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[Orthodontic treatment and periodontal problems. 1].

Because of the increasing frequency of orthodontic treatments of patients with periodontal problems, the authors evaluate effects deriving from orthodontic treatment on periodontal tissues and provide practical indications to manage such patients. Experimental and clinical studies on effects of trauma from occlusion on periodontal tissues in different clinical conditions are examined. The authors have also considered studies dealing with periodontal response to different orthodontic therapy items, with particular regard to gingival inflammation degree and likelihood of root resorption. From the results of such clinical and experimental studies, the authors have pointed out clinical indications to treat periodontal patients.

Animals↗

Time course of the discomfort in young patients undergoing orthodontic treatment.

Discomfort may accompany orthodontic movement of teeth. The purpose of this study was to determine the time envelope of discomfort induced in young patients (10-16 years) following placement of orthodontic separators and arch wires. Secondly, psychosocial factors concerning feelings of "self" were investigated. Forty-five experimental and 14 control patients seeking orthodontic treatment were included. A data sheet consisting of several visual analogue scales measuring patient perceptions of dental discomfort and psychosocial factors was used. The results indicated that the experimental group experienced significant discomfort with both separators and arch wires at 4 and 24 hr compared to controls; however, the discomfort dissipated by 7 days. The appearance of the teeth and face were significant factors predicting the patient's perspective of "self." The results have significant clinical implications and these are discussed.

Adolescent↗

Changes in craniofacial size and shape with two modes of orthodontic treatment.

Traditional cephalometric assessments not only provide cursory descriptions of craniofacial form but cannot withstand critical scientific appraisal. A more rigorous technique termed finite element analysis was used in this study. The study was based on lateral cephalographs from age-sex matched patient samples taken before and after the completion of orthodontic treatment. The results showed varying patterns of craniofacial change resulting from orthodontic treatment, compared with a control sample without treatment. These contrasts were shown to vary depending on the datum (nodal) point arrays used to define the component finite elements. The study therefore emphasized that the craniofacial changes resulting from orthodontic treatment are far more complex than envisaged from traditional cephalometric appraisals. These data also indicated the urgent need to investigate further the datum points used to define cephalometric form.

Adolescent↗

Correlates of the orthodontic aspects of the general dentist's practice.

A study was undertaken to determine the extent of orthodontic referrals and treatment performed by general dentists. The relevance of this study to dental education was found in attempting to ascertain the extent and type of predoctoral training of general dentists and relating this to the number of referrals and the extent and type of orthodontic treatment performed by the general practitioner. Results indicate that those general practitioners who graduated after 1945 tend to make significantly more referals than earlier graduates, and that general practitioners who had treated patients orthodontically in their predoctoral training tend to continue doing so in practice.

Adult↗

[I. Borderlines between orthodontics and oral surgery].

The division of responsibility between orthodontics and surgery is determined by the severity of deviation in facial development. In young, growing patients the border cannot be always determined at first. As a result there is an area of overlap whose extent is primarily influenced by the developmental age and cooperativeness of the patient, as well as by the cephalofacial type and therefore growth pattern. When the indications are for a surgical treatment of the facial structures, thre is a fundamental change in the orthodontic goals. One of the first steps of a joint planning must be the determination of which facial structures, in which directions and to what extent, must be the determination of which facial structures, in which directions and to what extent, should be surgically moved. The proposed, but not yet realised, skeletal outline is the matrix for the orthodontic preparation. The presurgical efforts include, at a minimum, the removal of occlusal barriers that would interfere with the surgical displacement of the skeletal units and at a maximum, the anticipating coordination of both arches so that immediately after surgery perfect occlusal harmony is reached.

Adolescent↗

Nutritional considerations in orthodontics.

This discussion emphasizes that nutrition is an important factor, influencing the general health and tissue tolerance of orthodontic patients on many levels. While orthodontists will rarely see frank manifestations of nutritional deficiencies, it should be recognized that suboptimal levels of certain nutrients are common and have an effect on the biologic responses of the tissues influenced by orthodontic treatment. Additionally, the age group typically involved in orthodontic treatment has particularly high nutritional demands and particularly poor dietary behavior.

