The retraction of upper incisors with the PG retraction system. (1/27)

The aim of this study was to evaluate the effect on the dentoalveolar structures of the application of PG springs for retraction of upper incisors and to compare the outcome with the effect of a closed coil spring retraction system. Thirty-six subjects with Angle Class I or Class II malocclusions were selected for the study. Each subject had the two upper first premolars extracted and presented a symmetrical extraction space of at least 3 mm distal to the lateral incisors after canine retraction. The subjects were divided into two groups, the PG group with 17 subjects and the coil group with 19 patients. One group had the incisors retracted by PG universal retraction springs, whereas in the other a closed coil spring system was used. The average chronological ages were 18 years 4 months for the PG group, and 18 years 7 months for the coil group. In both groups the springs were activated to produce an initial force of 150 g per side. To examine the type of movement of the anterior and posterior teeth, and the time and rate of space closure, 20 parameters were measured and evaluated statistically with Wilcoxon and Mann-Whitney U-tests. In both groups the incisor retraction was accompanied by mesial movement of the buccal segments. Distal movement of the root apex of the incisors was observed in both groups, although more pronounced in the PG group (P < 0.01). A significant incisor intrusion resulting in a decrease in overbite was found in the PG group, whereas the deep bite increased significantly in the coil spring group. The PG spring produced a three-dimensional control in the movement of the upper incisors, so that application of additional intrusive mechanics after completion of the incisor retraction became unnecessary.  (+info)

The congenitally missing upper lateral incisor. A retrospective study of orthodontic space closure versus restorative treatment. (2/27)

Orthodontic treatment for patients with uni- or bilateral congenitally missing lateral incisors is a challenge to effective treatment planning. The two major alternatives, orthodontic space closure or space opening for prosthetic replacements, can both compromise aesthetics, periodontal health, and function. The aim of this retrospective study was to examine treated patients who had congenitally missing lateral incisors and to compare their opinion of the aesthetic result with the dentists' opinions of occlusal function and periodontal health. In this sample, 50 patients were identified. Thirty had been treated with orthodontic space closure, and 20 by space opening and a prosthesis (porcelain bonded to gold and resin bonded bridges). The patient's opinion of the aesthetic result was evaluated using the Eastman Esthetic Index questionnaire and during a structured interview. The functional status, dental contact patterns, periodontal condition, and quality of the prosthetic replacement was evaluated. In general, subjects treated with orthodontic space closure were more satisfied with the appearance of their teeth than those who had a prosthesis. No significant differences in the prevalence of signs and symptoms of temporomandibular dysfunction (TMD) were found. However, patients with prosthetic replacements had impaired periodontal health with accumulation of plaque and gingivitis. The conclusion of this study is that orthodontic space closure produces results that are well accepted by patients, does not impair temporomandibular joint (TMJ) function, and encourages periodontal health in comparison with prosthetic replacements.  (+info)

An unusual case of talon cusp on geminated tooth. (3/27)

A rare case of talon cusp on geminated permanent central incisor is described. These developmental anomalies cause clinical problems including unsightly dental appearance, occlusal interference, displacement of the affected tooth, attrition, periodontopathy, irritation of the tongue, loss of space and malocclusion. Clinical and radiographic characteristics of these anomalies and modes of treatment are presented. Recognition of this condition and early diagnosis are important to avoid complications.  (+info)

Hypodontia, ankylosis and infraocclusion: report of a case restored with a fibre-reinforced ceromeric bridge. (4/27)

Retained primary molars without permanent successors often undergo progressive infra-occlusion, without predictable exfoliation. Early prophylactic removal, after assessment of root resorption and adjacent periodontal support loss as well as age of onset, is often indicated. This article describes the joint orthodontic-restorative care of such a case and describes an alternative method of restoration using a fibre-reinforced ceromeric bridge. As well as a conservative preparation and good aesthetics, an overlay restoration provided a fully functional occlusion.  (+info)

A randomized clinical trial to compare three methods of orthodontic space closure. (5/27)

AIM: To compare the rates of orthodontic space closure for: Active ligatures, polyurethane powerchain (Rocky Mountain Orthodontics, RMO Europe, Parc d'Innovation, Rue Geiler de Kaysersberg, 67400 Illkirch-Graffenstaden, Strasbourg, France) and nickel titanium springs. SAMPLE: Patients entering the space closure phase of fixed orthodontic treatment attending six orthodontic providers. Twelve patients received active ligatures (48 quadrants), 10 patients received powerchain (40 quadrants) and 11 patients, nickel-titanium springs (44 quadrants). METHOD: Patients were randomly allocated for treatment with active ligatures, powerchain or nickel titanium springs. Upper and lower study models were collected at the start of space closure (T(o)) and 4 months later (T(1)). We recorded whether the patient wore Class II or Class III elastics. Space present in all four quadrants was measured, by a calibrated examiner, using Vernier callipers at T(o) and T(1.) The rate of space closure, in millimetres per month (4 weeks) and a 4-monthly rate, was then calculated. Examiner reliability was assessed at least 2 weeks later. RESULTS: Mean rates of space closure were 0.35 mm/month for active ligatures, 0.58 mm/month for powerchain, and 0.81 mm/month for NiTi springs. No statistically significant differences were found between any methods with the exception of NiTi springs showing more rapid space closure than active ligatures (P < 0.05). There was no effect of inter-arch elastics on rate of space closure. CONCLUSIONS: NiTi springs gave the most rapid rate of space closure and may be considered the treatment of choice. However, powerchain provides a cheaper treatment option that is as effective. The use of inter-arch elastics does not appear to influence rate of space closure.  (+info)

