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Results for “Orthodontic Anchorage Procedures”

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At least 37 records · Page 2Linked to original sources

PubMed2005

Extraoral vs intraoral appliance for distal movement of maxillary first molars: a randomized controlled trial.

Using randomized controlled trial methodology, the aim of this study was to evaluate and compare the treatment effects of an extraoral appliance (EOA) and an intraoral appliance (IOA) for distal movement of maxillary first molars. A total of 40 patients (mean 11.5 years, SD 1.29) at the Orthodontic Clinic, National Health Service, Skane County Council, Malmö, Sweden, were randomized to receive treatment with either extraoral traction (cervical headgear) or an IOA using superelastic coils for distal movement of maxillary first molars. The inclusion criteria were a nonextraction treatment plan, a Class II molar relationship and maxillary first molars in occlusion with no erupted maxillary second molars. The outcome measures to be assessed in the trial were treatment time, cephalometric analysis of distal molar movement, anterior movement of maxillary central incisors, ie, anchorage loss and sagittal and vertical skeletal positional changes of the maxilla and mandible. In the IOA group, the molars were distalized during an average time of 5.2 months, whereas in the EOA group the corresponding time was 6.4 months (P < .01). The mean amount of distal molar movement was significantly higher in the IOA than in the EOA group, three mm vs 1.7 mm (P < .001). Moderate anchorage loss was produced with the IOA implying increased overjet (0.9 mm) whereas the EOA created decreased overjet (0.9 mm). It can be concluded that the IOA was more effective than the EOA to create distal movement of the maxillary first molars.

Cephalometry↗

PubMed2005

Treatment of skeletal open bite with a device for rapid molar intrusion: a preliminary report.

An open bite is one of the most difficult malocclusions the clinician has to deal with. In recent years, interest has increased regarding mechanics that reduce dependency upon patient compliance for success. Some patient-independent mechanism for molar intrusion or vertical control is desirable. The rapid molar intruder (RMI) appliance consists of two elastic modules that are secured to orthodontic bands on the upper and lower first molars. Vertical forces from these modules typically produce intrusion of the permanent molars in four to six months. The RMI modules may be used in the mixed dentition or incorporated in full-fixed mechanics in the permanent dentition. To avoid buccal flaring of the molars, these modules should be attached to a transpalatal arch and a mandibular lingual arch. Case reports are provided to stimulate interest in further investigation of the properties of this appliance.

Adult↗

PubMed2005

Maxillary molar intrusion with fixed appliances and mini-implant anchorage studied in three dimensions.

The intrusion of an overerupted maxillary molar using traditional orthodontic treatment is a real challenge. The aim of this study was to investigate the envelope of intrusive movements of a maxillary molar in cases using mini-implants as anchorage with partial or full-mouth fixed edgewise appliances. The cusp tips of the pretreatment and postintrusion dental casts were recorded by a three-dimensional (3D) digitizer. The 3D data of the serial dental casts were analyzed to distinguish the direction and magnitude of individual tooth movement. The mean intrusive movement of the maxillary first molars was three to four mm, with a maximum of over eight mm. For the adjacent maxillary second molars and second premolars, the amount of intrusion was two mm and 1-2 mm, respectively. This study demonstrated that significant true intrusion of maxillary molars could be obtained in a well-controlled manner by using fixed appliances with titanium mini-implants as bony anchorage.

Adolescent↗

PubMed2005

Anchorage control in bioprogressive vs straight-wire treatment.

