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At least 1,729 records · Page 96Linked to original sources

PubMed2006

Orthodontic retention: a systematic review.

OBJECTIVE: To evaluate the effectiveness of different retention strategies used to maintain tooth position after treatment by orthodontic appliances. DATA SOURCES: The search strategy was carried out according to the standard Cochrane systematic review methodology. The following databases were searched for randomized clinical trials (RCT) or controlled clinical trials (CCT): Cochrane Oral Health Group Trials Register, Cochrane Clinical Trials Register, MEDLINE and EMBASE. No language restrictions were applied. Authors of trials were contacted to identify unpublished trials. Inclusion and exclusion criteria were applied when considering the studies to be included and a quality assessment made for each paper. DATA SELECTION: The primary outcome was the amount of relapse. Secondary outcomes were survival of retainers, adverse effects on oral health and patient satisfaction. DATA EXTRACTION: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted in duplicate and independently by two reviewers. Five studies (2 RCTs and 3 CCTs) fulfilled the inclusion criteria. DATA SYNTHESIS: There was 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 (circumferential supracrestal fiberotomy) was used in conjunction with a Hawley retainer, compared with a Hawley retainer alone. However, this evidence may be unreliable due to flaws in the study design. There was also weak, unreliable evidence that teeth settle quicker with a Hawley retainer than with a clear overlay retainer after 3 months. CONCLUSIONS: There is currently insufficient evidence on which to base the clinical practice of orthodontic retention.

Humans↗

PubMed1988

Changes in the complexity of orthodontic treatment for patients referred to a teaching hospital.

The records of 200 orthodontic patients accepted for treatment by the Orthodontic Department of the Bristol Dental Hospital in 1977 were compared with 200 taken on in 1985 in order to determine whether there had been any change in the proportion of referred cases requiring more complex procedures. Within each sample, cases were categorized as follows: (a) suitable for removable appliance treatment by an undergraduate or general practitioner; (b) requiring simple one arch fixed appliance treatment such as might be attempted by a general practitioner after a period of further training; (c) needing specialist treatment such as full multibracketed fixed appliances or orthognathic surgery. It was found that there had been no change in the proportions of simple and complex cases referred during the 8-year period although the proportion of patients now receiving complex treatment had increased greatly. Possible explanations and implications are discussed.

England↗

PubMed1990

A profile of orthodontic treatment in the general dental service in Scotland 1979-1987.

The study casts and records of two samples of patients who had received orthodontic treatment involving the use of appliances within the General Dental Service (GDS) in Scotland during 1979/81 and 1986/87 were examined to study the pattern of treatment, and to determine whether there had been any change over this period. Both samples contained a wide range of malocclusions which were treated mostly with removable appliances. Although few fixed appliances were used and few lower arch treatments were carried out there was a trend towards a greater use of these appliances and an increase in these treatments in 1986/87 compared with 1979/81. There was no change in the infrequent use of headgear while functional appliances were used in only six of the treatments in the 1986/87 sample as compared to none in the 1979/81 sample. In the more recent sample many more treatments were undertaken by 'specialist' General Dental Practitioners (i.e. those who work in the GDS, but limit their practice to orthodontics) and fewer treatments were undertaken under the direction of a Consultant Orthodontist.

Adolescent↗

PubMed1991

Treatment co-operation in orthodontic patients.

The aim of the present investigation was to determine the reasons for lack of patient co-operation and premature termination of orthodontic treatment. Over a period of 10 years files at the School of Dentistry, Huddinge, Sweden, showed that 80 patients (4 per cent) terminated treatment prematurely. These patients were interviewed regarding their reasons for not completing treatment. Lack of motivation was the most common reason given. Insufficient information about orthodontic treatment and lack of communication between the orthodontist and patient were the basis for the reasons given. Orthodontists require more knowledge of psychology and should have some training in information communication in order to further reduce the level of discontinued treatments.

Activator Appliances↗

PubMed1992

The performance of first molar orthodontic bands cemented with glass ionomer cement--a retrospective analysis.

