scispace - formally typeset
Search or ask a question

Showing papers in "European Journal of Orthodontics in 2006"


Journal ArticleDOI
TL;DR: In this paper, the authors developed a psychometric instrument for assessment of orthodontic-specific aspects of quality of life (QoL) using the PIDAQ (Psychosocial Impact of Dental Aesthetics Questionnaire).
Abstract: The aim of this study was to develop a psychometric instrument for assessment of orthodontic-specific aspects of quality of life The study subjects, 194 young adults aged 18-30 years, were interviewed using a pool of 23 items dealing with the psychosocial impact of dental aesthetics Self- and interviewer-rating of the dental aesthetic appearance of each subject were carried out using the Aesthetic Component (AC) of the Index of Orthodontic Treatment Need (IOTN) Additionally, the Perception of Occlusion Scale and a modification of the Dental Aesthetic Index (DAI) were applied Factorial analyses identified four measures within the item pool, namely Dental Self-Confidence, Social Impact, Psychological Impact, and Aesthetic Concern The factor structure was confirmed in an independent sample of 83 subjects aged 18-33 years The reliabilities of the factor analysis-derived scales were between alpha (alpha) 085 and 091 They differed between respondents with varying severity of malocclusion, as assessed by subject and interviewer ratings The results suggest that the proposed instrument, termed the 'Psychosocial Impact of Dental Aesthetics Questionnaire' (PIDAQ), meets the criteria of factorial stability across samples and criterion-related validity and reliability, and might be a promising tool for further research and clinical application in orthodontics

199 citations


Journal ArticleDOI
TL;DR: A number of dentofacial variables and airway space in children suffering from obstructive sleep apnoea (OSA) syndrome with the corresponding variables in control children exhibiting a normal breathing pattern were compared to study the development of these variables prospectively over a 5-year-period following treatment for OSA.
Abstract: The aim of this study was to compare a number of dentofacial variables and airway space in children suffering from obstructive sleep apnoea (OSA) syndrome with the corresponding variables in control children exhibiting a normal breathing pattern, to study the development of these variables prospectively over a 5-year-period following treatment for OSA, and to compare the recorded changes with the corresponding changes occurring in the controls. The subjects were 17 children (10 boys and 7 girls, mean age 5.6 years) diagnosed with OSA syndrome. The treatment for the OSA was adeno-/tonsillectomy. The control group comprised 17 age- and gender-matched children (mean age 5.8 years) without breathing problems. Lateral cephalograms were taken of the OSA children at baseline and then at 1, 3, and 5 years post-treatment. The control records comprised registrations at baseline and then after 1 and 5 years. In comparison with the controls, the OSA children exhibited a more posteriorly inclined mandible (P < 0.05), a more anteriorly inclined maxilla (P < 0.001), a greater lower anterior face height (P < 0.01), a shorter anterior cranial base (P < 0.01), retroclined upper and lower incisors (P < 0.05 and P < 0.01, respectively), reduced airway space (P < 0.05 and P < 0.01), and a less pronounced nose (P < 0.05). At 5 years post-treatment, there were no statistically significant differences between the groups except for the lengths of the anterior cranial base and the nose which were still shorter (P < 0.05) in the patient group. OSA in young children has an unfavourable effect on the development of several dental and facial components. However, if OSA is diagnosed and treated at an early age, an almost complete normalization of dentofacial morphology may be achieved.

168 citations


Journal ArticleDOI
TL;DR: The malocclusion status of French schoolchildren was lower than that recorded in epidemiological studies of European children, and the dental health component (DHC) of the IOTN was found to be reliable and simple to use.
Abstract: This survey was undertaken to assess the orthodontic treatment need in a sample of 9- to 12-year-old French children (mean age: 9.77 years; standard deviation: 0.84) attending 12 different schools in the same geographic area of Ile de France. Two examiners used the Index of Orthodontic Treatment Need (IOTN) in order to estimate treatment need. Five hundred and eleven children (268 males, 243 females) who had not previously received orthodontic treatment were examined. Two examiners, who had been previously trained in the use of occlusal indices, screened all the schoolchildren. No radiographs, study casts, or previously written records of the children were used; the IOTN was calculated from direct examination. Qualitative data were analysed using the chi-square test to determine differences in treatment need between subgroups of subjects, and kappa("kappa") statistics to analyse the findings. A correlation coefficient was used to compare professional assessments. Twenty-one per cent of the children presented an objective need for orthodontic treatment, 28 per cent had crowding, 28 per cent an increased overjet, and 15 per cent an increased overbite. The dental health component (DHC) of the IOTN was found to be reliable and simple to use. The malocclusion status of French schoolchildren was lower than that recorded in epidemiological studies of European children.

123 citations


Journal ArticleDOI
TL;DR: It is suggested that landmarks showing poor reproducibility for both inter- and intraoperator data should be avoided, if at all possible, or at least used with caution.
Abstract: This study evaluated the reproducibility of 24 soft tissue landmarks on six three-dimensional (3D) facial scans. The scans were taken on a DSP400 facial scanner and were viewed using a customized software program. Intraoperator data were obtained by one researcher placing the 24 landmarks on all six scans a total of 30 times. Thirty different orthodontists of varying experience were then asked to place all 24 landmarks on each of the six facial scans in order to establish interoperator reproducibility. The standard deviations (SDs) from the mean were calculated from the data for each individual landmark in the x-, y-, and z-axes. For the intraoperator data, 12 of the 24 landmarks were found to be reproducible to within a 1 mm SD for each plane of space. The interoperator data showed lower reproducibility with just two landmarks showing less than a 1 mm SD in all three planes of space. Familiarity with 3D facial scans and associated software programs is important in improving reproducibility. In addition, the landmarks investigated in this study included those not often used. It is suggested that landmarks showing poor reproducibility for both inter- and intraoperator data should be avoided, if at all possible, or at least used with caution.