A clinical investigation of force delivery systems for orthodontic space closure. (6/27)

OBJECTIVE: To investigate the force retention, and rates of space closure achieved by elastomeric chain and nickel titanium coil springs. DESIGN: Randomized clinical trial. SETTING: Eastman Dental Hospital, London and Queen Mary's University Hospital, Roehampton, 1998-2000. SUBJECTS, MATERIALS AND METHODS: Twenty-two orthodontic patients, wearing the pre-adjusted edgewise appliance undergoing space closure in opposing quadrants, using sliding mechanics on 0.019 x 0.025-inch posted stainless steel archwires. Medium-spaced elastomeric chain [Durachain, OrthoCare (UK) Ltd., Bradford, UK] and 9-mm nickel titanium coil springs [OrthoCare (UK) Ltd.] were placed in opposing quadrants for 15 patients. Elastomeric chain only was used in a further seven patients. The initial forces on placement and residual forces at the subsequent visit were measured with a dial push-pull gauge [Orthocare (UK) Ltd]. Study models of eight patients were taken before and after space closure, from which measurements were made to establish mean space closure. MAIN OUTCOME MEASURES: The forces were measured in grammes and space closure in millimetres. RESULTS: Fifty-nine per cent (31/53) of the elastomeric sample maintained at least 50 per cent of the initial force over a time period of 1-15 weeks. No sample lost all its force, and the mean loss was 47 per cent (range: 0-76 per cent). Nickel titanium coil springs lost force rapidly over 6 weeks, following that force levels plateaued. Forty-six per cent (12/26) maintained at least 50 per cent of their initial force over a time period of 1-22 weeks, and mean force loss was 48 per cent (range: 12-68 per cent). The rate of mean weekly space closure for elastomeric chain was 0.21 mm and for nickel titanium coil springs 0.26 mm. There was no relationship between the initial force applied and rate of space closure. None of the sample failed during the study period giving a 100 per cent response rate. CONCLUSIONS: In clinical use, the force retention of elastomeric chain was better than previously concluded. High initial forces resulted in high force decay. Nickel titanium coil springs and elastomeric chain closed spaces at a similar rate.  (+info)

Clinical evaluation of the centre of resistance of the upper incisors during retraction. (7/27)

The aim of this study was to evaluate the movement of anterior teeth during retraction with a force applied through the assumed centre of resistance (CRe).Twenty-two subjects with a Class I or II malocclusion were included. Each subject had the two upper first premolars extracted, resulting in a symmetrical extraction space of at least 3 mm between the upper laterals and canines. The force was applied through the assumed CRe, located 9 mm gingival to the lateral tooth bracket. To examine the type of anterior tooth movement, 10 parameters were measured. A Wilcoxon test was used to determine the differences between pre- and post-retraction values, and a Mann-Whitney U-test to determine the mean differences between groups. In spite of the force application through the CRe, tipping of the anterior teeth was observed in 19 subjects and parallel movement in three patients. Consequently, the subjects were divided into two groups according to the location of the centre of rotation (CRo). In group 1 (nine cases), the CRo was located coronal to the root apex, and in group 2 (13 cases), apical to the root apex. Both groups showed a significant decrease in inclination (P < 0.01) and posterior crown movement (P < 0.01 for group 1 and P < 0.001 for group 2) of the anterior teeth. A significant posterior movement of the root apex was observed in group 2 (P < 0.001). Significant differences were found between the groups for anterior tooth inclination (P < 0.05) and root apex movement (P < 0.001). The reasons for these differences could not be conclusively determined. Even though experimental studies provide information regarding CRe location, factors such as bone support, root morphology and incisor inclination should be taken into consideration. The observation of tooth movement occurring during treatment and changes in treatment mechanics would be helpful in obtaining desired tooth movement.  (+info)

Hypodontia in orthodontically treated children. (8/27)

The frequency of hypodontia in orthodontically treated children, both male and female, and the association between tooth type, the upper or lower arch, the affected side and Angle's classification were studied using interviews, oral, study cast and panoramic radiographic examinations of 212 patients with a mean age of 12 years 7 months. A hypodontia frequency of 11.3 per cent was found for the total sample. This was higher than the incidence of hypodontia reported in other studies of orthodontically treated children. The most frequently missing teeth were the maxillary lateral incisors, and maxillary and mandibular second premolars. The missing teeth were more often absent on the right (54.2 per cent) than on the left (45.8 per cent) side, in both males and females. One tooth was absent in 29.2 per cent of patients, two in 58.5 per cent, but seldom three or more. Orthodontic space closure was the treatment of choice in 87.5 per cent of the subjects.  (+info)

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