Dental Plaque↗

[The prognostic significance of the presence of Actinobacillus actinomycetemcomitans in the subgingival plaque of young orthodontic patients].

The aim of present study was to evaluate the prognostic significance of the presence of Actinobacillus actinomycetemcomitans in subgingival plaque from young patients wearing fixed orthodontic appliances. Fifteen orthodontic patients, 3 males and 12 females, aged 10 to 27, systemically healthy, participated in the study. First examination took place in the spring of 1992 (T1) and consisted in the collection of clinical (pocket depth, PD; Gingival Index, GI; Plaque Index, P1I; Gingival Bleeding Index, GBI) and microbiological (Actinobacillus actinomycetemcomitans presence) parameters in 4-8 periodontal sites in each patient. The same clinical and microbiological parameters were collected again in the spring of 1994 (T2). Results showed that the presence of Actinobacillus actinomycetemcomitans in the examined periodontal sites underwent fluctuation, 25% of sites being positive for the sought after bacterium in T2 whereas the percentage of Actinobacillus actinomycetemcomitans positivity in T1 was 47.5% with a statistically significant difference (p < 0.005). On the contrary clinical parameters did not show significant modifications through the study period T1-T2. Differential analysis of clinical parameter modifications in relation to Actinobacillus actinomycetemcomitans positivity in T1 or Actinobacillus actinomycetemcomitans-positivity fluctuations in T1-T2 period did not evidence any significant difference among various microbiological conditions. The authors conclude that the mere presence of Actinobacillus actinomycetemcomitans in subgingival plaque from specific periodontal sites in young orthodontic patients does not seem sufficient to consider those sites at risk for periodontal destruction in the medium-short term.

Adolescent↗

[The decision to extract in orthodontics].

Serial extractions of premolars are submitted, in the present state of the contemporary orthodontics, in opposition to the non-extraction treatments (maxillary expansion, molar distancing...). The choice depends on many parameters including the severity and the nature of the malocclusion, the age and the morphological type of the patient and also the "orthodontic philosophy" relating to the techniques used by each orthodontist. The indications and contraindications of these teeth removals are explained showing the benefits and the disadvantages in different cases. "Orthodontics extractions" of other teeth (2nd bicuspid, 1st and 2nd molar, incisor) are also discussed.

Bicuspid↗

In vitro evaluation of an adhesive monomer as a bonding agent for orthodontic brackets to primary teeth and nickel-chromium ion crowns.

The adhesive monomer, Clearfil New Bond, was used to enhance the bond strength between orthodontic brackets and primary molars, premolars, and NiCr crowns. Twenty specimens of each had this dental adhesive applied according to the manufacturer's instructions in addition to a chemically cured composite material. The remaining specimens (20 each) were bonded without the adhesive monomer. Shear bond strengths were determined using a universal testing machine. Fracture sites were examined to determine the type of bond failure. All bond strengths were significantly increased with the addition of Clearfil New Bond (P < or = 0.0001). The shear bond strength to NiCr crowns with the addition of the adhesive monomer was 7.76 kg. This is comparable to the shear bond strength observed for primary molars (8.66 kg) and premolars (8.65 kg) without adhesive monomer. The observed decrease in adhesive bond failures with the addition of Clearfil New Bond indicated a stronger shear bond strength between the tooth surface and the bracket base. Clearfil New Bond can significantly increase the shear bond strength of orthodontic brackets to both primary molars and premolars. Additionally, it was shown that orthodontic brackets can be successfully bonded to Ni-Cr crowns at strengths comparable to primary or permanent enamel.

Analysis of Variance↗

Extended fissure sealants: an adjunctive aid in the prevention of demineralization around orthodontic bands.

