Dentistry Journal

Research

11 pages, 419 KiB

Open AccessArticle

Skeletal Anterior Open Bite Attenuates the Chewing-Related Increase in Brain Blood Flow

by Chihiro Kariya, Hiroyuki Kanzaki, Masao Kumazawa, Saaya Sahara, Kana Yoshida, Yuri Inagawa, Fumitaka Kobayashi and Hiroshi Tomonari

Dent. J. 2024, 12(6), 161; https://doi.org/10.3390/dj12060161 - 27 May 2024

Cited by 1 | Viewed by 1173

Abstract

The masticatory function of patients with skeletal anterior open bite (OPEN) is reported to be impaired compared with that of patients with normal occlusion (NORM). In this study, we compared brain blood flow (BBF) in patients with OPEN and NORM and investigated the [...] Read more.

The masticatory function of patients with skeletal anterior open bite (OPEN) is reported to be impaired compared with that of patients with normal occlusion (NORM). In this study, we compared brain blood flow (BBF) in patients with OPEN and NORM and investigated the factors related to BBF during mastication in patients with OPEN. The study included 17 individuals with NORM and 33 patients with OPEN. The following data were collected: number of occlusal contacts, jaw movement variables during mastication, and BBF measured with functional near-infrared spectroscopy during chewing. The number of occlusal contacts, maximum closing and opening speeds, closing angle, and vertical amplitude were smaller in the OPEN than in the NORM group. Interestingly, BBF increased less in the OPEN group. Correlation analysis revealed that several parameters, including number of occlusal contacts and closing angle, were correlated with changes in BBF during mastication. These results suggest that not only occlusion but also jaw movement variables and factors related to masticatory muscles contribute to the chewing-related increase in BBF. In conclusion, BBF increases less during mastication in patients with OPEN than in those with NORM. In addition, the higher increase in BBF is correlated with jaw movement. Together, we discovered that OPEN exhibits significant adverse effects not only on masticatory function but also on brain function. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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10 pages, 3026 KiB

Open AccessArticle

Effects of Froggy Mouth Appliance in Pediatric Patients with Atypical Swallowing: A Prospective Study

by Andrea Scribante, Maurizio Pascadopoli, Simone Gallo, Paola Gandini, Pietro Manzini, Giulia Fadani and Maria Francesca Sfondrini

Dent. J. 2024, 12(4), 96; https://doi.org/10.3390/dj12040096 - 4 Apr 2024

Viewed by 2639

Abstract

Atypical swallowing has a high incidence in growing subjects. Orthopedic treatment with orthodontic appliances and speech therapy are the main approaches to this problem. The aim of this prospective study was to evaluate the changes in the dental arches induced by one year [...] Read more.

Atypical swallowing has a high incidence in growing subjects. Orthopedic treatment with orthodontic appliances and speech therapy are the main approaches to this problem. The aim of this prospective study was to evaluate the changes in the dental arches induced by one year of treatment with the Froggy Mouth myofunctional appliance designed to correct atypical swallowing. In total, 16 patients with atypical swallowing were instructed to use the Froggy Mouth appliance. A digital intraoral impression was taken at baseline (T0). The Froggy Mouth appliance had to be used for 15 min/day throughout the treatment period. At the end of the first year of treatment (T1), another impression was taken with the same intraoral scanner. Digital casts of the T0 and T1 impressions were obtained using software and the two casts were superimposed to record the following measurements: upper intercanine distance, upper arch diameter, upper arch width, overbite and overjet. The data were statistically analyzed (significance threshold: p < 0.05). Student’s t-test was used to compare pre- and post-treatment measurements. Linear regressions were performed to assess the influence of arch width on anterior and posterior diameters. A significant increase was found for the upper arch diameters (p < 0.05), whereas no statistically significant difference was found for the incisor relationship (overjet/overbite) (p > 0.05). To date, the efficacy of this appliance has not been extensively studied. According to the present prospective study, the Froggy Mouth protocol could be a valuable method as a myofunctional therapy for atypical swallowing, but further studies are needed to confirm these preliminary results. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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15 pages, 3485 KiB

Open AccessArticle

Mandibular Endochondral Growth Is Specifically Augmented by Nutritional Supplementation with Myo-Inositol Even in Rabbits

by Miho Shimoyama, Hiroyuki Kanzaki, Syunnosuke Tohyama, Tomomi Ida, Misao Ishikawa, Yuta Katsumata, Chihiro Arai, Satoshi Wada, Shugo Manase and Hiroshi Tomonari

Dent. J. 2024, 12(3), 49; https://doi.org/10.3390/dj12030049 - 26 Feb 2024

Viewed by 2272

Abstract

Mandibular retrognathism occurs by insufficient mandibular growth and causes several issues, such as respiratory difficulty and diminished masticatory function. At present, functional orthodontic appliances are used for stimulating mandibular growth in pediatric cases. However, the effectiveness of functional appliances is not always stable [...] Read more.