114 citations


Journal ArticleDOI
TL;DR: A mutifactorial aetiology to this disorder is suggested, with both genetic and environmental factors playing an important role.
Abstract: A sample of 85 dental transpositions in 75 subjects (27 male, 48 female; mean age at diagnosis 12.25 years) involving both maxillary and mandibular arches was analysed using dental panoramic radiographs and clinical records. Transposition affected the maxillary dentition (76 per cent) more frequently than the mandibular dentition (24 per cent). Unilateral transposition accounted for 88 per cent of cases, with the maxilla being involved more commonly than the mandible. Overall, the most common transposition involved the maxillary canine and first premolar (58 per cent). Considering the jaws in isolation, the canine and first premolar were the most commonly affected teeth in the maxilla (83 per cent) whilst in the mandible, the canine and lateral incisor teeth were most commonly transposed (73 per cent). No significant difference in symmetrical distribution of the unilateral transposition sample occurred. There was evidence of associated hypodontia in 41 per cent of the sample; however, if third molars were excluded, this figure decreased to 25 per cent. Peg-shaped maxillary lateral incisors were judged to be present in 27 per cent of subjects, whilst 41 per cent had retained primary teeth; all of these, except one, were primary canines. Overall, the majority of the sample (76 per cent) demonstrated at least one of the dental anomalies under investigation. Multivariate analysis showed associations between unilateral transposition, gender, and the presence of peg-shaped maxillary lateral incisors; whilst bilateral transposition was more closely associated with gender and the presence of retained primary teeth. There was a poor association between both unilateral and bilateral transposition and hypodontia. Together, these results suggest a mutifactorial aetiology to this disorder, with both genetic and environmental factors playing an important role.

110 citations


Journal ArticleDOI
TL;DR: The prevalence of malocclusion in the Hungarian population seems to be comparable with other European communities, and the decayed, missing, and filled teeth (DMFT, DMFS), and the visible plaque indices scores (VPI) of the 340 adolescents with maloc inclusion were significantly higher than those of the adolescents who displayed no anomalies.
Abstract: The aim of this epidemiological study was to assess the prevalence of malocclusion, associated caries experience, and level of oral hygiene in the Hungarian population using the World Health Organisation (WHO) questionnaire designed to assess dentofacial anomalies. A total of 483 adolescents (289 girls, 194 boys), aged 16-18 years, were assessed. Orthodontic anomalies were detected in 70.4 per cent of the sample. Crowding and spacing were observed in 14.3 and 17 per cent, respectively, with the latter being more prevalent in the maxilla than in the mandible (10.4 and 2.9 per cent, respectively). A Class I occlusion was found in 52.8 per cent of the subjects. A half cusp anomaly in the antero-posterior molar relationship was more prevalent than a full cusp anomaly (26.9 and 20.3 per cent, respectively). The decayed, missing, and filled teeth (DMFT), the decayed, missing, and filled surfaces (DMFS), and the visible plaque indices scores (VPI) of the 340 adolescents with malocclusion were significantly higher ( P < 0.05) than those of the adolescents who displayed no anomalies. The prevalence of malocclusion in the Hungarian population seems to be comparable with other European communities.

109 citations


Journal ArticleDOI
TL;DR: The prevalence of a sella turcica bridge in adolescents with dental anomalies is increased, while age and gender do not greatly influence ossification of the ICL.
Abstract: Calcification of the interclinoid ligament (ICL) of the sella turcica, or sella turcica bridging, has been associated with severe craniofacial deviations. Despite no comprehensive study on the sella turcica bridge, a relationship with tooth and eruption disturbances has been reported. In order to investigate whether congenital absence of the second mandibular premolar, or the presence of a palatally displaced canine (PDC), is associated with sella bridging, a retrospective study was performed. Lateral cephalometric radiographs from 20 males and 14 females, aged between 8 and 16 years, with a PDC and second mandibular premolar aplasia were reviewed and compared with a control group. A standardized scoring scale was established to quantify the extent of a sella turcica bridge from each radiograph (no calcification, partially calcified, and completely calcified). The prevalence of complete calcification of the ICL in adolescents with dental anomalies was equal to 17.6 per cent, while an incidence 9.9 per cent was found in the control group. A partially calcified sella turcica was observed in 58.8 per cent of adolescents with dental anomalies compared with 33.7 per cent in the control group. The association between the degree of calcification of the ICL and the presence of dental anomalies in the studied adolescents was statistically significant according to chi-square statistics (P = 0.004). This was confirmed by Fisher's exact test (P = 0.003). According to these findings, the prevalence of a sella turcica bridge in adolescents with dental anomalies is increased, while age and gender do not greatly influence ossification of the ICL. The very early appearance during development of a sella turcica bridge should alert clinicians to possible tooth anomalies in life later.

