Ingested foreign bodies associated with orthodontic treatment: report of three cases and review of ingestion/aspiration incident management.
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Foreign body ingestion/aspiration episodes are potential complications in all branches of dentistry. The handling of small orthodontic components requires particular care, especially where the patient is supine or semi-recumbent. Three cases of foreign body ingestion are presented, involving patients undergoing orthodontic treatment. Once the foreign bodies had been located, all instances were treated using a combination of serial radiography and 'watchful waiting'. All patients remained asymptomatic during this period, although none of the foreign bodies were retrieved. No active intervention was deemed necessary, and the patients were able to resume their orthodontic treatment. The potential complications of ingestion/aspiration episodes are discussed and a management regime suggested. (+info)
A model for evaluating friction during orthodontic tooth movement.
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Orthodontic forces for sliding tooth movement during space closure are applied at a distance from the centre of resistance of the teeth. For this reason, the teeth will tip until contacts are established between the archwire and diagonally opposite corners of the bracket wings. They will also rotate until the wire contacts opposite corners of the ligature tie or the buccal shield with self-ligating brackets, and the base of the slot. Frictional forces measured with models that do not enable such movements may therefore not be representative of the clinical condition. To test this hypothesis, a dentoalveolar model that allowed accurate reproduction of the width of a material of similar elastic properties as the periodontal ligament (PDL) was fabricated. In addition, a device was designed that allowed accurate adjustment of the bracket slot in all three planes of space during mounting of the model in an Instron machine. Frictional forces during sliding of ceramic brackets with 0.022 x 0.028-inch bracket slots along 0.019 x 0.025-inch stainless steel wires were tested using models with simulated PDL widths of 0.00, 0.33, 0.67, and 1.00 mm. ANOVA detected a significant effect of PDL width on mean frictional force (P < 0.001). Pairwise comparisons at 0.05 significance level indicated no differences between the models without PDL and those with a width of 0.33 mm, and between models with PDL widths of 0.67 and 1.00 mm. However, the two models with smaller widths produced significantly lower frictional forces. (+info)
A clinical investigation into the behaviour of crimpable archwire hooks.
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The objective of this study was to measure the force applied to attach crimpable hooks securely to rectangular stainless steel archwires, both inside and outside the mouth. A specially designed strain gauge was utilized to measure the force applied by each operator. In vitro testing of the attached hooks was carried out using an Instron Universal Testing Machine. Two operators crimped a total of 80 TP Orthodontic crimpable hooks to 0.019 x 0.025-inch stainless steel archwires. For one operator there was a significant difference between the intra- and extra-oral forces used to produce firmly attached crimpable hooks (P = 0.03). However, in vitro testing demonstrated no statistically significant difference between the force levels required to displace the crimped hooks for either operator. The clinical significance of these findings is also discussed. Better reliability of crimpable hooks may be achieved by placing them out of the mouth. (+info)
Hard palate deformation in an animal model following quasi-static loading to stimulate that of orthodontic anchorage implants.
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The aim of the present investigation was to identify adequate implant treatment for young patients. In an animal model palate deformation was investigated by acute quasi-static loading. Three series of tests (with newborn, young and adult pigs) were performed, each with two groups (one or two-point stress) and 5-7 animals per group. Discs with a diameter of 3 and 5 mm were placed in group 1 in the suture area, and in group 2 at both the right and left sides of the suture. Deformation was analysed by a computerized three-dimensional (3D) photo-imaging evaluation system. In young animals the one-point load at a significantly lower force level led to fractures in comparison with the two-point load (P < 0.001). Similar results were measured by an increase in the size of one disc from 3 to 5 mm (P < 0.001). In contrast, adult pigs showed stable results with both methods. In general, a larger disc diameter led to less instability. The one-point load seems to be suitable for adult animals, whereas a two-point load might be favourable during ossification. The advantage of the two-point load is the generation of a higher stress and therefore improved control of dental fixation. However, further tests are necessary to investigate the long-term effects. (+info)
The effect of zigzag elastics in the treatment of Class II division 1 malocclusion subjects with hypo- and hyperdivergent growth patterns. A pilot study.