Mandibular retrognathism occurs by insufficient mandibular growth and causes several issues, such as respiratory difficulty and diminished masticatory function. At present, functional orthodontic appliances are used for stimulating mandibular growth in pediatric cases. However, the effectiveness of functional appliances is not always stable in daily practices. A more effective, reliable, and safer therapeutic method for mandibular growth promotion would be helpful for growing mandibular retrognathism patients. As we previously discovered that nutritional supplementation of myo-inositol in growing mice specifically increases mandibular endochondral growth, we performed preclinical animal experiments in rabbits in this study. Briefly, six-week-old male Japanese white rabbits were fed with or without myo-inositol supplementation in laboratory chow until 25 weeks old, and 3D image analysis using micro CT data and histological examinations was done. Myo-inositol had no systemic effect, such as femur length, though myo-inositol specifically augmented the mandibular growth. Myo-inositol increased the thickness of mandibular condylar cartilage. We discovered that the nutritional supplementation of myo-inositol during the growth period specifically augmented mandibular growth without any systemic influence, even in rabbits. Our results suggest the possibility of clinical use of myo-inositol for augmentation of the mandibular growth in growing mandibular retrognathism patients in the future. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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10 pages, 1042 KiB

Open AccessArticle

Short- and Long-Term Effects of Maxillary Expander with Tongue Crib in Growing Open-Bite and Skeletal Class II Patients: A Retrospective Study

by Selene Barone, Francesco Bennardo, Federica Diodati, Marianna Salviati, Elena Calabria, Walter Colangeli, Alessandro Antonelli, Carmen Giudice and Amerigo Giudice

Dent. J. 2024, 12(2), 22; https://doi.org/10.3390/dj12020022 - 24 Jan 2024

Viewed by 2402

Abstract

The purpose of this study was to evaluate short- and long-term changes in growing patients with Class II malocclusion and open bite after rapid maxillary expansion (RME). A retrospective cohort study was conducted with 16 growing patients with open-bite malocclusion enrolled in a [...] Read more.

The purpose of this study was to evaluate short- and long-term changes in growing patients with Class II malocclusion and open bite after rapid maxillary expansion (RME). A retrospective cohort study was conducted with 16 growing patients with open-bite malocclusion enrolled in a group treated with a rapid maxillary expander (RME) with a crib (TG), and 16 untreated patients with similar malocclusion in the control group (CG). Cephalograms were recorded before starting the treatment (T0), at the end of the latency phase (T1), and before the fixed therapy (T2) in order to analyze skeletal and dental changes in vertical, transversal, and sagittal relationships. Statistical analysis was performed with α = 0.05 as level of significance. At the end of the active expansion (T1), all subjects in the TG showed a corrected overbite with a statistically significant difference compared to the CG (p > 0.05). A significant decrease in jaw divergence was found in the TG compared to the CG (p < 0.05). At T2, all treated patients maintained a correct overbite. Statistical analysis revealed a significant decrease in maxillary, mandibular, and intermaxillary divergence in the TG compared to the CG (p < 0.05). This protocol could be effective in growing open-bite patients, showing a long-term decrease in facial divergence. The fixed crib allowed to normalize myofunctional activity. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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14 pages, 2418 KiB

Open AccessArticle

Efficiency and Predictability of Coronal Maxillary Expansion Repercussion with the Aligners System: A Retrospective Study

by Ana Sofia Rocha, Maria Gonçalves, Ana Catarina Oliveira, Rui M. S. Azevedo and Teresa Pinho

Dent. J. 2023, 11(11), 258; https://doi.org/10.3390/dj11110258 - 6 Nov 2023

Cited by 1 | Viewed by 2764

Abstract

The Invisalign^® system (SmartForce^® G8) aims to guarantee aesthetics and provide good orthodontic treatment results. Dentoalveolar expansion is possible with clear aligners and can be used to correct dentoalveolar crossbite, resolve crowding or modify the arch shape. Despite the treatment’s effectiveness, [...] Read more.

The Invisalign^® system (SmartForce^® G8) aims to guarantee aesthetics and provide good orthodontic treatment results. Dentoalveolar expansion is possible with clear aligners and can be used to correct dentoalveolar crossbite, resolve crowding or modify the arch shape. Despite the treatment’s effectiveness, there is still disagreement among professionals concerning its true clinical potential. This study aimed to analyze the effectiveness and predictability of coronal tooth expansion movement in permanent dentition in patients who had completed the first phase of treatment with Invisalign^® orthodontic aligners. Materials and Methods: The tooth movement tables of 75 previously selected cases were analyzed in terms of dental-arch width and expansion efficiency, through the Invisalign^® platform, considering the pre-treatment (T0), planned treatment (TP) and post-treatment models (T1) using ClinCheck Pro^® 6.0 software. All patients were treated by an orthodontic specialist and Invisalign^® Diamond Provider in a private practice (T.P.). Results: Difference between T1 and T0: for each maxillary and mandibular measurement, there was a statistically significant difference between pre- and post-aligner treatment values. The greatest amount of expansion occurred in both the upper and the lower premolars. Difference between TP and T1: for each maxillary measurement, statistically significant differences were verified for the molar and canine. At the mandibular level, statistically significant differences were only verified in the first molar. Conclusions: The Invisalign^® clear aligners are effective for simultaneous intra-arch expansion in both jaws. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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11 pages, 3834 KiB