Orthodontic techniques with different concepts and philosophies have emerged to provide adequate anchorage control. The purpose of this study was to compare the effectiveness of the Bioprogressive and Straight-wire techniques in the control of lower anchorage. Data were obtained from the records of 40 patients presenting Class I and II malocclusions treated with first bicuspid extractions. One group of 20 patients was treated with a utility arch used to set up cortical anchorage in the lower arch and sectional retraction mechanics for space closure. The second group was treated with straight wire with a preadjusted appliance system. Treatment evaluation revealed no significant between-group differences in the amount of skeletal growth relative to cranial base and lower mesial movement of first molars. Mean lower anchorage loss was 3.1 mm in the Bioprogressive patients and four mm in the Straight-wire patients. The apical base change was the most important component to molar correction. Although cortical anchorage did not impede lower molar movement, it was no less effective in controlling molar movement with a partial appliance than was the fully banded Straight-wire appliance.

Adolescent↗

PubMed2006

Use of zygomatic anchors during rapid canine distalization: a preliminary case report.

Rapid canine distalization is a technique involving periodontal ligament distraction. The primary aim of this technique is to distalize the canines without anchorage loss and to shorten the duration of orthodontic treatment. After the rapid canine distalization, the healing process of the periodontal ligament is similar to rapid palatal expansion and requires a consolidation period. The long consolidation period of the technique conflicts with the second aim. Skeletal anchorage systems seem to compensate for this conflict because they can be also used for retraction of incisors during consolidation period. This case report presents the orthodontic treatment of a 16-year-old female, who had a bimaxillary retrusion and a dental Class II division I malocclusion. Upper first premolars were extracted and, while the canines were being distalized rapidly by periodontal ligament distraction, the incisors were retracted using a zygomatic anchorage system. The treatment of the patient was completed in five months without any anchorage loss.

Adolescent↗

PubMed2006

Skeletal anchorage for orthodontic correction of maxillary protrusion with adult periodontitis.

Because the number of adult patients seeking orthodontic treatment is increasing, orthodontists are becoming more likely to encounter patients with adult periodontitis. However, it is sometimes difficult to establish anchorage because of poor periodontal tissues in patients with adult periodontitis. This article reports the successful use of skeletal anchorage to treat a maxillary protrusion case complicated by severe adult periodontitis. A female patient aged 50 years seven months showed a skeletal Class II jaw base relationship. A spacing of five mm in the upper anterior teeth with an overjet of 7.5 mm and overbite of four mm was observed. She had generalized horizontal bone loss in both arches, with vertical bone loss in the posterior segment. After periodontal treatment, miniplates were placed in the zygomatic process, and retraction and intrusion of the maxillary incisors were performed. After active treatment for 21 months, the upper incisors had been inclined 9.5 degrees lingually, intruded two mm at the apex, and good anterior occlusion was achieved. Acceptable occlusion and periodontal tissue were maintained after a retention period of two years. Our results suggest that skeletal anchorage is useful for retraction and intrusion of upper incisors in cases of maxillary protrusion with severe adult periodontitis.

Female↗

PubMed2006

Orthopedic protraction with skeletal anchorage in a patient with maxillary hypoplasia and hypodontia.

Multipurpose titanium miniplates were placed on the lateral nasal wall of the maxilla as anchorage for face mask protraction in an 11-year-old girl presenting with severe maxillary hypoplasia and hypodontia. Applying orthopedic forces directly to the maxilla resulted in an eight mm maxillary advancement. Intraosseous titanium screws were also placed on the palatal bone, near the alveolar crests, to provide anchorage for the expansion appliance. The maxilla was expanded from the median palatal suture, and seven mm of expansion was achieved across the buccal segments. No other tooth support was used for the expansion or the protraction of the maxilla.

Anodontia↗

PubMed2006

Noncompliance unilateral maxillary molar distalization:.

