10 females), 17 to 20 years of age, were treated with fixed orthodontic appliances in the maxillary arch. Using atomic absorption spectrophotometer, the concentration of both metals was recorded during pretreatment, at 3 and 12 months into treatment, and 1 month after debonding. The depth of gingival crevice was recorded as well. RESULTS: After 3 months, 20% of females and 10% of males in this study showed allergic reaction in a form of gingivitis. This had disappeared by 1 month after appliance removal. CONCLUSION: While allergy to either nickel or chromium is not a serious medical problem, oral hygiene measures in at-risk patients should be optimal, with use of fluoride-free toothpaste and mouthrinse.