109 citations


Journal ArticleDOI
TL;DR: It was concluded that the combined use of an AmF/SnF2 toothpaste/mouthrinse had a slightly more inhibitory effect on white spot lesion development, plaque and gingivitis on maxillary anterior teeth during fixed orthodontic treatment compared with NaF.
Abstract: The aim of this study was to examine the effect of combined use of a toothpaste/mouthrinse containing amine fluoride/stannous fluoride (AmF/SnF2; meridol) on the development of white spot lesions, plaque, and gingivitis on maxillary anterior teeth in orthodontic patients. A prospective, randomized, double-blind study with 115 orthodontic patients (42 males and 73 females, average age 14.4 years, drop outs 18) was designed. Group A (50) brushed twice daily with an AmF/SnF2 toothpaste (1400 ppm F) and rinsed every evening with an AmF/SnF2 solution (250 ppm F). Group B (47) brushed twice daily with a sodium fluoride (NaF) toothpaste (1400 ppm F) and rinsed every evening with a NaF solution (250 ppm F). Visible plaque index (VPI), gingival bleeding index (GBI) and white spot lesion index (WSL) were recorded on the six maxillary anterior teeth at bonding and after debonding, and evaluated with t tests. In group A no significant differences between bonding and debonding were recorded for WSL (1.02 +/- 0.08 versus 1.05 +/- 0.13, P = 0.14), VPI (0.10 +/- 0.21 versus 0.12 +/- 0.21, P = 0.66) or GBI (0.13 +/- 0.21 versus 0.16 +/- 0.22, P = 0.47), whereas statistically significant differences were found in group B between bonding and debonding for WSL (1.00 +/- 0.02 versus 1.08 +/- 0.17, P = 0.01), VPI (0.06 +/- 0.13 versus 0.17 +/- 0.25, P = 0.01) and GBI (0.06 +/- 0.12 versus 0.16 +/- 0.21, P = 0.01). The increase in lesions on the upper anterior teeth was 4.3 per cent in group A and 7.2 per cent in group B. It was concluded that the combined use of an AmF/SnF2 toothpaste/mouthrinse had a slightly more inhibitory effect on white spot lesion development, plaque and gingivitis on maxillary anterior teeth during fixed orthodontic treatment compared with NaF.

106 citations


Journal ArticleDOI
TL;DR: It is concluded that occlusal indices are not reliable predictors of masticatory performance and traditional descriptors of malocclusion type and severity apparently cannot explain most of the variation in masticatories performance in children and adolescents.
Abstract: SUMMARY It is not fully understood whether masticatory performance is compromised in individuals with the more common forms of malocclusion (i.e. Class I and Class II). The aim of this prospective investigation was to establish the relationships between masticatory performance, malocclusion (type and severity), age, body size and gender, in children and adolescents. A total of 335 individuals were examined at the average ages of 6, 9, 12 and 15 years. Each subject’s occlusal status was described by Angle classifi cation and by the Peer Assessment Ratio (PAR) index. Masticatory performance was quantifi ed by the median particle size (MPS) and the broadness of particle distribution using artifi cial food. Masticatory performance improved signifi cantly with age. The 6-year-old children were less able to break down the food particles (MPS 4.20 mm 2 ) than the 15 year olds (MPS 3.24 mm 2 ). Analysis of covariance showed that age differences in performance are related to an increase in body size. There were statistically signifi cant differences in masticatory performance between children with normal occlusion and those with a Class I malocclusion; no differences were found between normal occlusion and Class II malocclusion. Gender differences did not explain the variation in masticatory performance. It is concluded that occlusal indices are not reliable predictors of masticatory performance. Traditional descriptors of malocclusion type and severity apparently cannot explain most of the variation in masticatory performance in children and adolescents.

102 citations


Journal ArticleDOI
TL;DR: On a short-term basis, the Herbst/MB appliance combination was found to be a powerful tool for non-surgical, non-extraction, treatment of Class II division I subjects in early and late adulthood.
Abstract: SUMMARY A prospective study of 23 consecutive adult Class II division 1 malocclusion subjects (19 female and 4 male) treated with the Herbst/multibracket (MB) appliance is presented. The skeletal, dental, and facial profi le changes were evaluated in addition to the mechanism of Class II correction during the Herbst phase and the settling of the occlusion during the MB phase. The mean pre-treatment age of the subjects was 21.9 years (15.7 – 44.4 years). Lateral head fi lms in habitual occlusion from before treatment (T1) and after the Herbst (T2) and MB (T3) phases were analysed using standard cephalometrics and the sagittal occlusion analysis. For the standard cephalometrics, normal growth standards were utilized as control parameters. All patients were treated successfully to a Class I occlusal relationship with a normal overjet and overbite. The mandibular variables (SNB and SNPg) showed an angular increase (1.22 and 0.93 degrees, respectively) during T2 – T1 followed by an angular reduction (0.40 and 0.23 degrees, respectively) during T3 – T2. Compared with normal growth standards, all mandibular parameters were affected favourably by Herbst/MB treatment. Both the skeletal and soft tissue profi le convexities were signifi cantly reduced. Over the entire observation period (T3 – T1), the largest amount of profi le convexity reduction was seen for the soft tissue profi le excluding the nose (mean 3.14 degrees). Class II correction was achieved by both skeletal and dental changes: overjet correction by 13 per cent skeletal and 87 per cent dental changes, and molar correction by 22 per cent skeletal and 78 per cent dental changes. In conclusion, on a short-term basis, the Herbst/MB appliance combination was found to be a powerful tool for non-surgical, non-extraction, treatment of Class II division I subjects in early and late adulthood.

99 citations


Journal ArticleDOI
TL;DR: The increased frequency of hypodontia in affected individuals and common findings of a family history regarding tooth eruption problems suggests a significant genetic component to the aetiology of this rare condition.
Abstract: Primary failure of eruption (PFE) is a poorly understood condition associated with tooth eruption failure. This investigation systematically reviews the literature, evaluates clinical features and associations with PFE, and describes five further cases. Publications were selected and identified as describing PFE when there was no identifiable aetiological factor contributing to eruption failure and no evidence of successful orthodontic extrusion of the affected tooth or teeth. A data abstraction form recorded the following additional information; subject age, gender, general health status, and teeth present. Eighteen publications were sourced that detailed at least one case of PFE in a manner conforming to the selection criteria; these papers included a total of 35 individual cases, to which five previously unreported subjects were added. Within the whole sample of 40 cases, a total of 24 (60 per cent) were females and 16 (40 per cent) males. First and second molar teeth were most commonly affected; incisors, canines, and premolars were also involved, but with a reduced individual frequency. There was no significant difference in incidence between the maxilla and mandible, or between left and right sides. A family history of eruption failure was found in almost 50 per cent of the sample, with eruption failure or ankylosis affecting at least one primary tooth, also a common finding. Within the 40 cases, hypodontia was present at levels higher than population norms. PFE appears to be a condition that predominantly affects the molar dentition. The increased frequency of hypodontia in affected individuals and common findings of a family history regarding tooth eruption problems suggests a significant genetic component to the aetiology of this rare condition.