Open AccessArticle

Coronal Repercussions of the Maxillary Central Incisor Torque in the First Set of Aligners: A Retrospective Study

by Ana Catarina Oliveira, Ana Sofia Rocha, Rita Leitão, Manuela Maia and Teresa Pinho

Dent. J. 2023, 11(8), 186; https://doi.org/10.3390/dj11080186 - 3 Aug 2023

Cited by 2 | Viewed by 1500

Abstract

Coronal torque is one of the key factors in orthodontic treatment. An adequate torque value has an impact on aesthetics and soft tissue profile. The aim of this quantitative, comparative and observational longitudinal cohort study was to analyze the efficacy of the maxillary [...] Read more.

Coronal torque is one of the key factors in orthodontic treatment. An adequate torque value has an impact on aesthetics and soft tissue profile. The aim of this quantitative, comparative and observational longitudinal cohort study was to analyze the efficacy of the maxillary central incisor coronal torque in the Invisalign^® system and evaluate the relation between coronal torque movement and patient’s facial biotype. In total, 27 patients were selected. The planned movements (TP) were obtained from the Invisalign Doctor Site^® using mathematical formulas that consider the T0 measurements. Pre-treatment (T0) and after full use of the first set of aligners (T1) scanners were evaluated using Geomagic^® Control X ^TM by superimposing T0 and T1 models using a transverse plane and the long axis of the tooth crown. IBM^® SPSS^® software was used for statistical purposes. We found statistically significant differences between T0 and T1 in pro-inclination and retro-inclination, as well as between achieved and planned values in pro-inclination (p = 0.011). We verified that hyperdivergent clinical cases presented higher mean values of coronal torque, and hypodivergent cases presented lower values. In pro-inclination, the differences between the planned and achieved values were greater in hypodivergent cases and smaller in hyperdivergent cases. In retro-inclination, the differences between the planned and achieved values were greater in normodivergent cases and smaller in hypodivergent cases. This study highlights that inefficacy is more accentuated in pro-inclination. Aligners are an effective tool for producing coronal repercussions of torque movement, being more effective in retro-inclination. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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9 pages, 1698 KiB

Open AccessArticle

Adverse Events Related to Direct-To-Consumer Sequential Aligners—A Study of the MAUDE Database

by Priyanka Belgal, Sahil Mhay, Vrunda Patel and Romesh P. Nalliah

Dent. J. 2023, 11(7), 174; https://doi.org/10.3390/dj11070174 - 17 Jul 2023

Cited by 1 | Viewed by 1792

Abstract

Background—Direct-to-consumer (DTC) sequential aligners promote “teeth straightening” at a low cost and with added patient convenience. DTC sequential aligners have risen in popularity among the general public and sparked debate among dental professionals. Dental professionals argue that using these aligners without an in-person [...] Read more.

Background—Direct-to-consumer (DTC) sequential aligners promote “teeth straightening” at a low cost and with added patient convenience. DTC sequential aligners have risen in popularity among the general public and sparked debate among dental professionals. Dental professionals argue that using these aligners without an in-person diagnosis and treatment planning protocol set by a licensed dentist or orthodontist may lead to adverse effects on teeth and surrounding structures. The objective of this study is to describe adverse clinical events associated with the use of DTC sequential aligners as reported in the Food and Drug Administration’s Manufacturer and User Facility Device Experience (FDA MAUDE) database. Methods—We searched the MAUDE database from 1 January 2010 to 31 December 2020 for the product code of ‘NXC’ (sequential aligners). The year, type of adverse event, reporter occupation, and event description were noted. Results—651 reports associated with sequential aligners were found, of which 104 were related to DTC sequential aligners. Fifty-four adverse events were reported in 2019. From the event description, 41.3% comprised bite problems, 29.8% comprised orofacial pain, and 26.6% of patients had some form of periodontal sequelae. Furthermore, 69.2% of the patients followed up after an adverse event with a dentist not associated with DTC aligners. Conclusions—The use of DTC sequential aligners without dental supervision has led to oral health problems, as documented in the MAUDE database. Commonly reported adverse events include bite problems, pain, sensitivity, and periodontal disease, and some adverse events are irreversible. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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9 pages, 913 KiB

Open AccessArticle

Chewing Efficiency Test in Subjects with Clear Aligners

by Luca Levrini, Salvatore Bocchieri, Federico Mauceri, Stefano Saran, Andrea Carganico, Piero Antonio Zecca and Marzia Segù

Dent. J. 2023, 11(3), 68; https://doi.org/10.3390/dj11030068 - 1 Mar 2023

Cited by 6 | Viewed by 1812

Abstract

The aim of this study was to evaluate the masticatory function of subjects with clear aligners and to propose a simple and repeatable method for the clinical and experimental evaluation of masticatory function. For the testing we used almonds, a natural substance that [...] Read more.