Various factors influencing the survival time of orthodontic bands cemented to first permanent molars with glass ionomer cement (KETAC-CEM, Espe) have been investigated. Data on 513 patients with 1424 first molar bands who completed orthodontic treatment between 1985 and 1989 inclusive were analysed. Performance of bands cemented to first permanent molars varied according to the operator, age of the patient and treatment mechanics, but not according to the sex of the patient or quadrant in which the band was fitted.

Adolescent↗

PubMed1995

An evaluation of the views of general dental practitioners who have participated in an extended orthodontic training scheme.

A questionnaire was sent to 255 dental practitioners who had participated in an extended orthodontic training scheme, incorporating formal teaching and supervised clinical sessions over a period of not less than 24 months. The response of the practitioners was good; 78 per cent of the forms returned were suitable for analysis. Overall, the practitioners responded favourably to the schemes and felt that they had been of benefit to their clinical practice. The majority undertook more orthodontic treatment as a result and on average, fixed appliances were used in half of these treatments.

Adolescent↗

PubMed1996

Consultant orthodontic services for cleft patients in England and Wales.

A postal questionnaire survey of consultant orthodontists in England and Wales was undertaken as part of a national audit of the care of children born with cleft lip/and or cleft palate. A 100% response rate was achieved. The majority of respondents stated that they provide orthodontic treatment for cleft patients but only 78% of these attend multi-disciplinary cleft clinics. Consultant orthodontists provide treatment not only in the form of appliances for patients born with clefts but are also involved in the counselling of parents and coordination of regional data bases. Only 24% of hospital orthodontists are involved in the provision of presurgical appliances for cleft babies on a regular basis. The lack of rationalisation of orthodontic services and a low uptake of standardised record keeping protocols for cleft patients by consultant orthodontists gives cause for concern.

Child↗

PubMed2007

Unusual extraction treatment in Class II division 1 using C-orthodontic mini-implants.

This paper describes the treatment of a female patient, aged 23 years and 5 months, with a Class II division 1 malocclusion, who showed severe anterior protrusion and lower anterior crowding. Specially-designed orthodontic mini-implants were placed bilaterally in the interdental space between both the upper and the lower posterior teeth. Both lower first molars showed severe apical lesions. Therefore, the treatment plan consisted of extraction of both upper first premolars and lower first molars, en masse retraction of the upper six anterior teeth, lower anterior alignment, and protraction of all the lower molars. C-implants(R) were used as substitutes for maxillary posterior anchorage teeth during anterior retraction and as hooks for mandibular molar protraction. The correct overbite and overjet were obtained by intruding and retracting the upper six anterior teeth into their proper positions. The dentition was detailed using conventional orthodontic appliances. The upper C-implants contributed to an improvement in facial balance, and the lower C-implants made it possible to protract the lower second and third molars with less effect on the axis of the lower anterior teeth. The active treatment period was 29 months and the patient's teeth continued to be stable 11 months after debonding.

Adult↗

PubMed1997

The need and demand for orthodontic treatment in 13- to 15-year-olds in Nairobi, Kenya.

The need for orthodontic treatment in Kenya was previously not been investigated. This study was undertaken to assess the need for orthodontic treatment in 13- to 15-year-old children in Nairobi. The objective need was assessed in 919 children by using the Norwegian treatment need index, and the subjective need was assessed in 739 children by using a structured questionnaire. Objective treatment need was recorded in 29% and subjective need in 33% of the children. Less than 1% were allocated the 'very great need' category. Relatively more girls than boys were dissatisfied with the appearance of their teeth, and a significantly higher number of girls (P < 0.001) said they would like to have their teeth straightened. The children's perceived need for treatment correlated significantly with the treatment need index. Fixed appliances were found necessary for correcting malocclusion in 23% of the children and removable appliances in 6%. Future studies in Kenya should be directed at determining the societal perception of malocclusion, upon which treatment standards may be based.

Adolescent↗

PubMed1975

[Orthodontic therapy using removable and fixed appliances--a statement of position].

Even in the planning process of orthodontic therapy the primary question should not be directed to the type of appliance to be used. An outline of basic considerations is presented, the evaluation of which leads in a logical way to the choice of appliance and the appropriate procedure. No controversy can evolve between "removable" and "fixed" provided the orthodontist is capable in both sectors. In regard to fixed appliance, it can be stated that the technical limitations of the edgewise mechanism--designed by Angle almost 50 years ago, in the meantime modified and again supplemented by a variety of extraoral force systems--still exceed by far the biologically imposed limitations. The technical versatility of this mechanism could fulfill until now almost all of the changing demands of orthodontic therapy which derived from the continuously enlarging spectrum of knowledge.

