Yassir, Yassir A.;Nabbat, Sarah A.;McIntyre, Grant T.;Bearn, David R.
The korean journal of orthodontics
/
v.52
no.3
/
pp.220-235
/
2022
Objective: To evaluate the available evidence regarding the clinical effectiveness of different types of anchorage devices. Methods: A comprehensive literature search of different electronic databases was conducted for systematic reviews investigating different anchorage methods published up to April 15, 2021. Any ongoing systematic reviews were searched using PROSPERO, and a grey literature search was undertaken using Google Scholar and OpenGrey. No language restriction was applied. Screening, quality assessment, and data extraction were performed independently by two authors. Information was categorized and narratively synthesized for the key findings from moderate- and high-quality reviews. Results: Fourteen systematic reviews were included (11 were of moderate/high quality). Skeletal anchorage with miniscrews was associated with less anchorage loss (and sometimes with anchorage gain). Similarly, skeletal anchorage was more effective in retracting anterior teeth and intruding incisors and molars, resulting in minor vertical skeletal changes and improvements in the soft tissue profile. However, insufficient evidence was obtained for the preference of any anchorage method in terms of the duration of treatment, number of appointments, quality of treatment, patient perception, or adverse effects. The effectiveness of skeletal anchorage can be enhanced when: directly loaded, used in the mandible rather than the maxilla, used buccally rather than palatally, using dual rather than single miniscrews, used for en-masse retraction, and in adults. Conclusions: The level of evidence regarding anchorage effectiveness is moderate. Nevertheless, compared to conventional anchorage, skeletal anchorage can be used with more anchorage preservation. Further high-quality randomized clinical trials are required to confirm these findings.
Objective: We aimed to compare the retention characteristics of Essix and Hawley retainers. Methods: Adolescents undergoing fixed appliance treatment at 2 centers were recruited for this study. Twenty-two patients (16 women and 6 men) wore Essix retainers (Essix group) while 20 (14 women and 6 men) wore Hawley retainers (Hawley group). The mean retention time was 1 year, and the mean follow-up recall time for both groups was 2 years. Two qualified dental examiners evaluated the blind patient data. Maxillary and mandibular dental casts and lateral cephalograms were analyzed at 4 stages: pretreatment (T1), post-treatment (T2), post-retention (T3), and follow-up (T4). Results: The results revealed that Essix appliances were more efficient in retaining the anterior teeth in the mandible during a 1-year retention period. The irregularity index increased in both arches in both groups after a 2-year post-retention period. The mandibular arch lengths increased during treatment and tended to return to their original value after retention in both groups; however, these changes were statistically significant only in the Hawley group. Cephalometric variables did not show any significant differences. Conclusions: The retention characteristics of both Essix and Hawley retainers are similar.
The movement of teeth during orthodontic treatment requires bone remodeling process in periodontal tissue. To find out the changes occuring in the cell itself, mechanical force was applied to the cultured periodontal ligament cells. Following results were obtained from measuring the changes in cyclic AMP and $PGE_2$, $^3H$-thymidine incorporation amount in time lapse after application of mechanical force. 1. When mechanical force was applied to cultured PDL cells, the amount of cAMP in cells were increased significantly after 15 min. of force application, but were decreased gradually as time lapsed. 2. When mechanical force was applied to cultured PDL cells, the amount of PGE2 were increased at 20,40,60 min. and was significantly increased at 20 min. 3. When mechanical force was applied to cultured PDL cells, the amount of $^3H$-thymidine incorporation was some increased, but was not statistically significant.
