Safe orthodontic bonding for children with disabilities during general anaesthesia.
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General anaesthesia (GA) may be employed to overcome management difficulties in the orthodontic treatment of disabled children. This report introduces the application of a rubber dam as a useful aid for a high quality bonding and as an effective safeguard in bonding of brackets in general anaesthesia, in the handicapped in particular. GA was used in 12 patients, of a cohort of 49 disabled patients, to facilitate the placing of the fixed appliance. The first seven were bonded solely with the use of an oropharyngeal pack and a high velocity suction to prevent aspiration, and the last five additionally underwent placement of a rubber dam. The use of a rubber dam to facilitate the safe and reliable bonding of orthodontic brackets in handicapped children under general anaesthesia is highly recommended. (+info)
Effects of a three-dimensional bimetric maxillary distalizing arch.
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This study aimed to investigate the dental effects of a three-dimensional (3D) bimetric maxillary distalizing arch. The Wilson rapid molar distalization appliance for Class II molar correction was used in 14 patients (10 girls and four boys with a mean age of 12.18 years). The open coil springs were activated with bent Omega stops and Class II intermaxillary elastics. The mandibular anchorage was gained by a 0.016 x 0.016 utility arch with a 3D lingual arch or a lip bumper with a standard lingual arch. The lateral cephalograms taken before and after treatment formed the material of the research. A Wilcoxon test was used to statistically evaluate the treatment effects. The results showed that the distal tipping of the maxillary first and second molars, and first and second premolars and canines were statistically significant. Significant distal movement occurred in all posterior and canine teeth. The maxillary first molar distalization was found to be 3.5 mm. The maxillary incisor showed significant proclination and protrusion. The decrease in overbite was found to be statistically significant. The mandibular plane angle significantly increased by a mean of 0.5 mm. In addition, significant soft tissue changes were observed. (+info)
Functional and social discomfort during orthodontic treatment--effects on compliance and prediction of patients' adaptation by personality variables.
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During the course of treatment orthodontic patients frequently endure a number of functional complaints and are anxious about their appearance. The aims of this longitudinal study were to follow the progress of patients' adaptation to discomfort, to elucidate the putative relationship between the type of appliance worn and functional and social discomfort experienced, to study potential predictability by their attitude to treatment and to evaluate the effects of discomfort as predictors of patients' compliance. Eighty-four patients undergoing either removable, functional, or fixed appliance treatment monitored their complaints during the first 7 days of treatment and rated them retrospectively 14 days, and 3 and 6 months after appliance insertion. The most frequent complaints were impaired speech, impaired swallowing, feeling of oral constraint and lack of confidence in public. A significant reduction in the number of complaints was observed between 2 and 7 days after insertion of the appliance. No further differences were revealed after longer periods of appliance wear. The type of appliance had an effect on impaired speech and swallowing. Patients' expectations of favourable treatment performance and appreciation of dental aesthetics were predictive of reported feeling of oral constraint and lack of confidence in public. There was a relationship between the complaints and acceptance of the appliance, as well as between lack of confidence in public and compliance with treatment. The results of this study highlight the importance of patients' attitudes to treatment and of functional and social discomfort associated with appliance wear for the theory and practice of the management of orthodontic patients, and the necessity for early intervention by clinicians. (+info)
A prospective controlled clinical trial was undertaken to evaluate the effectiveness of stannous fluoride-releasing elastomeric modules (Fluor-I-Ties) and chain (Fluor-I-Chain) in the prevention of enamel decalcification during fixed appliance therapy. Forty-nine patients (782 teeth) were included in the experimental group, where the fluoride-releasing elastomerics were used. Forty-five patients (740 teeth) who received non fluoride-releasing elastomerics formed the control group. All patients had their elastomerics replaced at each visit. Enamel decalcification incidence and distribution were recorded using an index by direct clinical observation. In the control group enamel decalcification occurred in 73 per cent of patients and in 26 per cent of all teeth. In the experimental group the corresponding incidence was 63 and 16 per cent, respectively. The overall reduction in score per tooth produced by the fluoride-releasing elastomerics was 49 per cent, a highly significant difference (P < 0.001). A significant difference was seen in all but the occlusal enamel zones. The majority (over 50 per cent) of lesions occurred gingivally. The teeth most severely affected were the maxillary lateral incisors and mandibular second premolars. There was no difference in treatment duration between groups. (+info)
Class II combination therapy (distal jet and Jasper Jumpers): a case report.
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Class II combination therapy is a method that combines orthodontic and orthopedic mechanics in a single stage of treatment. Molar distalization is followed by fixed functional mechanics to reduce the dependence upon patient compliance while seeking more predictable completion of Class II correction. (+info)
Class II correction-reducing patient compliance: a review of the available techniques.
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The correction of Class II malocclusions has been hampered by the use of appliances which require the patient to co-operate with headgear, elastics, or the wearing of a removable appliance. 'Non-compliance therapy' involves the use of appliances which minimize the need for such co-operation and attempt to maximize the predictability of results. This article reviews and describes the types of appliances used, and their mode of action-based on the current available research. (+info)
A survey of the delegation of orthodontic tasks and the training of chairside support staff in 22 European countries.
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This paper reports on a survey which was undertaken to investigate the delegation of orthodontic tasks and the training of chairside support staff in Europe. Two questionnaires were posted to all members of the EURO-QUAL BIOMED II project together with an explanatory letter. The first dealt with the delegation of nine clinical tasks during orthodontic treatment. The second with the types of chairside assistant employed in each country and the training that they are given. Completed questionnaires, which were subsequently validated, were returned by orthodontists from 22 countries. They indicated that there was no delegation of clinical tasks in six of the 22 countries and delegation of all nine tasks in five countries. The most commonly delegated tasks were taking radiographs (in 14 of the 22 countries) and taking impressions (in 13 of the 22 countries). The least commonly delegated tasks were cementing bands (in five of the 22 countries) and trying on bands (in six of the 22 countries). Seven of the 22 countries provided chairside assistants with training in some clinical orthodontic tasks. Eighteen of the 22 countries provided general training for chairside assistants and offered a qualification for chairside assistants. Four of these 18 countries reported that they only employed qualified chairside assistants. Of the four countries which reported that they did not provide a qualification for chairside assistants, two indicated that they employed chairside assistants with no formal training and two that they did not employ chairside assistants. It was concluded that there were wide variations within Europe as far as the training and employment of chairside assistants, with or without formal qualifications, and in the delegation of clinical orthodontic tasks to auxiliaries was concerned. (+info)
Hazards of orthodontics appliances and the oropharynx.
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Occasionally orthodontic appliances or parts of orthodontic appliances have caused problems with either the airway or the gastrointestinal tract. The type of appliances that have caused problems and their clinical management are discussed. A case is described in which an upper removable appliance with inadequate retention became lodged in a patient's pharynx lacerating the palatine tonsils. Suggestions are made to try and avoid the problems that were encountered in this case and others reported in the literature in patients undergoing orthodontic treatment. (+info)