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Alignment stability in Class II malocclusion treated with 2- and 4-premolar extraction protocols.

INTRODUCTION: The purpose of this study was to compare the postretention stability of the correction of mandibular anterior-tooth irregularity in patients with Class II malocclusions whose orthodontic treatments included extraction of 2 or 4 premolars. METHODS: A total of 66 patients were selected who initially had at least one-half-cusp Class II malocclusions. Nineteen patients (9 male, 10 female) with an initial mean age of 14.04 years were treated with extraction of 2 premolars (group 1); 47 patients (20 male, 27 female) with an initial mean age of 13.03 years were treated with extraction of 4 premolars (group 2). A subgroup of group 2, with a similar amount of initial anterior-tooth irregularity as group 1, was also compared with group 1. Little's irregularity index was used to evaluate anterior tooth irregularity in dental casts obtained from each patient before treatment, after treatment, and 5 years after active treatment. Initial cephalometric variables, initial treatment priority index, pretreatment age, treatment time, and posttreatment time of the groups were compared with t tests. Similarly, Little's irregularity index values at prettreament, posttreatment, and postretention were also compared with the t test. Cephalometric treatment changes within groups were evaluated with dependent t tests. RESULTS: There were no statistically significant differences in posttretention anterior-tooth irregularity between groups 1 and 2 or the subgroup. CONCLUSIONS: Treatment of Class II malocclusion with extraction of either 2 maxillary premolars or 4 premolars provides the same mandibular anterior-tooth alignment stability.

Adolescent↗

[15 years of treatment of temporomandibular joint algo-dysfunctional syndromes].

For more than 15 years, the maxillo-facial and stomatological center in Lyon has received approximately 100 cases of T.M.A.D.S. per year. The etiological basis of the symptomatology is muscular dysfunction due to malocclusion variable degree and duration. Simple radiological investigations complete the examination. Treatment aims at correcting the malocclusion, either by simple methods: dental occlusion and prosthesis, or by orthognathic orthodontic and surgical techniques. Surgery involving the temporo-mandibular joint is reserved for rare cases of condylar deformation which is often post-traumatic. Favorable results can be obtained in 85% of cases.

Adult↗

Retention procedures for stabilising tooth position after treatment with orthodontic braces.

BACKGROUND: Retention is the phase of orthodontic treatment that attempts to keep teeth in the corrected positions after orthodontic (dental) braces. Without a phase of retention there is a tendency for the teeth to return to their initial position (relapse). To prevent relapse almost every patient who has orthodontic treatment will require some type of retention. OBJECTIVES: To evaluate the effectiveness of different retention strategies used to stabilise tooth position after orthodontic braces. SEARCH STRATEGY: The Cochrane Oral Health Group's Trials Register, CENTRAL, MEDLINE and EMBASE were searched. Several journals were handsearched. No language restrictions were applied. Authors of randomised controlled trials (RCTs) were identified and contacted to identify unpublished trials. Most recent search: December 2002. SELECTION CRITERIA: RCTs on children and adults, who have had retainers fitted or adjunctive procedures undertaken, following orthodontic treatment with braces to prevent relapse. The outcomes are: how well the teeth are stabilised, survival of retainers, adverse effects on oral health and quality of life. DATA COLLECTION AND ANALYSIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two reviewers. As no two studies compared the same retention strategies (interventions) it was not possible to combine the results of any studies. MAIN RESULTS: Four trials satisfied the inclusion criteria. These trials all compared different interventions: circumferential supracrestal fiberotomy (CSF) combined with full-time removable retainer versus a full-time removable retainer alone; circumferential supracrestal fiberotomy (CSF) combined with a nights-only removable retainer versus a nights-only removable retainer alone; removable Hawley retainer versus a clear overlay retainer; and three types of fixed retainers versus a removable retainer. There was weak unreliable evidence, based on data from one trial, that there was a statistically significant increase in stability in both the mandibular (p < 0.001) and maxillary anterior segments (p < 0.001) when the CSF was used, compared with when it was not used. There was also weak, unreliable evidence that teeth settle quicker with a Hawley retainer than with a clear overlay retainer after 3 months. The quality of the trial reports was generally poor. REVIEWER'S CONCLUSIONS: There are insufficient research data on which to base our clinical practice on retention at present. There is an urgent need for high quality randomised controlled trials in this crucial area of orthodontic practice.

Humans↗