The aim of this study was to evaluate the masticatory function of subjects with clear aligners and to propose a simple and repeatable method for the clinical and experimental evaluation of masticatory function. For the testing we used almonds, a natural substance that can be easily found and stored, has intermediate consistency and hardness, is insoluble in saliva, and has the ability easily lose the moisture absorbed in the mouth. Thirty-four subjects using the Invisalign^® (Align Technology, Santa Clara, CA, USA) protocol were randomly selected. This was an “intercontrol test”, i.e., all subjects under the same conditions acted as controls but also as cases whilst wearing the clear aligners. Patients were asked to chew an almond for 20 s, once with aligners and once without aligners. The material was then dried, sieved, and weighted. Statistical analysis was performed to investigate any significative differences. In all our subjects, the efficiency of chewing with clear aligners was found to be comparable to the efficiency of chewing without clear aligners. In detail, the average weight after drying was 0.62 g without aligners and 0.69 g with aligners, while after sieving at 1 mm, the average weight was 0.08 g without aligners and 0.06 g with aligners. The average variation after drying was of 12%, and after sieving at 1 mm, it was 25%. In summary, there was no substantial difference between chewing with or without clear aligners. Despite some discomfort in chewing, the clear aligners were well tolerated by most subjects, who wore them without difficulty even during meals. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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10 pages, 2757 KiB

Open AccessArticle

Effect of Different Surface Treatments on the Shear Bond Strength of Metal Orthodontic Brackets Bonded to CAD/CAM Provisional Crowns

by Dany Haber, Elie Khoury, Joseph Ghoubril and Nunzio Cirulli

Dent. J. 2023, 11(2), 38; https://doi.org/10.3390/dj11020038 - 2 Feb 2023

Cited by 3 | Viewed by 1990

Abstract

Background: The aim of this study was to find the best surface treatment for CAD/CAM provisional crowns allowing the optimal bond strength of metal brackets. Methods: The sample consists of 30 lower bicuspids and 180 provisional crowns. The provisional crowns were randomly divided [...] Read more.

Background: The aim of this study was to find the best surface treatment for CAD/CAM provisional crowns allowing the optimal bond strength of metal brackets. Methods: The sample consists of 30 lower bicuspids and 180 provisional crowns. The provisional crowns were randomly divided into six different groups. Orthophosphoric acid etching (37%) was applied to 30 lower bicuspids. The provisional crowns had undergone different surface treatments. Group 1: No treatment (Control Group). Group 2: Diamond bur. Group 3: Sandblasting. Group 4: Plastic Conditioner. Group 5: Diamond bur and Plastic Conditioner. Group 6: Sandblasting and Plastic Conditioner. The brackets in all groups were identically placed using Transbond XT^® Primer and Transbond XT^® Paste. Then, the entire sample underwent an artificial aging procedure, and a measurement of the bond strength was conducted. After debonding, the surface of the crowns was examined to determine the quantity of the adhesive remnant. Results: Bonding to natural crowns recorded the highest average, followed by the averages of groups 5 and 6. However, group 1 recorded the lowest average. Groups 2 and 4 had very close averages, as well as groups 5 and 6. A statistically significant difference between the averages of all groups was recorded (p < 0.001) except for groups 2 and 4 (p = 0.965) on the one hand, and groups 5 and 6 (p = 0.941) on the other hand. Discussion: The bonding of brackets on provisional crowns is considered a delicate clinical procedure. In fact, unlike natural crowns, the orthophosphoric acid usually used does not have any effect on the surface of provisional crowns. Conclusions: Using a diamond bur combined with the plastic conditioner and sandblasting combined with that same product resulted in a bond strength close to natural crown. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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10 pages, 1150 KiB

Open AccessArticle

Occlusal Plane Modification in Clear Aligners Treatment: Three Dimensional Retrospective Longitudinal Study

by Domenico Ciavarella, Carlotta Fanelli, Carmela Suriano, Angela Pia Cazzolla, Alessandra Campobasso, Laura Guida, Michele Laurenziello, Gaetano Illuzzi and Michele Tepedino

Dent. J. 2023, 11(1), 8; https://doi.org/10.3390/dj11010008 - 27 Dec 2022

Cited by 4 | Viewed by 2851

Abstract

The purpose of the present study was to evaluate: (i) maxillary occlusal plane changes after clear aligners therapy with a 3D measurement technique; and (ii) as a secondary outcome, if such changes were correlated to the patient’s 1axilla-mandibular divergence. 3D maxillary models of [...] Read more.

