The extraction of permanent second molars and its effect on the dentofacial complex of patients treated with the Tip-Edge appliance.
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The aim of this investigation was to assess the dentofacial changes in a group of patients consecutively treated with Tip-Edge appliances and the extraction of four permanent second molars by one specialist orthodontic practitioner. Before and after treatment lateral cephalograms and study cast measurements of 45 individuals, 26 females (mean age 13.8 years) and 19 males (mean age 13.9 years), were collated and statistically analysed. Cephalometric variables that exhibited, before treatment, significant sex differences, included SNA, SNB (both smaller in males, P < 0.05) and U1-NA degrees (P < 0.05), nasolabial angle (P < 0.05), and upper lip length P < 0.01 (all larger in males). After treatment, sex differences were demonstrated for SNA (smaller in males, P < 0.05), mandibular length (P < 0.01), upper face height (P < 0.05), lower face height (P < 0.01), anterior face height (P < 0.001), posterior face height (P < 0.01), nasolabial angle (P < 0.05), and upper lip length and thickness (P < 0.001; all larger in males). For the cast analysis, before treatment differences indicated larger values for males than females for lower arch inter-canine, premolar, and molar widths, arch depth (all P < 0.05), tooth size, and arch length (P < 0.01). Similar findings were noted in the upper arch except for inter-canine and premolar arch width. Despite most arch variables displaying sex differences, no gender effect was found for irregularity or crowding parameters. The same variables exhibited significant sex differences and changes after treatment (except tooth size, lower arch depth, and upper arch inter-canine width). Overall, the pattern of correction exhibited by the subjects included dental, skeletal, and soft tissue changes. Males tended to have greater mean increases in mandibular skeletal and soft tissue variables compared with females. Both males and females had increases in most dental arch variables measured from the study casts. Both sexes demonstrated a small uprighting, but statistically non-significant distalizing of the buccal segments. The lower incisors in the sagittal plane revealed a mean tendency to remain in their pre-treatment positions, with some individual variation. Overall, the treatment results were considered favourable, but case selection appeared to bias towards Angle Class I skeletal patterns of average to slightly reduced facial height, overbite and overjet < or = 4 mm, lip competence, no incisor protrusion, and moderate tooth size to arch length discrepancy (3-3.5 mm lower arch, 1 mm upper arch). Further evaluation of third molar eruption responses may provide insight into appropriate timing of second molar extractions. (+info)
The Orthoworld Specialist Practitioner Prize Cases 2000.
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This paper describes the orthodontic management of three diverse malocclusions that were awarded the Orthoworld Specialist Practitioner Prize (2000) and presented at the British Orthodontic Conference in Harrogate 2001. (+info)
Invisible treatment of a Class III female adult patient with severe crowding and cross-bite.
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This article reports on the treatment for a 24 year 9 month adult female patient with severe skeletal Class III and crowding. As the patient wanted to wear an invisible appliance treatment we provided treatment with lingual brackets. (+info)
Perception of orthodontic treatment need: opinion comparisons of orthodontists, pediatric dentists, and general practitioners.
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AIM: To determine the relationship between treatment need assessment scores of orthodontists, general practitioners, and pediatric dentists. STUDY DESIGN: Observational. SAMPLE: Ten general dental practitioners, 18 orthodontists and 15 pediatric dentists reviewed 137 dental casts and recorded their opinion on whether orthodontic treatment was needed. RESULTS: We found a high level of agreement between pediatric dentists, orthodontists and general practitioners (Kappa range 0.86-0.95). Between the groups, the amount of agreement was lower. CONCLUSIONS: Orthodontists, general dental practitioners, and pediatric dentists in this sample exhibit high levels of agreement on orthodontic treatment need. (+info)
Intentional use of the Hawthorne effect to improve oral hygiene compliance in orthodontic patients.
