Orthodontic treatment for disabled children--a survey of patient and appliance management.
(33/412)
The objective of this article was to investigate the management problems encountered during the orthodontic treatment of children with disability, and took the form of a retrospective analysis. The investigation took place at the Center for the Treatment of Cranio-facial Disorders, Department of Orthodontics, Hebrew University Hadassah School of Dental Medicine, Jerusalem, Israel, between years 1989 and 1997. The subjects were the 37 children with mental and/or physical disability whose orthodontic treatment was either completed or nearly completed, whose parents were given a questionnaire. Thirty-five patients responded with a mean age of 13 years (range 7-21 years), representing 94.6 per cent of the sample. Most of the patients (94.3 per cent) were able to conclude the orthodontic treatment and 91.4 per cent of the parents reported that the added responsibilities were either negligible or bearable. In 63 per cent of the children, compliance increased during the treatment as anxiety decreased. The problems encountered with fixed appliances were generally more severe than with removable appliances. The two major obstacles were attendance at frequent and regular intervals (37.1 per cent) and maintaining an appropriate level of oral hygiene (37.1 per cent). Children with a disability are able and willing to undergo orthodontic treatment. Recommendations intended to facilitate management are presented. (+info)
Mandibular advancement using an intra-oral osteogenic distraction technique: a report of three clinical cases.
(34/412)
Osteogenic distraction has been used for decades to lengthen limbs and now attention is focused upon its use within the craniofacial skeleton. This paper addresses distraction of the mandible. It is proposed that mandibular osteogenic distraction could be a possible adjunct to the orthodontic treatment of those adult patients with skeletal anomalies, who would benefit from combined orthodontic/orthognathic treatment. Three consecutive cases from one unit are presented, where adult patients with severe Class II division 1 malocclusions have undergone orthodontic treatment combined with mandibular osteogenic distraction, instead of conventional bilateral sagittal split osteotomies. (+info)
Quality of life and its importance in orthodontics.
(35/412)
Over the last 10-15 years, the terms quality of life (QOL) and health-related quality of life (HRQL) have been seen increasingly in medical literature. Much of the orthodontic treatment that is undertaken is justified on the basis of improving health-related quality of life. With this in mind, studying HRQL in orthodontic patients has the potential to provide information about treatment needs and outcomes, and may also facilitate improved care. Clinicians should therefore be aware of some of the ways in which health-related quality of life may be assessed. The first part of this review article looks at the general concepts of health-related quality of life, whilst the second section focuses on dentistry and orthodontics. (+info)
Functional occlusion: II. The role of articulators in orthodontics.
(36/412)
Opinion is divided on whether there is a place for the use of semi-adjustable dental articulators in orthodontics. In this review we explore the validity and reproducibility of the techniques involved in mounting study models on a semi-adjustable dental articulator. We also look at the role of articulated study models in orthodontic diagnosis and treatment planning, in the finishing stages of orthodontics and in planning for orthognathic surgery. We report that each of the many stages involved in mounting study models on a semi-adjustable articulator is a potential source of error and that only if the technique is carried out with a high degree of accuracy is it worth the additional chairside time. (+info)
A prospective optical surface scanning and cephalometric assessment of the effect of functional appliances on the soft tissues.
(37/412)
The aim of this study was to evaluate the effect of different functional appliances on the soft tissues as assessed by cephalometry and optical surface scanning. Forty-two patients were randomly allocated to Bass, Twin Block (TB), and Twin Block + Headgear (TB + Hg) groups. Lateral cephalograms and optical surface scans were recorded before and after the 10-month study period. ANOVA was used to test the cephalometric variables for differences at the 5 per cent level. The optical surface scanning and cephalometric results were consistent in the sagittal dimension. In the vertical dimension, however, the optical surface scans consistently recorded a greater increase compared with cephalometric values. No differences were detected with regard to cephalometric values at the 5 per cent level. However, the Bass appliance produced greater forward positioning of soft tissue pogonion as assessed by optical surface scanning. (+info)
The influence of orthodontic extraction treatment on dental structures: a two-factor evaluation.
(38/412)
The purpose of this investigation was to evaluate the effects of different growth patterns and treatment types on dentoalveolar structures in patients treated with fixed Edgewise mechanics and the extraction of four first premolars. A total of 41 patients with a mean chronological age of 14 years 7 months and skeletal age of 14 years 6 months were included in the study. The type of growth pattern was assessed as mesio- or hyper-divergent, and the treatment type as the use or non-use of headgear. The results were analysed by two-way analysis of variance (ANOVA). The decrease in overbite in the mesiodivergent group was statistically significant when compared with the increase in the hyper-divergent group (P < 0.01). Extrusion of the lower molar was observed in all groups, and a statistically significant difference was found between the mesio- and hyper-divergent groups (P < 0.05). Interaction between growth pattern and treatment type was not found to be significant for any variable. It can be concluded that premolar extractions and the use of headgear with fixed appliances does not significantly change the overjet, occlusal plane angle, upper and lower anterior dentoalveolar heights, upper posterior dentoalveolar height, or the inclination of the upper and lower incisors. The only significant changes were observed in overbite as a result of treatment mechanics and in lower posterior dentoalveolar height due to the growth pattern. (+info)
Professional perceptions of the benefits of orthodontic treatment.
(39/412)
The aim of this study was to assess general dental practitioners' and orthodontists' perceptions of the benefits of orthodontic treatment. A specially designed questionnaire was sent to a random sample of 150 general dental practitioners (GDPs) and all orthodontists in Northern Ireland (excluding hospital practitioners) with a postgraduate qualification (n = 29). There was a 93 per cent response rate by the general dental practitioners and all but one specialist practitioner returned the questionnaire. The questionnaire comprised 14 visual analogue scales (VAS) whereby participants were asked to rate the importance of various possible dental health and psychosocial benefits of orthodontic treatment. In addition to the VAS, the influence of dentist variables such as number of years since qualification, orthodontic cases completed, referral rates and attendance at postgraduate lectures were examined. When ratings on the 14 dental health and psychosocial scales were examined overall, GDPs rated an improvement in self-esteem while orthodontists considered an improvement in physical attractiveness as the most important benefit of orthodontic treatment. Even though psychosocial variables received the highest ratings, examination of the mean ratings (and 95 per cent confidence intervals) revealed that some dental health factors were also rated highly by both groups. While the results do indicate an encouraging awareness of the psychosocial benefits of orthodontic treatment, they also suggest that both GDPs and orthodontists have an unrealistic expectation of the dental health gain likely to result from orthodontic treatment. (+info)
Interdisciplinary approaches to adult orthodontic care.
(40/412)
The orthodontic treatment of adult patients is most frequently just one component of a more complex treatment involving several dental disciplines. This report discusses the potential problems related to the establishment of a treatment plan and the necessity for the patient's full acceptance, and understanding of the pros and cons related to different treatment approaches. In addition, the case report underlines the importance of a well-defined treatment goal. We have illustrated the team approach and the treatment principles in this combined perio-, ortho-, and prosthodontic patient. (+info)