Dental Stress Analysis↗

PubMed2001

Adjunctive orchestrated orthodontic therapy.

The altruistic goal of any cosmetic dental rehabilitation is the re-establishment of a healthy maintainable aesthetic functional interface from an otherwise damaged dentition. To this end, a multi-disciplinary treatment plan is necessary to fulfill the periodontal, orthodontic, maxillofacial and cosmetic requirements for a healthy, stable dentition that has a favorable long-term prognosis. This comprehensive treatment approach strives for the constituent components of the dentition to have a proper occlusal scheme with properly aligned and positioned teeth prior to prosthetic therapy. This can easily be achieved by the cosmetic dentist in office through the process of adjunctive orchestrated orthodontic therapy, using socially acceptable aesthetic appliances.

Adult↗

PubMed2001

[Orthodontic treatment of overbite by the Tip Edge technique in conjunction with an anterior bite elevator. Part 1].

In orthodontics, incisor overbite has always been considered as an anomaly difficult to correct but also as the one most hindering the solving of the problems resulting from other associated malpositions. The recent concept of unlocking, introduced by the bioprogressive School, proves that the profession has become aware of its importance in any orthodontic treatment plan. Due to the fact that overbite also hinders the setting up of inferior brackets or forces the practitioner to bond them in a position liable to burden the parodontal health of the lower incisors has therefore induced the author to put in place, at the beginning of the treatment with the Tip-Edge technique, an anterior bite raiser thus generating space in the lateral sectors. Considering how fast the anterior problem is solved once the occlusion is lifted, the bite raiser can be suppressed within three months. Another advantage resides in the possible adjunction of an expansion screw also aimed at unlocking the occlusion in transverse direction. The question then raised in to know whether that approach which ought to be compared to the one of the functional appliances is not the ideal solution to unlock the occlusion in the three dimensions of space when the use of fixed appliances alone might be unsuitable or too slow, regarding current therapeutic aims. Attributing that spectacular therapeutic result to an incisor intrusion or a molar extrusion is of little interest as far as those alterations do not lead to an increase of the vertical dimension of the lower portion of the face. A cephalometric study, published concomitantly, has evidenced that the use of an anterior bite raiser together with the Tip-Edge technique only leads to perfectly similar alterations to those observed with the Ricketts bioprogressive technique or the Schudy edgewise technique, without the help of a bite raiser. From now on, integrating the bite raiser in our therapeutic armamentarium in conjunction with fixed techniques is highly recommended.

Cephalometry↗

PubMed2002

Temporary tongue thrust: failure during orthodontic treatment.

This report presents the case of a 25-year-old male patient who sought orthodontic treatment. Oral examination revealed an Angle Class I relation, with a bimaxillary dento-alveolar protrusion, evidence of anterior crowding, and a large overbite and overjet. Radiographic examination revealed a skeletal Class I occlusion. During the distal movement of the canines, occlusal interferences between the canines occurred and the commencement of a tongue thrust was observed. After correction of the applied forces, the canine movement was completed and the habit was no longer detectable. The incident indicates that an unusual oral habit suspiciously occurring during treatment should lead to an immediate reconsideration of the orthodontic treatment strategy.

Adult↗

PubMed1992

Biomechanical responses of tooth to orthodontic forces applied at the lingual bracket positions.

The present study was designed to investigate biomechanical responses of tooth to orthodontic forces applied at the lingual bracket positions. A three-dimensional finite element model of the upper central incisor was developed to analyze tooth displacements and stress distributions in the periodontal ligament. Lingual horizontal and apical vertical forces of 100 gf were applied at a point on the labial surface of the crown and at three different points on the lingual surface of the crown. Tooth displacements and stress distributions from the forces applied at the lingual points were compared with those from the labial force loading. The following results were obtained. 1. Lingual horizontal force produced almost similar patterns of tooth displacements and stress distributions, irrespective of labial and lingual application points of the orthodontic forces. 2. Apical vertical force applied at the lingual points produced more uniform tooth displacements and stress distributions than labial application of the force, although the force applied at the lingual point close to the cervix generated different patterns from those with the remaining lingual force loadings. The present results suggest an important role of the positional relation of force application points to the center of resistance. It is shown that lingual force application may produce more optimal tooth movement in terms of more uniform patterns of tooth displacements and subsequent stress distributions in the PDL.

