Yijin Ren's review of the randomized orthodontic trial.
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Adolescent↗
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Results for “ORTHODONTICS, CORRECTIVE”
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Borderline cases. 3.
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Follow-Up Studies↗
The interception of the open bite in the early growth period.
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Adolescent↗
The CR-CO discrepancy and its effect on cephalometric measurements.
The purpose of the present study was to compare cephalometric measurements derived from a centric occlusion (CO) tracing with those of a converted centric relation (CR) tracing. The sample consisted of 68 consecutively treated patients, with a CR-CO discrepancy of 2 mm or greater in either the horizontal and/or vertical planes, measured at the condyles from mounted models. Comparisons were also made within the sample between the 39 females and 29 males; and the 35 skeletal Class I and 33 Class II patients. In analyzing the CR-CO discrepancy, the vertical component was greater than the horizontal in 96% of the sample. Every patient had a vertical component, although 10% had no horizontal component. Correlations between the horizontal discrepancy and the two tracings showed high values for approximately 50% of the measures, whereas little correlation was found with the vertical discrepancy. Paired t tests used to compare the CO and CR cephalometric values demonstrated significant differences (p < 0.05) for the majority of the values studied. However, there generally were no differences between the groups of males and females, or between the skeletal Class I and Class II individuals. The results of this study suggest that to make a correct orthodontic diagnosis the mandible should be placed in centric relation rather than in the more traditional centric occlusion.
Adolescent↗
Occlusal changes from adolescence to adulthood in untreated patients with Class II Division 1 deepbite malocclusion.
A sample of 47 untreated children (M 32:F 15) with Class II Division 1 (II/1) deep-overbite malocclusion was collected from a group of patients who declined orthodontic therapy. Longitudinal records consisted of plaster dental casts and lateral cephalograms at original diagnosis and plaster dental casts at a follow-up observation in adulthood, an average of 11.5 years later. To study retrospectively natural changes in dental occlusion during this interval, plaster-cast millimetric measurements were recorded of sagittal dental relationships (first molar and canine), overjet, overbite, and crowding/spacing at the two registrations. Results showed statistically significant improvements in untreated II/1 deepbite malocclusion from adolescence to adulthood for all measured occlusal variables except development of mild crowding. Therefore, assumptions that untreated II/1 distoclusion will worsen with age appear to be unfounded. The evidence indicates that the absence of orthodontic correction for adolescent patients with Class II Division 1 deepbite malocclusion will not usually lead to measurable occlusal deterioration in young adulthood.
Adolescent↗
Mandibular symphyseal distraction and its geometrical evaluation: report of a case.
In this report, the case of a patient who has been treated with a different use of a tooth-borne custom-made mandibular symphyseal distraction device is presented. The difference in the application is that the distal arm of the device was sectioned during the retention phase to allow the possible relapse of displaced condyles to their original positions while the labial segment expansion is being maintained. The effect of this procedure was also evaluated on a geometrical model using measurements from the patient's cast. We conclude that symphyseal distraction is an effective and fast method of correcting orthodontic anomalies. The effect of the procedure on the condyle was only 3 degrees of distolateral rotation as calculated using the geometrical model.
Adolescent↗
Maxillary impacted canine with congenitally absent premolars.
Multiple treatment options are available to patients who have impacted canines in addition to congenitally absent premolars. Management options for impacted maxillary canines can include (1) continued observation, (2) extraction of the primary canine to aid spontaneous eruption, (3) uncovering and bonding of the impacted tooth and its eruption using orthodontic traction, (4) autotransplantation, and (5) extraction followed by prosthetic replacement. The options for the treatment of missing premolars can include the following: (1) maintaining the primary molars, (2) spontaneous space closure after early extraction of the primary molar, (3) autotransplantation, (4) prosthetic replacement, and (5) orthodontic space closure. In this case report, treatment of a patient with an impacted maxillary canine and agenesis of three second premolars will be presented.
Anodontia↗
Orthodontic treatment need from eight to 12 years of age in an early treatment oriented public health care system: a prospective study.