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The purpose of this study was to evaluate whether the home care of noncompliant adolescent orthodontic patients with "poor" oral hygiene could be improved through the use of a deception strategy designed to intentionally induce the Hawthorne effect. This effect is often cited as being responsible for oral health improvements of control groups that receive placebo treatments. It is thought that participating in and fulfilling the requirements of a study alters subjects' behavior, thereby contributing to the improvement. Forty patients with histories of poor oral hygiene were assigned, in a quasi-random fashion, to two groups. Experimental subjects (n = 20) were presented with a situation that simulated participation in an experiment. These included the use of a consent form; distribution of tubes of toothpaste labeled "experimental"; instructions to brush twice a day for two minutes using a timer; and a request to return unused toothpaste. Control subjects (n = 20) had no knowledge of study participation. Tooth surface area covered with plaque was used as a proxy measure of home care behavior. It was measured at baseline, three months, and six months. Mean percentages of tooth surface covered with plaque for the experimental and control groups were 71 (+/- 11.52) and 74 (+/- 11.46) at baseline; 54 (+/- 13.79) and 78 (+/- 12.18) at three months; and 52 (+/- 13.04) and 79 (+/- 10.76) at six months. No statistically significant difference (p > .05) was obtained between groups at baseline. Statistically significant differences (p < .05) were found between groups at three and six months. Significant differences (p < .05) were also found only for the experimental subjects between baseline and each of the two subsequent observation periods. The efficiency and potential effectiveness of this strategy suggest that additional research be conducted to assess oral health improvements and possible applications to the private practice setting. (+info)
Mandibular outline assessment in three groups of orthodontic patients.
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The feasibility of using computer-based parameters for quantifying mandibular asymmetry was investigated. Four methods of calculating asymmetry were used, based on the digitized facial photographs of three groups of patients: those with no observable asymmetry, a group with mild asymmetry, and a group presenting for orthognathic surgery. Three of the methods involved right/left difference ratios, namely, area, perimeter length, and compactness. The fourth, moment ratio (centre of area), was expressed as a percentage. Repeatability of both photography and digitization proved satisfactory, the standard deviation of the differences between repeated photographs being 0.016 and 0.014 for area and compactness ratios, respectively. Area, perimeter, and compactness successfully discriminated between the three groups. For area, median ratios (deviations from 1.00) for the 'normal', 'mild asymmetry', and 'surgical' groups were 0.015, 0.030, and 0.078, respectively. Those patients in the surgical group for whom asymmetry correction had been the main reason for surgery recorded higher asymmetry scores than the other subjects in that group. Moment ratio did not adequately distinguish between the three groups. Better repeatability for digitization was found when a baseline involving the ear insertions was used, than either the outer or inner canthi of the eyes. The potential uses of this approach are presented in relation to clinically relevant mild asymmetry, as well as auditing the outcome of surgical correction. (+info)
Long-term follow-up of Class II adults treated with orthodontic camouflage: a comparison with orthognathic surgery outcomes.
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Thirty-one adults who had been treated with orthodontics alone for Class II malocclusions were recalled at least 5 years posttreatment to evaluate cephalometric and occlusal stability and also their satisfaction with treatment outcomes. The data were compared with similar data for long-term outcomes in patients with more severe Class II problems who had surgical correction with mandibular advancement, maxillary impaction, or a combination of those. In the camouflage patients, small mean changes in skeletal landmark positions occurred in the long term, but the changes were generally much smaller than in the surgery patients. The percentages of patients with a long-term increase in overbite were almost identical in the orthodontic and surgery groups, but the surgery patients were nearly twice as likely to have a long-term increase in overjet. The patients' perceptions of outcomes were highly positive in both the orthodontic and the surgical groups. The orthodontics-only (camouflage) patients reported fewer functional or temporomandibular joint problems than did the surgery patients and had similar reports of overall satisfaction with treatment, but patients who had their mandibles advanced were significantly more positive about their dentofacial images. (+info)
Idiopathic gingival hyperplasia and orthodontic treatment: a case report.
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There are many reasons for gingival hyperplasia. Mostly, proper oral hygiene is sufficient to achieve normal healthy gingiva. In some situations, however, gingival hyperplasia is drug-induced or can be a manifestation of a genetic disorder. In the latter, it may exist as an isolated abnormality or as part of a syndrome. If orthodontic treatment is needed in patients with gingival hyperplasia, both orthodontic and periodontal aspects need to be considered. Extreme hereditary gingival fibromatosis was periodontally treated, by removal of all gingival excess using flaps and gingivectomies. After a follow-up period, the orthodontic treatment started with fixed appliances. Monthly periodontal check-ups (scaling and polishing) were scheduled to control the gingival inflammation. After the orthodontic treatment, permanent retention was applied, once more followed by a complete gingivectomy in both maxilla and mandible. One of the most important keys to successful treatment of hyperplasia patients is the cooperation between the periodontist and the orthodontist. (+info)