Journal ArticleDOI
TL;DR: Traditional methods of assessing orthodontic treatment need using mainly clinical measures are inadequate and would be improved by integrating normative, oral health-related quality of life (OHRQoL), and behavioural propensity measures, according to a socio-dental system developed and test in Thailand.
Abstract: Traditional methods of assessing orthodontic treatment need using mainly clinical measures are inadequate and would be improved by integrating normative, oral health-related quality of life (OHRQoL), and behavioural propensity measures. This study aimed to develop and test a socio-dental system of orthodontic needs assessment, and to compare normative and socio-dental estimates of orthodontic need. The socio-dental system integrates three types of need: normative need (NN), impact-related need (IRN) and propensity-related need (PRN). A cross-sectional survey of all 1,126 children aged 11-12 years in Suphanburi, Thailand, was carried out to test the new system. The dental health component of the Index of Orthodontic Treatment Need was used to assess NN, and the simplified oral hygiene index for oral hygiene status. Oral impacts were assessed using the child-Oral Impacts on Daily Performances (child-OIDP) index. A self-administered questionnaire recorded information on demographic and oral health-related behaviour. Treatment needs were assessed according to the developed socio-dental system. The socio-dental approach to assess orthodontic needs was easy to use and readily accepted by the children. The estimates of orthodontic need assessed normatively and socio-dentally differed markedly. The prevalence of NN and IRN was 35.0 and 10.5 percent, respectively, thus representing a reduction of approximately 70 percent in the volume of treatment need according to the new method. Children with IRN had different levels of propensity for orthodontic treatment, and therefore required appropriate treatment plans according to their PRN. Of the 10.5 percent with IRN, 6.9 percent had high or medium-high PRN, while 3.6 percent were at medium-low and low levels of propensity.

Journal ArticleDOI
TL;DR: The number of visits required to reach the working archwire was greater for sequence B than for A (P = 0.012) but this could not be explained by the increased number of archwires used in sequence B.
Abstract: The aim of this study was to compare three orthodontic archwire sequences. One hundred and fifty-four 10- to 17-year-old patients were treated in three centres and randomly allocated to one of three groups: A = 0.016-inch nickel titanium (NiTi), 0.018 x 0.025-inch NiTi, and 0.019 x 0.025-inch stainless steel (SS); B = 0.016-inch NiTi, 0.016-inch SS, 0.020-inch SS, and 0.019 x 0.025-inch SS; and C = 0.016 x 0.022-inch copper (Cu) NiTi, 0.019 x 0.025-inch CuNiTi, and 0.019 x 0.025-inch SS. At each archwire change and for each arch, the patients completed discomfort scores on a seven-point Likert scale at 4 hours, 24 hours, 3 days, and 1 week. Time in days and the number of visits taken to reach a 0.019 x 0.025-inch SS working archwires were calculated. A periapical radiograph of the upper left central incisor was taken at the start of the treatment and after placement of the 0.019 x 0.025-inch SS wire so root resorption could be assessed. There were no statistically significant differences between archwire sequences A, B, or C for patient discomfort (P > 0.05) or root resorption (P = 0.58). The number of visits required to reach the working archwire was greater for sequence B than for A (P = 0.012) but this could not be explained by the increased number of archwires used in sequence B.

Journal ArticleDOI
TL;DR: This retrospective investigation to compare tooth size discrepancies among subjects with different skeletal malocclusions in an orthodontic population revealed that the mean anterior ratio for the whole sample was statistically significantly different from Bolton's but no significant difference was found for the overall ratio.
Abstract: SUMMARY This retrospective investigation was designed to compare tooth size discrepancies among subjects with different skeletal malocclusions in an orthodontic population. The study employed the pretreatment models of 200 patients (100 males, 100 females, aged from 14 to 20 years) selected from the records of the Orthodontic Department, Shiraz Dental School. The subjects were from four malocclusion groups, Class I, Class II division 1, Class II division 2, and Class III, with the corresponding skeletal characteristics. Each group comprised 50 healthy individuals (25 males, 25 females). The mesio-distal dimensions of teeth were measured using digital electronic callipers (accurate to 0.01 mm) and the Bolton indices were determined. The data were statistically analysed using analysis of variance and Duncan’s multiple range test, with the level of signifi cance set at P < 0.05. The results revealed that the mean anterior ratio (79.01) for the whole sample was statistically signifi cantly different from Bolton’s (77.2) but no signifi cant difference was found for the overall ratio. The posterior and overall ratios of the Class III malocclusion group were statistically greater than the other malocclusion groups ( P < 0.05). The mean anterior ratio of the Class III group was greater than that of the Class II group. However, there was no difference when compared with the Class I malocclusion group. For the two types of Class II malocclusion, no signifi cant ratio differences were observed.

Journal ArticleDOI
TL;DR: The results showed that the DBA/2J, BALB/cJ, and 129P3/J inbred mouse strains are highly susceptible to RR, whereas A/J, C57BL/6J and SJL/J mice are much more resistant.
Abstract: Root resorption (RR) is an unwanted sequela of orthodontic treatment. Despite rigorous investigation, no single factor or group of factors that directly causes RR has been identified. The purpose of this study was to examine the effect of the genotype on susceptibility or resistance to develop RR secondary to orthodontic force. Nine-week-old male mice from eight inbred strains were used and randomly distributed into control (C) or treatment (T) groups as follows: A/J (C = 9,T = 9), C57BL/6J (C = 7,T = 8), C3H/HeJ (C = 8,T = 6), BALB/cJ (C = 8,T = 6), 129P3/J (C = 6,T = 8), DBA/2J (C = 8,T = 9), SJL/J (C = 8,T = 10), and AKR/J (C = 9,T = 8). Each of the treated mice received an orthodontic appliance to tip the maxillary left first molar mesially for 9 days. Histological sections of the tooth were used to determine RR and tartrate resistant acid phosphatase (TRAP) activity. The Wilcoxon ranked-sum non-parametric test was used to evaluate differences between the groups. The results showed that the DBA/2J, BALB/cJ, and 129P3/J inbred mouse strains are highly susceptible to RR, whereas A/J, C57BL/6J and SJL/J mice are much more resistant. The variation in the severity of RR associated with orthodontic force among different inbred strains of mice when age, gender, food, housing, and orthodontic force magnitude/duration are controlled support the hypothesis that susceptibility or resistance to RR associated with orthodontic force is a genetically influenced trait.