The aim of this study was to investigate the effects of an early treatment oriented orthodontic program on treatment need at age 12 years in a public health care system. The subjects consisted of one whole age cohort in a municipality in Finland, 87 children in total. All children were examined at ages eight, 10, and 12 years. Treatment need was assessed on casts using a modified Dental Health Component of the Index of Orthodontic Treatment Need and a 10-Grade Scale based on the Treatment Priority Index. Early treatment was started on children having definite treatment need according to both indices. The agreement between indices was good at ages eight and 12 years and moderate at age 10 years. Treatment need changed significantly from eight to 12 years. Of the 29 children with definite treatment need at age eight years, only two had treatment need at age 12 years. Of the 38 children with no treatment need at age eight years, 28 remained in this category and only two children had definite need for treatment at age 12 years. The duration of treatment ranged from one to 61 months, although 59% of the treatments lasted two years or less. We conclude that systematically planned early orthodontic treatment may have contributed to the significant reduction in treatment need from eight to 12 years of age.
Age Factors↗
[Post-orthodontic rehabilitation of the sequellae of alveolar clefts: implantation or periodontal plastic surgery?].
Just as they do for many cranio-facial deformities, the treatment team begins the care of cleft palate patients early and continues treatment over a long period. Throughout the growth period, they perform well-timed interventions and re-evaluations according to the individual plan they have prepared. When growth is completed and the orthopedic and orthodontic corrections have contributed as much as possible to an esthetic and functional equilibrium, a final prosthetic replacement will frequently be required. When the correct edentulous space between the teeth on each side of the defect has been created, or maintained, practitioners can choose between two alternatives: implants or traditional fixed bridges. They should analyze any secondary anatomic discrepancies, severe or superficial, that may have developed, and prepare the best therapeutic pathway for a reconstruction of crestal gingival morphology by means of periodontal surgery.
Alveolar Process↗
Early treatment and evidence-based orthodontics. Timing of treatment.
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Evidence-Based Medicine↗
Comparison of radiographic and photographic measurement of mandibular asymmetry.
This study compared measurement of mandibular asymmetry by digitization of mandibular outlines from standardized facial photographs and posteroanterior cephalometric radiographs. Four ratios were used in calculating asymmetry: area (relative size of right and left mandibular segments), perimeter or length of outlines, compactness (shape), and moment. The records of 28 patients with varying degrees of asymmetry were used. A significant relationship was found for 3 of the ratios (area, compactness, and moment) between measurements from photographs and radiographs. A further comparison showed that measurements from the radiographs correlated more closely with those from photographs when the mastoid processes were used as a baseline, rather than latero-orbitale. Repeatability of mandibular outline digitization proved satisfactory. Although digitization from standardized photographs is the preferred approach, the results indicated that posteroanterior cephalometric radiographs can be used similarly. Unlike other cephalometric analyses for mandibular asymmetry, this method avoids problems of landmark identification, thus presenting a clinically useful method of quantifying asymmetry, eg, in auditing the surgical-orthodontic correction of asymmetry or monitoring change over time.
Adult↗
Initial tooth displacement in vivo as a predictor of long-term displacement.
In the past, the dry skull has been used as a hypothetical model to test initial orthodontic and orthopaedic force systems. However, the question as to whether this hypothetical model can be used as a predictor of long-term displacements in vivo remains unanswered. In this study, an attempt was made to compare initial tooth displacement with the long-term effect after application of the force system for a longer period of time, in six adult dogs. Tooth displacement was obtained by applying a force by means of a coil spring (push) system. Following application of a force of 50 g in the first series (n = 3) and 80 g in the second series (n = 3), initial displacements were registered by means of speckle interferometry. The long-term displacement was registered by means of standardized cephalometry in the same dog by leaving the force system in place for 5 weeks. The mean values of the displacement vectors of the second premolars in the six dogs were compared. A paired t-test revealed no significant differences between the initial and long-term displacements in any of the dogs. The results show that both groups of measurements belong statistically to the same sample and that initial tooth displacement measured by means of speckle interferometry is a valuable predictor for forecasting long-term displacement in vivo after 5 weeks.
Animals↗
Undergraduate orthodontic education: what should we teach rather than what can we teach?
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Curriculum↗
Le Fort type III osteotomy for midface deficiency in selected cleft palate patients.