The purpose of the present study was to evaluate: (i) maxillary occlusal plane changes after clear aligners therapy with a 3D measurement technique; and (ii) as a secondary outcome, if such changes were correlated to the patient’s 1axilla-mandibular divergence. 3D maxillary models of 32 patients (7 males and 25 females; mean age 22.3 +/− 3.4 year) treated with clear aligners were analyzed. The angle (α) between a reference palatine plane and a maxillary occlusal plane was measured. Five angular cephalometric measurements (NSL/MP; PP-OP; OP-MP; PP-MP; PFH/AFH%) were performed and related to Δα. The subjects were further divided into three groups according to facial divergence. After aligner treatment, Δα increased in hyperdivergent patients and decreased in hypodivergent patients (p < 0.05). Δα showed a significant positive correlation with NSL/MP (rho = 0.44) and negative correlation with PFH/AFH% (rho = −0.53). Aligners treatment produced a counterlockwise rotation of the maxillary occlusal plane, even if this rotation occurs differently depending on divergence. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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10 pages, 1100 KiB

Open AccessArticle

Golden Mean and Proportion in Dental Esthetics after Orthodontic Treatments: An In Vivo Study

by Patrizia Lucchi, Giulia Fortini, Giorgia Preo, Antonio Gracco, Alberto De Stefani and Giovanni Bruno

Dent. J. 2022, 10(12), 235; https://doi.org/10.3390/dj10120235 - 12 Dec 2022

Cited by 1 | Viewed by 2901

Abstract

Purpose: The definition of the golden ratio was established around the sixth century BC; Levin and Snow developed specific theories applicable in dentistry, which apply the golden proportion rule with the intention of reproducing a perfect smile. This study analyzed the literature and [...] Read more.

Purpose: The definition of the golden ratio was established around the sixth century BC; Levin and Snow developed specific theories applicable in dentistry, which apply the golden proportion rule with the intention of reproducing a perfect smile. This study analyzed the literature and assessed whether these concepts remain valid and applicable in clinical practice, evaluating the theories with a group of patients followed by an experienced orthodontic team. Methods: This study was retrospectively performed on 400 patients (241 females and 159 males) who underwent orthodontic treatments. The analysis was conducted on intraoral frontal photos, both pre-treatment and post-orthodontic treatment, to observe if there was a statistically significant difference in the tooth display according to the golden mean and golden proportion theories. Results: The canine at the end of the orthodontic treatment had a greater visibility than that proposed by Levin and Snow. Conclusions: This study revealed how these theories could be considered in certain respects, but nowadays are not totally valid and applicable to the clinical reality. Snow’s theory appears to be more consistent with the clinical findings than Levin’s theory. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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11 pages, 1365 KiB

Open AccessArticle

Predictability of Invisalign^® Clear Aligners Using OrthoPulse^®: A Retrospective Study

by Luca Levrini, Andrea Carganico, Alessandro Deppieri, Stefano Saran, Salvatore Bocchieri, Piero Antonio Zecca, Sara Bertini, Anna D’Apote and Marzia Segù

Dent. J. 2022, 10(12), 229; https://doi.org/10.3390/dj10120229 - 6 Dec 2022

Cited by 2 | Viewed by 3040

Abstract

This preliminary retrospective study evaluates how effective the OrthoPulse^® (Biolux Technology, Austria) is in increasing the predictability of orthodontic treatment in patients treated with Invisalign^® clear aligners (Align Technology Inc., Tempe, AZ, USA). A group of 376 patients were treated with [...] Read more.

This preliminary retrospective study evaluates how effective the OrthoPulse^® (Biolux Technology, Austria) is in increasing the predictability of orthodontic treatment in patients treated with Invisalign^® clear aligners (Align Technology Inc., Tempe, AZ, USA). A group of 376 patients were treated with Invisalign^® orthodontic clear aligners in association with an OrthoPulse^®. The OrthoPulse^® was prescribed for 10 min a day for the entire duration of the orthodontic treatment. The OrthoPulse^® App remotely tracked the percentage compliance of each patient. The number of aligners planned with the ClinCheck software at the beginning of the treatment and the number of total aligners (including the adjunctive aligners) used to finish the treatment were then considered. After applying inclusion/exclusion criteria, a total of 40 patients remained in the study and were compared with a control group of 40 patients with the same characteristics as the study group. A statistical analysis was carried out to investigate whether using OrthoPulse^® led to a statistical reduction in the number of adjunctive aligners, thus leading to a more accurate prediction of the treatment. The statistical analysis showed that patients who used OrthoPulse^® needed fewer finishing aligners and a greater predictability of the treatment was obtained. In fact, in the treated group the average number of additional aligners represented 66.5% of the initial aligners, whereas in the control group 103.4% of the initially planned aligners were needed. In conclusion, in patients treated with clear aligners, OrthoPulse^® would appear to increase the predictability of orthodontic treatment with clear aligners, thus reducing the number of finishing phase requirements. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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11 pages, 782 KiB

Open AccessArticle

Physiotherapists and Osteopaths’ Attitudes: Training in Management of Temporomandibular Disorders

by Stefano Saran, Sabina Saccomanno, Maria Teresa Petricca, Andrea Carganico, Salvatore Bocchieri, Rodolfo Francesco Mastrapasqua, Elena Caramaschi and Luca Levrini

Dent. J. 2022, 10(11), 210; https://doi.org/10.3390/dj10110210 - 4 Nov 2022

Cited by 3 | Viewed by 3079

Abstract

Temporomandibular disorders (TMDs) are a condition which has multifactorial etiology. The most acknowledged method to classify TMDs is the diagnostic criteria (DC) introduced firstly by Dworkin. This protocol considers different aspects that are not only biological, but even psychosocial. Diagnosis is often based [...] Read more.