The aim of this prospective study was the three-dimensional (3-D) analysis of tooth movements after unilateral upper molar distalization by means of a noncompliance intraoral appliance, the Keles slider. This appliance exerts a distalizing force of 150 g at approximately the level of the center of resistance of the upper first molar. Twelve patients (six girls and six boys with a mean age of 13.1 years) with a unilateral Class II molar relationship participated in the study. Dental casts were taken immediately before placement and after removal of the appliance. The casts were digitized using a 3-D surface laser scanner and superimposed on a predefined area of the palate. The average unilateral upper first molar distal movement was 3.1 mm (range: 2.4 to 5.3 mm). Anchorage loss was expressed by a 2.1 mm (range: 0.8 to 3.8 mm) proclination of the central incisors and a 6.1 degrees mesial inclination of the ipsilateral first premolar (range: 1.7 degrees to 12.3 degrees ). There was approximately 1 mm of midline deviation toward the contralateral side and a 1.6 mm (range: 0.8 to 2.3 mm) buccal displacement of the contralateral first premolar. A substantial variation was observed among patients. Noncompliance unilateral upper molar distalization was an efficient treatment approach. There was, however, a substantial anchorage loss. Case selection is strongly recommended because significant anterior crowding, ectopic canines, or spacing can lead to significant anchorage loss.

Adolescent↗

PubMed2006

Orthodontic anchorage: a systematic review.

The aim of this systematic review was to examine, in an evidence-based way, what kind of orthodontic anchorage systems/applications are evaluated and their effectiveness. A literature survey from the Pub Med and Cochrane databases covering the period from January 1966 to December 2004 was performed. Randomized controlled trials (RCT), prospective and retrospective controlled studies, and clinical trials comparing at least two anchorage situations were included. Two reviewers selected and extracted the data independently and also assessed the quality of the retrieved studies. The search strategy resulted in 494 articles, of which 14 met the inclusion criteria. Two main anchorage situations were identified: anchorage of molars during space closure after premolar extractions and anchorage loss in the incisor or premolar region (or both) during molar distalization. Because of contradictory results and the vast heterogeneity in study methods, the scientific evidence was too weak to evaluate anchorage efficiency during space closure. Intraoral molar distalization leads to anchorage loss in various amounts depending on the choice of distalization unit. Most of the studies had serious problems with small sample size, confounding factors, lack of method error analysis, and no blinding in measurements. To obtain reliable scientific evidence, controlled RCT's with sufficient sample sizes are needed to determine which anchorage system is the most effective in the respective anchorage situation. Further studies should also consider patient acceptance and cost analysis as well as implants as anchorage.

Bicuspid↗

PubMed2006

New generation open-bite treatment with zygomatic anchorage.

This technical note aims to present the fabrication and application of a new generation of posterior intrusion appliances using zygomatic anchorage. The use of zygomatic anchorage enables en masse impaction of the posterior segment without any side effects such as labial flaring. A 14-year-old, female Class II patient with an anterior open bite was treated with a new generation posterior intrusion appliance. At the end of treatment, a Class I canine and molar relationship and a correction of the anterior open bite were achieved. The molars were impacted 3.6 mm, and this impaction was maintained throughout the treatment. The mandibular plane showed a counterclockwise autorotation of 4 degrees. This case report demonstrates that zygomatic anchorage can be used effectively for molar intrusion and anchorage maintenance. However, further clinical studies with larger samples are required to confirm its effectiveness.

Adolescent↗

PubMed2006

Maxillary molar distalization with a bone-anchored pendulum appliance.

To obtain an effective and compliance-free molar distalization without an anchorage loss, we designed the bone-anchored pendulum appliance (BAPA). The aim of this study was to evaluate the stability of the anchoring screw, distalization of the maxillary molars, and the movement of teeth anterior to maxillary first molars. The study group comprised 10 patients (mean age 13.5 +/- 1.8 years) with Class II molar relationship. A conventional pendulum appliance was modified to obtain anchorage from an intraosseous screw instead of the premolars. The screw was placed in the anterior paramedian region of the median palatal suture. Skeletal and dental changes were measured on cephalograms, and dental casts were obtained before and after distalization. A super Class I molar relationship was achieved in a mean period of 7.0 +/- 1.8 months. The maxillary first molars distalized an average of 6.4 +/- 1.3 mm in the region of the dental crown by tipping distally an average of 10.9 degrees +/- 2.8 degrees . Also, the maxillary second premolar and first premolar moved distally an average of 5.4 +/- 1.3 mm and 3.8 +/- 1.1 mm, respectively. The premolars tipped significantly distally. No anterior incisor movement was detected. The BAPA was found to be an effective, minimally invasive, and compliance-free intraoral distalization appliance for achieving both molar and premolar distalization without any anchorage loss.