Journal ArticleDOI
TL;DR: It is demonstrated that limited maxillary widening together with protraction of the maxilla, improve nasopharyngeal but not oropharyngeAL airway dimensions in the short term.
Abstract: The relationship between changes in the position of the maxillary structures caused by maxillary protraction therapy and airway dimensions have not been investigated as comprehensively as the accompanying skeletal changes. The purpose of this study was to examine the effects of rapid palatal expansion (RPE) used in conjunction with maxillary protraction headgear on the sagittal dimension of the airway. The treatment sample consisted of 19 Class III patients (12 girls, 7 boys) with a mean age of 10.51 +/- 1.15 years, presenting with maxillary retrognathism. A cap splint type rapid palatal expander that had hooks between the upper lateral and canine teeth was used intraorally, and a Petit type facemask device extraorally, for an average of 6.78 +/- 0.93 months. Pre- and post-treatment cephalometric radiographs were evaluated. The results of the study revealed that point A moved anteriorly. The palatal plane showed a counter-clockwise rotation matched by the clockwise rotation of the mandible and an accompanying decrease in SNB angle. The vertical parameters showed a statistically significant increase. The head was in a more extensive position in relation to the cervical vertebrae. The nasopharyngeal airway measurements (PNS-ad1, PNS-ad2) showed an increase of 2.71 +/- 3.35 and 3.03 +/- 2.37 mm, respectively. These results demonstrated that limited maxillary widening together with protraction of the maxilla, improve nasopharyngeal but not oropharyngeal airway dimensions in the short term.

Journal ArticleDOI
TL;DR: A significant improvement in the facial profile was shown, which closely followed the underlying dentoskeletal changes, and the most significant effects were a total facial profile improvement, retraction of the upper lip and anterior movement of soft tissue pogonion.
Abstract: SUMMARY The aim of this study was to evaluate changes in the facial profi le resulting from the use of a twin block (TB) functional appliance. The sample comprised 38 patients (24 males and 14 females) with a Class II division 1 malocclusion. Nineteen subjects were treated with a functional appliance while the remaining 19, who did not undergo any intervention, served as the control. The mean age of the treated group was 9.5 years (SD 10 months) and of the control group 9.9 years (SD 13 months). Lateral cephalograms were obtained for all subjects at the initial consultation and again after one year. The changes in facial profi le, resulting from treatment with the TB, were analysed after the infl uence of growth had been taken into account. The results showed a signifi cant improvement in the facial profi le, which closely followed the underlying dentoskeletal changes. Thus, the most signifi cant effects were a total facial profi le improvement, retraction of the upper lip and anterior movement of soft tissue pogonion (P < 0.05). Subjects treated with a TB appliance achieved improved facial harmony, but such changes were not observed in the control group.

Journal ArticleDOI
TL;DR: This in vivo study showed that brackets bonded using Transbond Plus Self-Etching Primer had an increased clinical bond failure rate compared with the conventional, separate, etch and prime system.
Abstract: This clinical trial evaluated, over a 12-month period, the performance of brackets bonded to teeth etched and primed with Transbond™ Plus Self-Etching Primer (SEP) when compared with a conventional separate two-step etch and primer system. Thirty-nine randomly selected patients requiring fixed appliance therapy were entered into the study. Random allocation of each etching system, along with a ‘split-mouth cross-quadrant’ design was used. A total of 661 brackets were placed by two operators. The failure and survival rates of the brackets were determined for age and gender of the patients, each etching system, operator, mode of failure, tooth position in the dental arch, and number of manipulations prior to curing the adhesive. Statistical analysis showed that SEP had a significantly higher bond failure rate (11.2 per cent) than the conventional etch and primer system (3.9 per cent) at the P = 0.001 level. Cox's proportional hazards regression showed the conventional etch and primer system to have a 60 per cent reduced chance of bracket failure over a 12-month observation period, while males had a 2.4 times increased risk compared with females. The predominant mode of failure was at the composite enamel interface for the SEP, while for the conventional etch and primer system, it was within the composite adhesive. No statistically significant differences were found for the failure rate with respect to the age of the patient, operator, tooth location, or the number of manipulations of the bracket. This in vivo study showed that brackets bonded using SEP had an increased clinical bond failure rate compared with the conventional, separate, etch and prime system.

Journal ArticleDOI
TL;DR: The index provides a useful treatment planning aid for the management of impacted maxillary canines and provides a moderate level of agreement between allocated difficulty grade and calculated difficulty scores.
Abstract: The aim of this study was to produce a treatment difficulty index (TDI) for unerupted maxillary canines. Thirty treated cases, each with an unerupted unilateral maxillary canine, were graded by 14 consultant orthodontists in terms of perceived alignment difficulty, and the four main factors which had contributed to each grade were listed in order of importance. The relationship between the grade and the contributory factors was then examined using regression analysis, and weightings were derived. These were applied to each factor, in order to derive a difficulty score total for each case. Linear regression analysis of difficulty scores against consultant grades produced an R2 value of 54.7 per cent using the original equation and an R2 of 52.3 per cent using values rounded to the nearest half. Both indicated a moderate level of agreement between allocated difficulty grade and calculated difficulty scores. The index provides a useful treatment planning aid for the management of impacted maxillary canines.