Temporomandibular disorders (TMDs) are a condition which has multifactorial etiology. The most acknowledged method to classify TMDs is the diagnostic criteria (DC) introduced firstly by Dworkin. This protocol considers different aspects that are not only biological, but even psychosocial. Diagnosis is often based on anamnesis, physical examination and instrumental diagnosis. TMDs are classified as intra-articular and/or extra-articular disorders. Common signs and symptoms include jaw pain and dysfunction, earache, headache, facial pain, limitation to opening the mouth, ear pain and temporomandibular joint (TMJ) noises. This study regards two kind of clinicians that started in the last years to be more involved in the treatment of TMDs: osteopaths (OOs) and physiotherapists (PTs). The purpose is to analyze their attitude and clinical approach on patients affected by TMDs. Four hundred therapists answered an anonymous questionnaire regarding TMJ and TMDs. OOs showed greater knowledges on TMDs and TMJ and, the therapists with both qualifications seemed to be most confident in treating patients with TMDs. In conclusion this study highlights OOs and all the clinicians with this qualification, have a higher confidence in treating patients with TMD than the others. Dentists and orthodontists, according to this study, should co-work with OOs and PTs, because they are the specialists more requested by them than other kinds of specialists. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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11 pages, 7574 KiB

Open AccessEditor’s ChoiceArticle

Comparing Distal-Jet with Dental Anchorage to Distal-Jet with Skeletal Anchorage: A Prospective Parallel Cohort Study

by Federica Altieri, Martina Mezio, Rosanna Guarnieri and Michele Cassetta

Dent. J. 2022, 10(10), 179; https://doi.org/10.3390/dj10100179 - 27 Sep 2022

Cited by 7 | Viewed by 3934

Abstract

The use of traditional intra-oral devices in maxillary molar distalization is not without undesirable consequences. The aim of the present study was to compare the miniscrew-supported distal-jet appliance to a traditional distal-jet appliance by evaluating the amount of upper first molar distalization and [...] Read more.

The use of traditional intra-oral devices in maxillary molar distalization is not without undesirable consequences. The aim of the present study was to compare the miniscrew-supported distal-jet appliance to a traditional distal-jet appliance by evaluating the amount of upper first molar distalization and the dentoalveolar side effects. Data of 600 subjects visited at the orthodontic unit of Sapienza University of Rom were analyzed. Only 46 patients met the inclusion criteria and were selected and treated. Subjects were assigned randomly to receive treatment either with miniscrew-supported distal-jet appliance (Group A) or with a traditional distal-jet appliance (Group B). In Group A, miniscrews were inserted using a computer-guided surgical guide. The amount of upper first molar distalization and the dentoalveolar side effects were assessed both on the digital casts and on the lateral cephalometric radiograph at the end of the distalization phase. A descriptive statistical analysis that included the mean values and the standard deviation was conducted to evaluate the molar distalization and the dentoalveolar effects in two groups. Intergroup differences were determined using the Student’s t-test. The significance was set at p ≤ 0.05. In Group A, greater maxillary first molar distalization and a spontaneous distalization of the first premolars and a palatal inclination of central incisors were observed. By contrast, in Group B, the first premolars tipped mesially and a proclination of the maxillary central incisors was observed. In both groups, the transverse widths of the dental arch increased while a greater tendency of first premolar extrusion and of maxillary first molar rotation was observed in Group B. The skeletal anchorage device achieved greater first molar distalization and did not cause dento-alveolar side effects. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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10 pages, 4482 KiB

Open AccessArticle

Analysis of Osteoclasts and Root Resorption in Corticotomy-Facilitated Orthodontics with Ibuprofen Administration—An Animal Study

by Chanakant Jindarojanakul, Pannapat Chanmanee and Bancha Samruajbenjakun

Dent. J. 2022, 10(9), 170; https://doi.org/10.3390/dj10090170 - 8 Sep 2022

Cited by 1 | Viewed by 2496

Abstract

Following corticotomy surgery, patients experience moderate to severe post-operative pain that necessitates prescriptions of analgesics. The prostaglandin inhibitory effect of ibuprofen influences the mobility of teeth during orthodontic treatment. This study aimed to determine how ibuprofen affects histological reactions and dental root resorption [...] Read more.