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The aim of this study was to investigate the effect of zigzag elastics in the treatment of Class II division 1 malocclusion subjects with hypo- or hyperdivergent growth patterns. Two groups were established, each consisting of 10 subjects classified as hypo- or hyperdivergent according to their pre-treatment SN-GoGn angle. The cephalometric radiographs taken before and after an elastic application period of approximately 4 months were used to generate 22 variables. In both groups, there were no statistically significant differences in the vertical position of the lower molars, the SN-GoGn angle or the inclination of the lower incisors, whereas the sagittal skeletal relationship was improved as a result of an increase in the SNB angle and the mandibular length (P < 0.01). Upper incisor extrusion was statistically significant in both groups (P < 0.05). The downward rotation of the occlusal plane and the increase in overbite were found to be significant in the hypodivergent group (P < 0.05). Significant differences were observed between the groups in the extrusion of the upper incisor, the inclination of the occlusal plane, and the amount of overbite (P < 0.05). The results show that the zigzag elastic system is preferable, especially in hyperdivergent Class II division 1 subjects, as the use of such elastics does not cause an unfavourable effect on vertical jaw base relationship. (+info)
Enamel colour changes following whitening with 10 per cent carbamide peroxide: a comparison of orthodontically-bonded/debonded and untreated teeth.
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The purpose of this study was to determine if a colour difference exists between teeth that had orthodontic appliances bonded to and debonded from them and untreated controls subjected to whitening with 10 per cent carbamide peroxide. The sample consisted of 20 pairs of first and second premolars extracted for orthodontic reasons. The contralateral surfaces were divided into an experimental and control group. The experimental group underwent orthodontic bonding/debonding procedures. Both groups were subjected to 4 hour whitening and 20 hour hydration sessions for 30 days. The L*a*b* colour system was chosen to evaluate any colour change and these changes were calculated by determining the delta E from the L*a*b* values using a colorimeter. Colour change readings were taken before and after each 4 hour whitening. Additional readings were taken at 48 hour intervals for 30 days following the cessation of active whitening. The results were analysed using statistical (ANOVA) and graphical analyses (alpha = 0.05). A colour change difference of 2 CIELAB units was set as being clinically significant. A mean clinical colour difference was found for enamel surfaces subjected to orthodontic bonding/debonding of attachments relative to control sites after whitening. Bonding and debonding procedures resulted in a significant colour difference between orthodontic bonded and control sites at the end of the active period, which became insignificant at the end of the 30 day period of monitoring. Both the control and debonded sites responded to whitening; however, the control sites responded initially to a greater extent; the orthodontic debonded sites did not respond until after 2 weeks of continuous whitening. After the 2 week period the improved response of the debonded sites decreased the colour difference between the two groups. (+info)
The Nd-YAG laser is useful in prevention of dental caries during orthodontic treatment.
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Plaque control during the course of orthodontic treatment is not an easy task, and dental caries are not an unlikely complication. We examined the possibility of controlling dental caries with Nd-YAG laser irradiation in orthodontic patients. As a preliminary experiment, we used the Nd-YAG laser to irradiate an extracted tooth and then left it to soak in lactic acid. The decay of the tooth was evaluated with a scanning electron microscope (SEM); tooth decay was inhibited by the action of the laser. Twenty patients undergoing orthodontic treatment for early decalcification of the teeth (white spot lesions) were selected, and photographs were taken of their oral cavities. White spot lesions on the four incisors and two canines of the maxilla were traced on tracing paper, and their areas were calculated by computer. Ten of the patients received laser treatment and acidulated phosphate fluoride solution (APF); the other ten acted as the control group. Between 11 and 12 months later, we photographed the oral cavity as we had previously; the white spot lesions were again traced and their areas calculated. The changes in the areas of the white spots of the laser-irradiated and control groups showed the following increases: laser-irradiated group, 1.41 times; controls, 2.87 times. The difference was statistically significant. These results demonstrate that Nd-YAG laser irradiation with application of APF acts as an effective method of caries control during orthodontic treatment. (+info)
Maxillary unilateral molar distalization with sliding mechanics: a preliminary investigation.
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Fifteen patients, eight males and seven females with a mean age of 13.32 years, were selected for unilateral molar distalization. Dentally, all presented with a unilateral Class II molar relationship. The subjects were all in the permanent dentition with second molars erupted and with a well aligned lower dental arch. For maxillary molar distalization a new intra-oral appliance was developed, the Keles Slider, which comprised two premolar and two molar bands. The anchorage unit was a Nance button with an anterior bite plane. From the palatal side, the point of distal force application was carried towards the level of centre of resistance of the maxillary first molar. A Ni-Ti coil spring was used and 200 g distal force was applied to the Class II first molar. Lateral cephalograms were taken and analysed before and 2 months after molar distalization. The Class II molars were distalized bodily, on average, 4.9 mm (P < 0.001). Mesial migration of the Class II first premolars was 1.3 mm (P < 0.05), incisor protrusion was 1.8 mm (P < 0.05) and incisor proclination 3.2 degrees (P < 0.05). The overbite was reduced by 3.1 mm (P < 0.001) and the overjet increased 2.1 mm (P < 0.01). For stabilization, the corrected Class II unilateral molar relationship was maintained with a Nance button for 2 months. The results show that this newly developed device achieved bodily distal molar movement with minimum anchorage loss. (+info)