The purpose of this study was to evaluate the morphological changes of olveolar bone and mandibular symphysis of lower incisor by presurgical orthodontic treatment and orthognathic surgery in skeletal class III malocclusion. The sample consisted of 30 adult class III malocclusion patients who have received bilateral sagittal split mandibular osteotomy. Lateral cephalograms were taken before treatment, after presurgical orthodontic treatment and 3 months after orthognathic surgery. Skeletal and symphyseal measurements were compared and the relationships between them were analysed. The results were as follow : 1. The labial and lingual alveolar bone height in presurgical and postsurgical group were decreased than that of pretreatment group. 2. The vertical measurements of the craniofacial skeleton showed reverse correlationship with anteroposterior width of basal alveolar bone, but IMPA showed correlatiionship (p<0.01) 3. The craniofacial skeleton and the change of symphyseal measurements(symphyseal length, symphyseal width) showed no correlationship. 4. The labial alveolar bone height showed correlationship with lingual alveolar bone height(p<0.001), and negative correlationship with lingual alveolar crestal width(p<0.01). Labial and lingual alveolar crestal width has negative correlationship (p<0.05). Mandibular symphyseal length and width has positive correlationship(p<0.01). 5. IMPA, LISA showed negative correlationship with labiolingual alveolar bone height and lingual alveolar width and positive correlationship with labial alveolar base bone width.
There are varieties of severe malocclusions, which can be treated orthodontically, but with a great deal of effort. Anterior openbite, in particular, is one malocclusion thought to be more difficult to treat, and therefore, most of them have to be corrected by means of surgical intervention. To solve these problems, numerous studies pertinent to treatment modalities have been introduced with controversies on the effectiveness of treatment. Suggested treatment modalities for anterior openbite are based directly or indirectly on the neuromuscular and morphological features and on the etiologic and/or the environmental factors. Even though the vertical relationship of the face is increased due to the growth variation, the normal occlusal relationship can be achieved by the adequate dentoalveolar compensatory mechanism, but in the case of inadequate or negative dentoalveolar compensation, openbite is likely to be present. If the skeletal dysplasia is too severe to be solved by orthodontic treatment alone, combined treatment with surgery should be done to restore the function and the esthetics of the orofacial complex. In many cases, however, orthodontic alteration of the dentition pertinent to the given skeletal pattern with the proper diagnosis and treatment planning can bring satisfactory results. The treatment changes with the Multiloop Edgewise Archwire(MEAW) therapy occurred mainly in the dentoalveolar region and showed a considerable similarity to the natural dentoalveolar compensatory mechanism. In other words, the MEAW technique allows orthodontists to produce the natural dentoalveolar compensation orthodontically. Even if an openbite is corrected by the orthodontic dentoalveolar compensation suitable for the skeletal pattern, relapse may still occur by the persisting etiologic factors which originally prohibited the natural dentoalveolar compensation. The etiologic factors should be determined at the time of initial diagnosis and should be controlled during treatment and retention.
Bone remodeling is a complex process regulated by various mediators. Cytokines are known to be associated with the mechanically induced response in orthodontic tooth movement. In particular, IL-$1\beta$ stimulates bone resorption and induces osteoclast proliferation. The purpose of this study was to identify and quantify IL-$1\beta$ in human gingival crevicular fluid(GCF), and to investigate the changes in its level during orthodontic tooth movement. Twelve patients(mean age of 19.2 years) were used as the subjects. An upper canine of each patient haying treatment lot distal movements served as the experimental tooth, whereas the contralateral was used as the control. The GCF of compression and tension side of the experimental teeth and the GCF of mesial side of control teeth was taken from the each subject immediately before activation, and at 1, 24, and 168 hr after initiation tooth movement. IL-$1\beta$ amount was detected by ELISA. The concentration of IL-$1\beta$ was higher in experimental group than in the control group after treatment. Its level was elevated after initiation of tooth movement and it was the highest level at 24 hr in compression side of experimental group. But there was no significant change in control group. The results indicate that the change in IL-$1\beta$ level in GCF is associated with orthodontic tooth movement.
Objective: This study was performed to evaluate functional changes of occlusion after orthodontic treatment by measuring the occlusal force (OcFr) and occlusal contact area (OcAr), and to compare OcFr and OcAr change according to premolar extractions. Methods: Data were obtained from 74 patients who had finished orthodontic treatment using fixed appliance aged between 18 and 40 years. Subjects were divided into groups who had four premolars extractions or non-extraction (Male extraction-16, Male nonextraction-18, Female extraction-19, Female nonextraction-21). All subjects were asked to bite pressure-sensitive sheets into maximum intercuspation with maximum bite force, and OcFr and OcAr were evaluated by measuring the sheet with a CCD camera. Records were taken right after debonding, 1 week, 1 month, 3 months, 6 months and 1 year after debonding. Results: OcFr and OcAr increased gradually in all groups during the 1 year retention period (p < 0.05). Male groups showed higher OcFr and OcAr than female groups throughout the retention periods (p < 0.05). There were no statistically significant differences of OcFr and OcAr between extraction and non-extraction groups in both males and females (p > 0.05). Conclusions: Occlusion was improved functionally throughout the 1 year retention, and premolar extraction did not induce a decline in the functional aspect of occlusion.