Following corticotomy surgery, patients experience moderate to severe post-operative pain that necessitates prescriptions of analgesics. The prostaglandin inhibitory effect of ibuprofen influences the mobility of teeth during orthodontic treatment. This study aimed to determine how ibuprofen affects histological reactions and dental root resorption during orthodontic tooth movement aided by corticotomy. Forty-two male Wistar rats were divided into three groups by random selection: (1) control group, (2) corticotomy group (CO), and (3) corticotomy with 0.6 mL of 15 mg/kg ibuprofen group (CI). On each buccal and palatal alveolar bone, two decortication points were made. Orthodontic tooth movement was induced on the maxillary first molar for 21 days utilizing a NiTi-closed coil spring with 10 g of force. Hematoxylin and eosin were used to prepare and stain the histological sections. The numbers of osteoclasts on days 0, 7, 14, and 21 were determined, and the root resorption area on days 0 and 21 was measured. Compared to the control group, the osteoclast counts in the CO and CI groups were considerably greater (p < 0.002). No significant differences were observed between the CO and CI groups in the numbers of osteoclasts or the percentages of root resorption (p > 0.05). The amounts of osteoclast activity and root resorption were unaffected by the administration of ibuprofen in corticotomy-facilitated tooth movement. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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10 pages, 1934 KiB

Open AccessEditor’s ChoiceArticle

Effect of Extending Corticotomy Depth to Trabecular Bone on Accelerating Orthodontic Tooth Movement in Rats

by Thanapat Pathomkulmai, Pannapat Chanmanee and Bancha Samruajbenjakun

Dent. J. 2022, 10(9), 158; https://doi.org/10.3390/dj10090158 - 29 Aug 2022

Cited by 3 | Viewed by 2557

Abstract

Corticotomy is a surgical procedure that induces injury to the cortical bone to accelerate tooth movement. This study aimed to increase the depth of corticotomy to the trabecular bone and to evaluate the amount and rate of tooth movement and alveolar bone changes [...] Read more.

Corticotomy is a surgical procedure that induces injury to the cortical bone to accelerate tooth movement. This study aimed to increase the depth of corticotomy to the trabecular bone and to evaluate the amount and rate of tooth movement and alveolar bone changes in response to various degrees of cortical and trabecular bone injury. Seventy-eight male Wistar rats were randomly divided into four groups based on procedure used: (1) baseline control group of orthodontic tooth movement (OTM) only; (2) OTM + 4 corticotomies (CO); (3) OTM + 4 osteotomies (OS); and (4) OTM + 16 CO. A closed-coil nickel–titanium spring was placed to move the maxillary first molar mesially with a 10 g force. On days 0, 7, 14, and 21, alveolar bone alteration and tooth movement were measured using microcomputed tomography. Significant tooth movement was related to the number and the depth of the perforations. The OTM + 16 CO group showed a greater amount and rate of tooth movement than the OTM + 4 CO group. When osteotomy and corticotomy were compared with the same volume of bone removed, the OTM + 4 OS group had a faster rate of tooth movement than the OTM + 16 CO group during the first week, with significantly reduced bone volume. However, no significant difference was observed in the amount of tooth movement between the OTM + 4 OS and OTM + 16 CO groups at the end of the study. Extending the depth of corticotomy to trabecular bone increased the amount of tooth movement by accelerating the induction and completion of bone remodeling, which accelerated the rate of tooth movement during the initial stage. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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9 pages, 588 KiB

Open AccessArticle

The Potential of Digital Impression in Orthodontics

by Sabina Saccomanno, Stefano Saran, Valeria Vanella, Rodolfo Francesco Mastrapasqua, Luca Raffaelli and Luca Levrini

Dent. J. 2022, 10(8), 147; https://doi.org/10.3390/dj10080147 - 8 Aug 2022

Cited by 6 | Viewed by 3362

Abstract

Background: Over the past 20 years, there have been many innovations in orthodontic diagnosis and therapy. Among the innovations, there is the taking of dental impressions (DIs). Dental impressions are the negative imprint of hard and soft tissues of one or both arches, [...] Read more.

Background: Over the past 20 years, there have been many innovations in orthodontic diagnosis and therapy. Among the innovations, there is the taking of dental impressions (DIs). Dental impressions are the negative imprint of hard and soft tissues of one or both arches, and they allow a plaster model to be formed, i.e., a positive reproduction. Traditional dental impressions can be made of different materials, such as alginate, while digital impression is captured by an intra-oral scanner. Digital impression, despite the evident advantages, has not yet replaced the conventional impression. The aim of this study is to evaluate which dental impressions are the most used by dentists. For this purpose, we considered 120 questionnaires sent electronically to patients of different dental private practices from different countries, where the dentists can use both techniques. The results highlighted that the kind of impression adopted is very much influenced by the type of therapy and orthodontic devices used in the treatment. We can conclude that, despite the advent of digital technology, conventional impressions are still used for fixed devices, while digital impressions are more adopted for orthodontic customized devices and therapies with clear aligners, that are very widespread among adult patients. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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14 pages, 3723 KiB

Open AccessEditor’s ChoiceArticle

The Interaction of Craniofacial Morphology and Body Mass Index in Obstructive Sleep Apnea

by Federica Bertuzzi, Antonio Santagostini, Matteo Pollis, Fabio Meola and Marzia Segù

Dent. J. 2022, 10(7), 136; https://doi.org/10.3390/dj10070136 - 19 Jul 2022

Cited by 6 | Viewed by 2280

Abstract

Aim: This study sets out to explore the relationship between craniofacial morphology and obstructive sleep apnea (OSA) severity, assessing the relative contribution of obesity, calculated using BMI. Methods: A sample of 30 adult patients (20 males; 10 females), mean age = 54(±76) years, [...] Read more.