Biomechanical Phenomena↗

PubMed2003

A longitudinal index study of orthodontic stability and relapse.

BACKGROUND: Previous studies of stability and relapse after orthodontic treatment report short-term stability is generally followed by slow relapse to the original condition. What these studies do not report is whether this relapse is continuous or interspersed with periods of improvement or stability. METHODS: A subjective 0-10 index of malocclusion was used to record post-treatment stability and relapse over 10 to 12 years following fixed appliance orthodontic treatment of 24 patients. The severity scores were plotted on timelines. RESULTS: Episodes of change, both favourable and unfavourable, were interspersed with episodes of stability. CONCLUSIONS: Changes in the first 3 and 12 months post-treatment are indicative of the 10 to 12 years post-treatment outcomes. This index may provide a useful instrument to analyze patients and/or their study models longitudinally.

Adolescent↗

PubMed2005

Prediction of treatment outcome following correction of anterior crossbites in the mixed dentition: orthodontic versus orthopaedic methods.

AIM: To separate subjects with anterior crossbite and mild maxillary deficiency into two groups: those that can be treated successfully with a 2 x 4 appliance and those that should be treated with reverse headgear and maxillary expansion. METHODS: Thirty mixed dentition subjects each with an anterior crossbite, a concave profile, a deficient maxilla, and an ANB angle between -2 and +1 degrees were used. Fifteen subjects (8 boys, 7 girls; Mean age: 9.17 +/- 1.1 years) were successfully treated with a 2 x 4 appliance (orthodontic treatment group) and remainder (5 boys, 10 girls; Mean age: 8.6 +/- 1.5 years) were successfully treated with reverse headgear and maxillary expansion after initial treatment with a 2 x 4 appliance had failed (orthopaedic treatment group). Unstandardised discriminant function coefficients and a constant were calculated for selected pretreatment cephalometric variables. RESULTS: The NSAr angle was significantly smaller (p < 0.01) and both anterior and posterior cranial base lengths were significantly longer in the orthodontic treatment group (p < 0.001) compared with the orthopaedic group. The prediction index developed was: (PI) = -0.2 NSAr + 0.243 S-N + 0.187 S-Ar + 3.366. The critical score was 0. With positive scores a 2 x 4 appliance can be used and with negative scores reverse headgear and expansion are indicated. CONCLUSION: An equation able to predict treatment success with either a 2 x 4 appliance or reverse headgear has been developed.

Algorithms↗

PubMed2006

Orthodontic extrusion with or without circumferential supracrestal fiberotomy and root planing.

The aim of this randomized clinical trial was to carry out a biometric comparison between the orthodontic extrusion (OE, group B) technique and OE combined with fiberotomy and root planing (OEFRP, group A). Twenty single-root teeth were extruded and assigned to two different groups. In both groups, fixed orthodontic appliances were activated weekly during the course of 3 weeks. After activation, the extruded teeth were maintained in retention for a period of 8 weeks. In group A, along with weekly activation, fiberotomy and root planing were carried out on the top of the alveolar bone crest. Statistical analysis revealed that the amount of dental structure exposed was greater in group A, where the gingival margin and bone tissue remained stable (P < .05). Group B presented coronal migration of the gingival tissue and bone tissue of 2 mm and 1.5 mm, respectively.

Adult↗

PubMed2006

A technique for post-orthodontic retention of maxillary anterior teeth in the restored dentition: A case report.

Retention is one of the most important factors in the long term success of orthodontic treatment. In the adult patient when orthodontic movement is part of an overall treatment plan involving other disciplines, the provision of permanent retention can he complicated. Several methods have been proposed in the literature to date, all with their own problems and risks. This case report presents a technique that may solve this problem for suitable patients in a way that is both non-invasive and has excellent long-term maintenance potential.

Composite Resins↗