Journal ArticleDOI
TL;DR: Managing developing Class III malocclusions with RPE and maxillary protraction presents favourable results, such as vertical and sagittal displacement of point A.
Abstract: The aim of this study was to determine the cephalometric changes in subjects with Class III malocclusions after rapid palatal expansion (RPE) and facemask treatment. The 30 subjects presented with developing Class III malocclusions. The treatment group comprised 15 patients (eight girls and seven boys, mean age 11 years 6 months) who had undergone RPE and facemask therapy. The control group consisted of nine girls and six boys with a mean age of 11 years 8 months. Radiographs were take at the same time intervals for both groups, and the average treatment time was 15 months. A Wilcoxon test was used to determine significant differences before and after treatment, and a Mann-Whitney U-test to analyse differences between the treatment and control groups. In the sagittal plane, significant changes were observed in both groups. In the treatment group, the following dimensions increased significantly: A perpendicular to FHp (P < 0.001), ANS-PNS (P < 0.01), 6 perpendicular to FHp (P < 0.05); in the control group Go-Gn (P < 0.05) increased significantly. In the treatment group, SN/Go-Gn and SN/ANS-PNS had higher values and this finding was significant (P < 0.05). Managing developing Class III malocclusions with RPE and maxillary protraction presents favourable results, such as vertical and sagittal displacement of point A.

Journal ArticleDOI
TL;DR: The results showed that, before therapy, the percentage of reverse-sequencing chewing cycles on the crossbite side was significantly higher than that on the normal side (P < 0.001) with both the soft and hard bolus.
Abstract: SUMMARY The aim of this study was to compare the percentage of reverse-sequencing chewing cycles in 22 children [9 boys and 13 girls; mean age ± SD, 8.6 ± 1.3 and 8.8 ± 1.5 years, respectively), with a unilateral right or left posterior crossbite, before and after therapy. The chewing cycles were recorded using a kinesiograph while the subjects masticated a soft and a hard bolus on both the crossbite and non-crossbite side. Chewing data were acquired before and 6 months after orthodontic treatment of the crossbite with an orthodontic functional appliance, the ‘ Function Generating Bite ’ . The results showed that, before therapy, the percentage of reverse-sequencing chewing cycles on the crossbite side was signifi cantly higher than that on the normal side ( P < 0.001) with both the soft and hard bolus. In addition, the percentage of reverse-sequencing chewing cycles on the crossbite side before therapy was signifi cantly greater than after therapy with both a soft and hard bolus ( P < 0.001). No signifi cant differences were found in the percentage of reverse-sequencing chewing cycles on the noncrossbite side, before or after therapy, either with a soft or hard bolus.

Journal ArticleDOI
Shinya Yano1, Mituru Motoyoshi1, Miwa Uemura1, Akiko Ono1, Noriyoshi Shimizu1 
TL;DR: The aim of this study was to investigate the initial stability of tapered orthodontic miniscrews (T-type screws) after placement, the necessity of a healing period, and the propriety of immediate loading, and to suggest that T- type screws can be used for orthmodontic anchorage immediately after placement.
Abstract: The aim of this study was to investigate the initial stability of tapered orthodontic miniscrews (T-type screws) after placement, the necessity of a healing period, and the propriety of immediate loading. Twenty male Wistar rats with a mean age of 20 weeks were divided into two groups. In the immediate-loading groups, straight orthodontic miniscrews (S-type screws) and T-type screws (five rats each) underwent experimental traction force for 2 weeks (W) immediately after placement. In the healing groups (S- and T-type, five rats each), force was applied for 2 W after a 6-W healing period. The right tibia in each rat was identified as the test limb, while the left tibia in each rat was used as the control group, and underwent no experimental force during the experimental period. The screw-to-bone contact was observed histologically and the bone-screw contact ratio was calculated. Scheffe's test was performed to compare the bone-screw contact ratio in each group using statistical software package (SPSS 8.0 for Windows). In the control group, the bone-screw contact ratio improved from 34.8 +/- 16.0 to 74.8 +/- 12.0 per cent with S-type screws in proportion to the experimental period (2 to 8 W, respectively). With the T-type screws in the test group, there was no significant difference between the immediate-loading and healing groups. In the immediate-loading group, the bone-screw contact ratio with T-type screws was significantly greater (82.3 +/- 15.0 per cent) than with the S-type screws (33.3 +/- 11.8 per cent; P < 0.05), suggesting that T-type screws can be used for orthodontic anchorage immediately after placement.

Journal ArticleDOI
TL;DR: This in vitro study showed that the use of a chemically-cured composite resin (Concise) reduced early S. sanguis biofilm formation and fluoride had a greater effect in reducing the PSC by S. SanguisBiofilms.
Abstract: Decalcification is a commonly recognized complication of orthodontic treatment with fixed appliances. A technology, based on a parallel plate flow chamber, was developed to investigate early biofilm formation of a strain of Streptococcus sanguis on the surface of four orthodontic bonding materials: glass ionomer cement (Ketac Cem), resin-modified glass ionomer cement (Fuji Ortho LC), chemically-cured composite resin (Concise) and light-cured composite resin (Transbond XT). S. sanguis was used as it is one of the primary colonizers of dental hard surfaces. Artificial saliva was supplied as a source of nutrients for the biofilms. The effects of two commercially available mouthrinses (i.e. a fluoride containing rinse and chlorhexidine) were evaluated. Initial colonization of the bacterium was assessed after 6 hours of growth by the percentage surface coverage (PSC) of the biofilm on the disc surfaces. There were statistically significant differences in bacterial accumulation between different bonding materials ( P < 0.05), Concise being the least colonized and Transbond XT being the most colonized by S. sanguis biofilms. All materials pre-treated with 0.05 per cent sodium fluoride mouthrinse showed more than 50 per cent reduction in biofilm formation. The 0.2 per cent chlorhexidine gluconate mouthrinse caused significant reduction of biofilm formation on all materials except Ketac Cem. This in vitro study showed that the use of a chemically-cured composite resin (Concise) reduced early S. sanguis biofilm formation. Also, fluoride had a greater effect in reducing the PSC by S. sanguis biofilms than chlorhexidine. Rinsing with 0.05 per cent sodium fluoride prior to placement of orthodontic appliances is effective in reducing early biofilm formation.