Adolescent↗

PubMed2006

Anchorage effect of osseointegrated vs nonosseointegrated palatal implants.

Palatal implants can be used with a transpalatal arch (TPA) connected with the second premolar to provide anchorage. The purpose of this study was to compare the anchorage effects of an osseointegrated palatal implant (OPI) with a nonosseointegrated palatal implant (NOPI), using finite element analysis. One model, which was composed of two maxillary premolars, periodontal ligament (PDL), alveolar bone, a palatal implant, palatal bone, a bracket, band, and TPA, was created on the basis of the clinical situation. The palatal implant was treated as either NOPI or OPI. The force on the premolars was investigated under three conditions: a distomesial horizontal force, a buccolingual horizontal force, and a vertical intrusive force. The PDL stress was calculated and compared with a model without an implant. The result showed that OPI could reduce PDL stress significantly. (The average stress was reduced by 14.44% for the distomesial horizontal force, 60.28% for the buccolingual horizontal force, and 17.31% for the vertical intrusive force.) The NOPI showed almost the same anchorage effect as OPI. The stress on the NOPI surface was higher than that on the OPI surface, but the stress was not high enough to result in failure of the implant. These results suggested that waiting for osseointegration might be unnecessary for an orthodontic implant.

Alveolar Process↗

PubMed2006

Implant vs screw loading protocols in orthodontics.

OBJECTIVE: This systematic review presents the loading protocols applied when using implants and/or screws in orthodontic treatments. MATERIALS AND METHODS: Clinical trials which assessed the use of implants and/or screws for orthodontic anchorage and studies involving treatment on syndromic patients, surgery, other simultaneous treatments, or appliances (ie mini-plates) were considered. Electronic databases (Medline, Medline In-Process & Other Non-Indexed Citations, Lilacs, Pubmed, Embase, Web of Science, and All Evidence Based Medicine Reviews) were searched with the help of a senior Health Sciences librarian. Abstracts which appeared to fulfill the selection criteria were selected by consensus. The original articles were then retrieved and evaluated with a methodological checklist. References were also hand searched for possible missing articles. RESULTS: Eleven articles fulfilled the selection criteria established. Five studies involved the use of implants while six involved the use of screws for orthodontic purposes. An individual methodological analysis for each article was made. CONCLUSIONS: Loading protocols for implants involve a minimum waiting period of 2 months before applying orthodontic forces while loading protocols for screws involve immediate loading or a waiting period of 2 weeks to apply forces. Success rates for implants were on average higher than for screws.

Bone Screws↗

PubMed2006

[Class II interceptive therapy in the mixed dentition: intra-oral distalization appliances].

Treatment of Class II malocclusion during the mixed dentition may sometimes require upper molar distalization. To achieve this, many devices have been suggested. The purpose of this article is to classify them and to point out their effects on the dentition and upon skeletal structures.

Child↗

PubMed2006

Quantitative measurement of speech sound distortions due to inadequate dental mounting.

In this paper, the most adequate quantitative parameters are sought that reflect the dependence of speech sound distortions on the correct position of dental mountings. We suggest the Hurst fractal exponent and some parameters calculated from the Paul wavelet transform of speech sound are useful as quantitative parameters. The investigations are focussed on the alterations of the first /s/ phoneme when the patient produces the Sisyphe sound. The results will be useful to obtain a rigorous, computer assisted method to establish (design) the optimal parameters of prosthetic mounts in order to ensure best speech quality.

Computer Simulation↗

PubMed2006

Tapered orthodontic miniscrews induce bone-screw cohesion following immediate loading.