The comprehensive treatment of cleft lip and palate continues to evolve as understanding of the pathogenesis of this malformation and refinement of surgical techniques for its treatment have improved. The malformation, although varying in severity from individual to individual, is now considered an abnormality of the entire maxilla. Our experience indicates that a finite minority of cleft patients exists with significant malar and midfacial projection deficiency in addition to class III malocclusion who will benefit from a more extensive midfacial advancement. We have treated 10 patients with a diagnosis of cleft lip and palate as well as malar and midfacial retrusion with a Le Fort type III advancement. In this group of patients, there were two early postoperative complications. Two patients (20%) experienced late occlusal changes; 4 patients underwent orthodontic correction; and the other required a Le Fort type I osteotomy. Three patients (30%) experienced predicted velopharyngeal insufficiency requiring a pharyngeal flap for correction. All patients demonstrated both subjective and objective improvement in facial aesthetics and Angle's class I occlusion after surgery. In patients with cleft lip and palate who also have midfacial retrusion, the Le Fort type III advancement provides a more complete correction of the facial deformity as well as the malocclusion. This approach should be integrated into the comprehensive management of this deformity by individuals trained in craniofacial techniques.
Adolescent↗
Molding of the regenerate in mandibular distraction: clinical experience.
Initial clinical experience with distraction osteogenesis has demonstrated the risk of developing postdistraction malocclusion that requires secondary orthodontic correction. In addition, optimal mandibular form is not always achieved. Both animal studies and preliminary clinical investigations have suggested that the regenerate can be successfully "molded" during active mandibular distraction. The authors have applied this concept clinically to obtain a more desirable occlusal relationship in a group of mandibular distraction patients. Eleven patients are described in whom angulation of the distraction device or intermaxillary/interdental elastics were employed to mold the regenerate. Two representative case studies are provided to illustrate the principles. When using elastic traction to close an anterior open bite, care must be taken that extrusion of individual teeth is minimized by distributing the force over the entire dental arch, especially the basilar portions of the jaws. The authors demonstrate that molding of the regenerate can be successfully accomplished not only during device activation but also early in the consolidation period. The outer limit of the time window in which molding is effective remains to be defined.
Adolescent↗
Predictors of fixed orthodontic treatment in 15-year-old adolescents in South Australia.
An understanding of the determinants of the provision of fixed orthodontic treatment would be beneficial in the planning of any system aimed at rationalising supply. The aim of this longitudinal study was to determine those factors which were predictive of the provision of fixed orthodontic treatment in adolescents. Baseline data, at age 13 years, on oral health, the history of orthodontic consultation and interceptive orthodontic care, a dental appearance score (DAI), socio-demographic characteristics and self and parental perceptions of both dental appearance and need for fixed orthodontic treatment were obtained from 2793 adolescents under the care of the South Australian School Dental Service who had not undergone fixed orthodontic treatment. Data on the orthodontic care provided to these adolescents in the ensuing 2 years were collected. At the end of the 24-month period 433 adolescents (15.5%) had undergone fixed orthodontic treatment. Significant bivariate associations were found between the provision of fixed orthodontic treatment and the DAI score, sex of the adolescent, familial history of fixed orthodontic treatment, income, private insurance, orthodontic consultation and interceptive orthodontic care before the age of 13 years and self and parental perceptions of both dental appearance and the need for fixed orthodontic treatment. Logistic regression was used to produce a predictive model of fixed orthodontic treatment. The model explained 30.2% of the variance, with a specificity of 0.94, a sensitivity of 0.49 and a hit rate of 0.84%. Odds ratios greater than one were found for the DAI score, private insurance, females, self and parental perception of need, higher incomes and orthodontic consultation and interceptive orthodontic care before the age of 13 years.
Adolescent↗
Autotransplantations and loss of anterior teeth by trauma.
The loss of anterior teeth by trauma has usually been corrected by orthodontic or prosthetic means. In some specific cases, however, the skeletal and dental relationship may contraindicate the use of space-closure mechanics. Autotransplantation of teeth, successfully depicted in many clinical studies, can help to reduce the severity of orthodontic cases complicated by traumatized anterior teeth. A case report is presented to stress both the indications and limitations of such treatment.
Bicuspid↗