Objective: This study compared soft tissue changes after extraction of the four premolars followed by maximum retraction of the anterior teeth according to the type of anterior teeth movement: tipping and translation. Methods: Patients who had undergone orthodontic treatment involving the extraction of four premolars were retrospectively selected and divided into either the tipping (n = 27) or translation (n = 26) groups based on the retraction of the incisor root apex and the axis changes of the incisors during the treatment period. Lateral pre- and post-treatment cephalograms were analyzed. Results: There were no significant differences between the tipping and translation groups before treatment. The retraction amounts of the root apex of the upper and lower incisors in the tipping group were 0.33 and 0.26 mm, respectively, and 5.02 and 5.31 mm, respectively, in the translation group (p < 0.001). The posterior movements of soft tissue points A and B in the tipping group were 0.61 and 1.25 mm, respectively, and 1.10 and 3.25 mm, respectively, in the translation group (p < 0.01). The mentolabial sulcus angle increased by 5.89° in the tipping group, whereas it decreased by 8.13° in the translation group (p < 0.001). Conclusions: An increased amount of retraction of the incisor root apex led to the increased posterior movement of soft tissue points A and B, and this appeared more distinct in cases involving the lower incisor and lower lip.
Objective: Soft tissue changes due to orthodontic treatment has large individual variation. Therefore continuous evaluation during treatment is required. Patients with fixed orthodontic appliances often wonder if their lip positions will change after the removal of brackets, but only a few studies exist on this topic. The objective of this study was to evaluate the changes of the lips and perioral soft tissue after bracket removal. Methods: The sample used in this study was 19 males and 33 females. Cephalometric X-rays were taken at 3 stages - T1 (before debonding), T2 (just after debonding), T3 (1.5 months after debonding). Results: The lower lip was retruded immediately after debonding (T2-T1), and 1.5 months after debonding (T3-T2). The mean amounts of retrusion from the vertical reference plane (sG perpendicular line) were about 0.38 mm for the upper lip and 0.88 mm for the lower lip. Immediately after debonding, lip retrusion of females was greater than that of males. During the post-debonding period, lower lip of males was retruded more than that of females. Conclusion: Lips are retruded after bracket removal, and there is no gender difference 1.5 months after debonding.
Heat treatment which removes internal stress enhances the mechanical properties of the orthodontic arch wire. The main purpose of this experiment was to investigate the effects of the heat treatment on the mechanical properties of the Elgiloy wire. The Elfiloy wire, 0.016' X 0.022' and 0.018' X 0.025', were heat treated in an electric oven for 5, 10 and 15 minutes at selected temperatures between 300 and $900^{\circ}C$. Tensile strength and load deflection rate were measured to reveal the changes of mechanical property at various conditions, and each specimen was observed under metallurgic microscope. Also to trace the precipitation material due to overheat treatment, a qualitative analysis was carried out with EDS system. It was found that heat treatment at a low temperature caused an increase in the tensile strength and bending resistance, and a maintenance in the fibrous in the tensile strength and bending resistance, and a maintenance in the fibrous structure of both sizes of wire. The changes observed in properties and appearance were probably due to the relief of internal stresses incurred in the metal during cold working. In both sizes of wire the tensile strength and the bending resistance continued to decrease at high temperature, and the fibrous structure continued to disappear then was not observed at $900^{\circ}C$. The carbide precipitation founded in grain boundary at $750^{\circ}C$ probably was other elements carbide (Ni, Co) except Cr. The grain growth was observed at $1100^{\circ}C$. Optimum heat treatment for the 0.016' X 0.022' Elgiloy wire was 10 minutes at $500^{\circ}C$, and for the 0.018' X 0.025' Elgiloy wire it was 5 to 15 minutes at $500^{\circ}C$.
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