The aim of this study was to investigate the initial stability of tapered orthodontic miniscrews (T-type screws) after placement, the necessity of a healing period, and the propriety of immediate loading. Twenty male Wistar rats with a mean age of 20 weeks were divided into two groups. In the immediate-loading groups, straight orthodontic miniscrews (S-type screws) and T-type screws (five rats each) underwent experimental traction force for 2 weeks (W) immediately after placement. In the healing groups (S- and T-type, five rats each), force was applied for 2 W after a 6-W healing period. The right tibia in each rat was identified as the test limb, while the left tibia in each rat was used as the control group, and underwent no experimental force during the experimental period. The screw-to-bone contact was observed histologically and the bone-screw contact ratio was calculated. Scheffe's test was performed to compare the bone-screw contact ratio in each group using statistical software package (SPSS 8.0 for Windows). In the control group, the bone-screw contact ratio improved from 34.8 +/- 16.0 to 74.8 +/- 12.0 per cent with S-type screws in proportion to the experimental period (2 to 8 W, respectively). With the T-type screws in the test group, there was no significant difference between the immediate-loading and healing groups. In the immediate-loading group, the bone-screw contact ratio with T-type screws was significantly greater (82.3 +/- 15.0 per cent) than with the S-type screws (33.3 +/- 11.8 per cent; P < 0.05), suggesting that T-type screws can be used for orthodontic anchorage immediately after placement.

Animals↗

PubMed2006

Ninety percent success in palatal implants loaded 1 week after placement: a clinical evaluation by resonance frequency analysis.

To investigate the behaviour of early loaded palatal implants when observed with resonance frequency analysis (RFA). Twenty patients (seven males and 13 females, mean age 26.4 years) received one palatal implant each (length: 4 mm, diameter: 3.3 mm; Orthosystem) for maximum orthodontic anchorage. The implants' stability was observed by RFA. Measurements were carried out at the time of surgery, after first orthodontic loading and subsequently once a week over a period of 12 weeks. Two palatal implants were lost. The other 18 remained stable. The average period from insertion to first loading was 6.7+/-0.8 days. The mean orthodontic force applied was 272.2+/-73.2 cN. The implant stability quotient (ISQ) value at the time of surgery averaged 69.4+/-3.9. The mean ISQ value 6.7 days after insertion was 69.8+/-3.6. Twelve weeks post-surgery the mean ISQ value was 69.8+/-3.5. A statistically significant decrease in stability was observed after 2 and 3 weeks post-surgery (P=0.005 and 0.04). The behaviour of early loaded palatal implants showed an initial decrease of the ISQ values. From 6 weeks post-surgery onward the ISQ values increased. Within the limitations of this study, the results suggest that the healing time of palatal implants reported in the literature (12 weeks) should be discussed. An orthodontic loading of palatal implants 6 weeks post-surgery with a force up to 400 cN seems to be justified. Yet further investigations are necessary to evaluate the behaviour of early loaded palatal implants considering observation periods of over 12 weeks.

Adolescent↗

PubMed2006

Intrusion of molars with implants as anchorage: a report of two cases.

BACKGROUND: Osseointegrated implants do not move in response to orthodontic loads. PURPOSE: The aim of this study was to describe a method to intrude supra-erupted molars using prosthetic implants as anchorage. MATERIALS AND METHODS: A 51-year-old female and a 36-year-old male were treated with adjacent implants for orthodontic anchorage for supra-erupted teeth in the maxilla (16, 17) and in the mandible (46, 47), respectively. In both cases, the force of intrusion applied was 300 g. RESULTS: The therapy was completed without complications or abnormalities of the intruded teeth or anchorage implants. Intrusion required 13 months in the first case and 19 months in the latter. CONCLUSION: The present method makes it possible to secure enough space for prosthodontic therapy at edentulous segments and perform highly reliable implant therapy.

Adult↗