Banding of molars is still the attachment mode of choice to the majority of clinical orthodontists. One of the acknowledged hazards of orthodontic treatment continues to be the presence of clinically detectable areas of enamel demineralization following the removal of orthodontic appliances. Factors that contribute to this demineralization include inaccurate adaptation of the bands and breakdown of the seal as a consequence of the inadequate bonding strength of the cements and their solubility in oral fluids. Traditional cleaning methods limit adequate plaque control to those areas gingival and incisal to the cemented bands. The iatrogenically created defective band-tooth interface areas pose particular problems, because the ingress of food particles and bacterial plaque make these areas prone to demineralization. A technique is introduced whereby fissure sealant is extended to cover the entire occlusal perimeter, effectively sealing the band-tooth circumferential interface. This technique represents an additional method of prophylaxis against the demineralization that can accompany orthodontic intervention.

Adolescent↗

[Occlusal contact changes before and after orthodontic treatment of TMJD patients in children and adolescents].

Occlusal contacts were examined in a sample of 32.8-17 Years old TMJD patients before and after orthodontic treatment. Computer-aided video system was applied to the silicone occlusal record obtained in the intercuspid position to assess the quantitative and qualitative changes of occlusal contacts. The results showed that after orthodontic treatment, the mean number of contacts on anterior teeth decreased, the mean area per contact decreased, the location of contacts on centric stops increased and the contacts on inclined plane were decreased. All of these indicated that the occlusal stability increased after orthodontic treatment.

Adolescent↗

West Midlands regional training scheme for orthodontics in dental practice.

The need for continuing education in orthodontics is recognised by many practitioners and the demand for post-graduate courses is high. The limitations of such courses, particularly the short technique type, are recognised and within the West Midlands the value of a longer term clinical attachment has been emphasised. The West Midlands has a well established orthodontic consultant service with fifteen NHS and one honorary consultant; the specialist practitioner service is small by national standards. All of the orthodontic consultants have long supported the clinical assistant post as a valuable vehicle for practitioners' continuing education. Building on the example given by the consultants in the four Thames Regions, a structured, centralised academic programme has been developed to enhance the clinical training given during these two year posts.

Curriculum↗

Practice characteristics of dual trained pediatric dentistry and orthodontic specialists.

Most respondents to this survey are providing both pediatric dental and orthodontic services to their patients. Almost half of the respondents reported that both specialties are fully integrated without separate times or days. Patient treatment time was reported as 41 percent pediatric dental services and 59 percent orthodontic services; when asked how they would like to adjust patient treatment time in ten years, however, the response was 20 percent pediatric dentistry and 73 percent orthodontics. A high percentage of respondents (44 percent) were involved in teaching full or part time or in continuing education courses.

Canada↗

Orthodontic band retention on primary molar stainless steel crowns.

The retention of orthodontic bands cemented on primary molar stainless steel crowns (SSC) was studied in vitro. Unitek maxillary and mandibular 1st and 2nd primary molar SSC were fitted with one of four commonly used orthodontic bands (Unitek regular, Unitek narrow, Rocky Mountain, or custom bands made from SSC) using glass ionomer cement. The cemented samples were tested for their resistance to dislodgment on the Instron Universal Testing Machine (Instron Engineering Corp., Canton, MA) in tensile mode. Alpha level for statistical significance was set at alpha = 0.05. Unitek regular bands cemented on the 2nd molar crowns and Unitek narrow bands cemented on the 1st molar crown samples had equivalent or superior resistance to dislodgment compared with the other bands in the study. When the inside of the band and the outside band-bearing surfaces of selected crowns were lightly scored with a diamond bur prior to cementation, samples exhibited significantly superior retention. Subgroup means increased from 107 to 330%, compared to the values obtained in their preroughened state. The mean values obtained using the roughened band/crown interface technique (range 52.9 +/- 7.6 to 73.6 +/- 8.4 lbs) compared favorably with retention values from the literature for orthodontic bands cemented on permanent molar and premolar teeth.