Journal ArticleDOI
TL;DR: A significant amount of controversy regarding the soft tissue changes produced by the Activator and the Bionator exists and long-term, double-blinded, prospective randomized clinical trials are needed to confirm the findings.
Abstract: The objective of the present systematic review was to evaluate, through lateral cephalograms, facial soft tissue changes after the use of the Activator and Bionator appliances in Class II division 1 malocclusion subjects. Several electronic databases (PubMed, Medline, Medline In-Process and Other Non-Indexed Citations, Cochrane Database, Embase, Web of Sciences, and Lilacs) were searched with the assistance of a senior health sciences librarian. Abstracts, which appeared to fulfil the initial criteria, were selected by consensus. The original articles were then retrieved. Their references were also hand searched for possible missing articles. Clinical trials, which assessed facial soft tissue changes with the use of either an Activator or a Bionator appliance without any surgical intervention or syndromic characteristics, were considered. A comparable untreated control group was required to factor out normal growth changes. Five articles using the Activator and six using the Bionator fulfilled the selection criteria and quantified facial soft tissue changes. An individual analysis of these articles was undertaken and some methodological flaws were identified. Based on the available evidence, a significant amount of controversy regarding the soft tissue changes produced by the Activator and the Bionator exists. Soft tissue changes that were reported as being statistically significant were of questionable clinical significance. Long-term, double-blinded, prospective randomized clinical trials are needed to confirm the findings. Three-dimensional quantification is also required to overcome current limitations in our understanding of the soft tissue changes obtained with the use of removable functional appliances.

Journal ArticleDOI
TL;DR: The results showed no significant differences in the level of molar eruption or in lower anterior face height, suggesting that the vertical control expected from the chin cup therapy did not occur, and the dentoalveolar changes at the anterior region of the dental arches were mainly responsible for closure of the AOB in patients treated in the mixed dentition.
Abstract: SUMMARY The aim of this prospective randomized clinical study was to cephalometrically investigate the dentoalveolar and soft tissue changes produced by a removable appliance with a palatal crib associated with high-pull chin cup therapy in children with an Angle Class I anterior open bite (AOB) malocclusion. Thirty children (8 males and 22 females) with an initial mean age of 8.3 years and a mean AOB of 4.1 mm were treated with a removable appliance composed of a palatal crib associated with chin cup therapy for 12 months. A control group of 30 individuals (7 males and 23 females) closely matched for age, initial mean age 8.6 years, gender, and ethnicity with a mean AOB of 4.6 mm was followed without treatment. The measurements (means and standard deviations) were statistically analysed using a paired t-test. The results showed no signifi cant differences in the level of molar eruption or in lower anterior face height, suggesting that the vertical control expected from the chin cup therapy did not occur. Dentoalveolar changes at the anterior region were evident, with statistically signifi cant extrusion, retrusion, and lingual tipping of the maxillary and mandibular incisors ( P ≤ 0.05). However, these hard tissue changes did not imply soft tissue changes and the variables related to the soft profi le were not statistically signifi cantly different between the groups. The dentoalveolar changes at the anterior region of the dental arches were mainly responsible for closure of the AOB in patients treated in the mixed dentition.

Journal ArticleDOI
TL;DR: Overall changes during the observation period T3-T1 revealed that correction was mainly due to favourable changes in the mandibular and dentoalveolar components of the discrepancy, while these in maxillary position were not different from the control group.
Abstract: The aim of this study was to examine the dentofacial changes in Class III patients treated with fixed appliances subsequent to rapid maxillary expansion (RME) and facemask therapy. The material consisted of the cephalograms and hand-wrist films of 14 (9 girls, 5 boys) skeletal Class III and 15 (10 girls, 5 boys) untreated subjects obtained at the beginning of treatment/observation T1, immediately after orthopaedic therapy T2, and at the end of the observation period T3. The mean pre-treatment/control ages were approximately 11.5 years and the observation period was 3 years T2-T1: 1 year, T3-T2: 2 years). The cephalometric films were analysed according to the structural superimposition method of Bjork. All tracings were double-digitized and the measurements were calculated by a computer program. Intragroup changes and intergroup differences were statistically analysed. Forward movement of the maxilla (P < 0.01), backward movement and rotation of the mandible, an increase in the ANB angle (P < 0.001), lower face height and overjet (P < 0.001), a decrease of overbite, and an improvement in the sagittal lip relationship (P < 0.01) presented significant intergroup differences between T2 and T1. During the second phase of treatment T3-T2, although not statistically significant, forward movement of the maxilla was less than in the control subjects. Overall changes during the observation period T3-T1 revealed that correction was mainly due to favourable changes in the mandibular and dentoalveolar components of the discrepancy, while these in maxillary position were not different from the control group. The soft tissue profile improved significantly (P < 0.001) in the treatment group. Comparison with the Class I controls at the end of the observation period confirmed that some Class III characteristics still remained in the treated patients.

Journal ArticleDOI
TL;DR: Shear bond strength (SBS) and bond failure types were examined with six surface-conditioning methods: silane application to glazed surface, air particle abrasion with 25- and 50-microm aluminium trioxide (Al(2)O(3)), etching with 9.6 per cent hydrofluoric acid (HFA), and roughening with 40- and 63- microm diamond burs.
Abstract: The aim of this study was to determine the effectiveness of bonding brackets to ceramic restorations. Sixty feldspathic and 60 lithium disilicate ceramic specimens were randomly divided into six groups. Shear bond strength (SBS) and bond failure types were examined with six surface-conditioning methods: silane application to glazed surface, air particle abrasion (APA) with 25- and 50-μm aluminium trioxide (Al2O3), etching with 9.6 per cent hydrofluoric acid (HFA), and roughening with 40- and 63-μm diamond burs. Silane was applied to all roughened surfaces. Metal brackets were bonded with light cure composite, then stored in distilled water for 1 week and thermocycled (×500 at 5-55°C for 30 seconds). The ceramic surfaces were examined with a stereomicroscope at a magnification of ×10 to determine the amount of composite resin remaining using the adhesive remnant index. The lowest SBS values were obtained with HFA for feldspathic (5.39 MPa) and lithium disilicate (11.11 MPa) ceramics; these values were significantly different from those of the other groups. The highest SBS values were found with 63-μm diamond burs for feldspathic (26.38 MPa) and lithium disilicate (28.20 MPa) ceramics, and were not significantly different from 40-μm diamond burs for feldspathic and lithium disilicate ceramics (26.04 and 24.26 MPa, respectively). Roughening with 25- and 50-μm Al2O3 particles showed modest SBS for lithium disilicate (22.60 and 26.15 MPa, respectively) and for feldspathic ceramics (17.90 and 14.66 MPa, respectively). Adhesive failures between the ceramic and composite resin were noted in all groups. Damage to the porcelain surfaces was not observed. The SBS values were above the optimal range, except for feldspathic ceramic treated with HFA and silane. With all surface-conditioning methods, lithium disilicate ceramic displayed higher SBS than feldspathic ceramic.

Journal ArticleDOI
TL;DR: A statistically significant relationship was found between mandibular outline asymmetry and both anteroposterior and vertical skeletal discrepancy in this sample, when compared with patients with an average skeletal pattern.
Abstract: The aim of this study was to investigate the relationship between mandibular outline asymmetry and skeletal discrepancy in a sample of orthodontic patients (33 females, 33 males) aged from 8 to 19 years. Skeletal discrepancy was assessed in both the anteroposterior and vertical planes, using standard cephalometric analyses. All were photographed under standardized conditions and the photographs were then digitized for analysis using a computerized system to assess differences in four variables (area, perimeter, compactness and moment-ratio) between the right and left sides of the mandibular outline. The results showed good repeatability of the photographic, cephalometric and digitization methods. A statistically significant relationship was found between mandibular outline asymmetry and both anteroposterior and vertical skeletal discrepancy in this sample, when compared with patients with an average skeletal pattern. There appeared to be a statistically significant relationship between a reduced ANB angle (< 3 degrees) and mandibular outline asymmetry (P = 0.051), as well as between an increase in lower face height and mandibular asymmetry (P = 0.023).

Journal ArticleDOI
TL;DR: The results of this study suggest an ongoing change in head posture possibly due to a change in the mode of breathing from oral to nasal as a result of RME, thereby contributing to achange in craniofacial development, supporting and adding to the soft tissue stretching hypothesis.
Abstract: SUMMARY Rapid maxillary expansion (RME) has been shown to increase nasal permeability and reduce nasal airway resistance. A number of studies have examined the relationship between RME and the change in airway resistance, or the relationship between airway resistance and natural head position (NHP). Few studies, to date, have examined the relationship between RME and the change in NHP resulting from the consequent change in airway resistance. A sample of 43 adolescent patients with uni- or bilateral crossbite in the permanent dentition underwent RME as part of normal orthodontic treatment. Cephalograms in NHP were taken before, immediately after expansion, and one year after RME. No signifi cant changes in the craniofacial angles were observed immediately after expansion. One year post-expansion, however, NSL/VER had reduced by 3.14 degrees (P < 0.01), OPT/HOR by 2.13 degrees (P < 0.05), and CVT/HOR by 2.55 degrees (P < 0.05). The results of this study suggest an ongoing change in head posture possibly due to a change in the mode of breathing from oral to nasal as a result of RME, thereby contributing to a change in craniofacial development, supporting and adding to the soft tissue stretching hypothesis.

Journal ArticleDOI
TL;DR: The cephalometric results revealed that SNB angle was responsible for the skeletal sagittal difference between the two groups, and the Class II division 1 group had higher vertical proportions and the class II division 2 group a more concave profile with a prominent chin.
Abstract: The aim of this compound cephalometric and arch-width study was to determine any dental and/or skeletal differences between subjects with Class II division 1 and Class II division 2 malocclusions. The dento-skeletal characteristics of Class II subjects were evaluated using lateral cephalometric radiographs and dental casts of 90 untreated patients. The sample included 46 Class II division 1 patients (19 girls and 27 boys) with a mean age of 15.27 ± 2.48 years, and 44 Class II division 2 patients (27 girls and 17 boys) with a mean age of 15.95 ± 3.25 years. The intermolar, interpremolar and intercanine measurements were carried out on study models. The radiographs were digitized and processed using Dolphin Imaging software. In addition to standard descriptive statistical calculations, an independent samples t -test was carried out in order to compare the two groups. The non-parametric Mann–Whitney U test was utilized for the parameters for the data which were not normally distributed. The only statistically significant difference between the groups for the study model measurements was mandibular intercanine width. The cephalometric results revealed that SNB angle was responsible for the skeletal sagittal difference between the two groups. In addition, the Class II division 1 group had higher vertical proportions and the Class II division 2 group a more concave profile with a prominent chin. The sagittal skeletal pattern of Class II division 2 subjects was found to be very similar to the Class I skeletal relationship, with no evidence of any mandibular restriction.