Analysis of Variance↗

[The relationships between orthodontics and temporomandibular joint dysfunction. A review of the literature and longitudinal study].

The fist part of this study concerns a literature review on temporomandibular dysfunction (TMD). There exists an equal amount of literature relating occlusal interferences to TMD, as there are reports denying any causal relationship. It is remarkable, however, that the latter reports are relatively recent. The relationship between the Angle classification and TMD is reported to be only weak in a "normal" orthodontic population. The relationship between morphologic malocclusion, e.g. deep bites or crossbites, with TMD seems to be somewhat stronger. The vast majority of the reports did not find any relationship between TMD and orthodontic treatment or extractions. Our own longitudinal prospective study could not reveal any systematic relationship between orthodontic treatment or extractions and TMD.

Adolescent↗

Application of porcelain veneers following orthodontic treatment.

To date, porcelain laminate veneers have been used primarily to solve esthetic problems. As bonding materials and veneer restoration techniques have improved, however, functional demand has now been accepted. Porcelain laminate veneers have been applied to compensate for the limitations of orthodontic treatment. In order to allow optimum functional movement of the mandible, anterior and lateral guidances are required in the maxillary dentition. These guidances provide pathways for the opposing mandibular teeth. Anterior and canine guidances have been established by means of veneer placement, and no broken restorations have been observed in the past four years. When diastema spaces have recurred subsequent to orthodontic space closure, they have been restored with porcelain veneers so effectively that no relapse has been observed. This paper also examines instances where small lateral incisors have caused a discrepancy in the tooth size ratio between the upper and lower arches. Porcelain veneers were placed to harmonize the tooth size and to stabilize the occlusion. Relapse sometimes occurs after orthodontic tooth alignment. Over correction, therefore, is usually applied for rotated teeth, anterior deep or open bite, and Class II or III molar relationships. Some malocclusions, however, cannot be over corrected. For example, the spacing between the teeth, such as diastema, can easily reopen because it is impossible to apply over correction once space closure has been achieved. The same is true of lateral open bites, because occlusal contact cannot be corrected properly. In these cases, the patient must wear a retainer for longer than usual, and/or permanent splints must be used to stabilize the occlusion. Another causal factor of relapse is dysfunctional occlusion.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Dental caries and fluorides in relation to fixed orthodontic treatment: a review.

This paper reviews the cariological aspects of fixed orthodontic treatment and discusses the role played by topical fluorides. During fixed orthodontic treatment, carious lesions may occur in the form of white spots. These may constitute an aesthetic problem. The clinical management of white spot lesions remains unresolved. In order to prevent development of these lesions, the use of topical fluorides is advocated. The need for patient co-operation in the use of self-administered topical fluorides is critical. To reduce this critical need, the use of fluoride-releasing orthodontic cements is recommended. The literature suggests that calcium fluoride, which is the major reaction product on enamel during topical fluoride application, plays an important role in the cariostatic mechanism.

Dental Bonding↗

Stability of occlusion after orthodontic treatment with tooth extraction in adult cases.

The purpose of this study was to evaluate stability of occlusion in adult cases at least 4 years after orthodontic treatment and to clarify parameters influencing this stability. The subjects were 25 cases (mean age: 19 y 8 m) who had been treated with Edgewise technique involving first-premolar extraction. During orthodontic treatment, decreases in the maxillary and mandibular incisors' irregularity index (Max.I.I. and Mand.I.I.), posterior movement of the upper and lower incisors, increases in upper incisal height, decreases in lower incisal height, and increases in upper and lower canine width were noted. In the posttreatment period, increases in Max.I.I. and Mand.I.I., anterior movement of incisors, increases in incisal height, and decreases in canine width were observed. The amounts of overjet and overbite decreased during the treatment period and increased during the post-treatment period. Multiple regression analysis was useful to deduce which parameters influenced stability of occlusion after orthodontic treatment.

Adult↗