Aim: This study sets out to explore the relationship between craniofacial morphology and obstructive sleep apnea (OSA) severity, assessing the relative contribution of obesity, calculated using BMI. Methods: A sample of 30 adult patients (20 males; 10 females), mean age = 54(±76) years, with a polysomnography-confirmed diagnosis of OSA, i.e., with an apnea-hypopnea index (AHI) of over 5 events/h, was recruited and underwent cephalometric evaluation. Sleep parameters, namely AHI, AHI supine, oxygen desaturation index (ODI), and mean oxygen saturation [Mean SaO2%], were assessed. Correlation analysis between 13 cephalometric features and AHI was performed using a Pearson test. The sample was split into three groups based on AHI score (mild = 10 < AHI < 15; moderate = 15 < AHI < 30; severe = AHI > 30), and ANOVA was performed to compare the means of cephalometric features. In addition, the sample was split into two groups according to BMI (normal weight = BMI < 25; overweight = BMI > 25). Correlation analysis between cephalometric features and AHI was performed for each group using a Pearson test. Results: The average polysomnographic values were AHI = 29.08(±16); AHI supine = 43.45(±21); ODI = 23.98(±21); mean SaO2(%) = 93.12(±2). Posterior facial height (PFH) was significantly lower in the severe OSA group than in patients with moderate OSA (p = 0.05). In the normal-weight group, negative correlations of the PFH and SNA angle with AHI (r = −0.36; r = −0.25, respectively), and positive correlations of the FMA angle and MP-H distance with AHI (r = 0.29; r = 0.20, respectively), were found. In the overweight group, negative correlations of AO-BO distance, SPAS (upper posterior airway space) and PAS (posterior airway space) with AHI (r = −0.30; r = −0.28; r = −0.24, respectively), and positive correlations of AFH (anterior facial height) and the FMA angle with AHI (r = 0.32; r = 0.25, respectively), emerged. Conclusions: PFH seems to be related to the aggravation of OSA. In normal-weight subjects, hard tissue-related factors have a greater impact on OSA severity, whereas in overweight subjects, the impact of fat tissue is greater. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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10 pages, 4123 KiB

Open AccessEditor’s ChoiceArticle

Initial Displacement and Stress Distribution of Upper Central Incisor Extrusion with Clear Aligners and Various Shapes of Composite Attachments Using the Finite Element Method

by Pratchawin Laohachaiaroon, Bancha Samruajbenjakun and Ekachai Chaichanasiri

Dent. J. 2022, 10(6), 114; https://doi.org/10.3390/dj10060114 - 20 Jun 2022

Cited by 13 | Viewed by 3598

Abstract

A clear aligner is an esthetic and more comfortable option for patients who need orthodontic treatment. However, some types of tooth movement, such as extrusion, are difficult with this tool. Therefore, composite attachments have been suggested to improve tooth movement. This study aims [...] Read more.

A clear aligner is an esthetic and more comfortable option for patients who need orthodontic treatment. However, some types of tooth movement, such as extrusion, are difficult with this tool. Therefore, composite attachments have been suggested to improve tooth movement. This study aims to evaluate the initial displacement and stress distribution during upper central incisor extrusion using the conventional composite attachments. Maxillary models with the upper teeth, clear aligners, and composite attachments placed on the labial surface of the upper right central incisor were constructed. Four models were created to simulate upper central incisor extrusion: (1) without any composite attachment; (2) rectangular beveled attachment; (3) ellipsoid attachment; and (4) horizontal rectangular attachment. Clear aligners were designed to perform upper central incisor extrusion. The constructed models were analyzed using the finite element method. Initial displacement and stress distribution were analyzed. Output analysis found that the upper right central incisor in the model with a horizontal rectangular attachment had the greatest extrusive movement, followed by the model with ellipsoid attachment and the model with beveled attachment. Maximum compressive stress was seen at the cervical region of the composite attachment. Composite attachments including horizontal rectangular attachment, ellipsoid attachment, and rectangular beveled attachment can be used to perform upper central incisor extrusion. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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10 pages, 941 KiB

Open AccessArticle

Pilot Study of a New Mandibular Advancement Device

by Marzia Segù, Giovanna Campagnoli, Marco Di Blasio, Antonio Santagostini, Matteo Pollis and Luca Levrini

Dent. J. 2022, 10(6), 99; https://doi.org/10.3390/dj10060099 - 6 Jun 2022

Cited by 9 | Viewed by 3353

Abstract

This study was conducted to determine the efficacy of a customized mandibular advancement device (MAD) in the treatment of obstructive sleep apnea (OSA). Eight patients (M = 3; F = 5; mean age = 56.3 ± 9.4) with a diagnosis of OSA confirmed [...] Read more.

This study was conducted to determine the efficacy of a customized mandibular advancement device (MAD) in the treatment of obstructive sleep apnea (OSA). Eight patients (M = 3; F = 5; mean age = 56.3 ± 9.4) with a diagnosis of OSA confirmed by polysomnography (PSG) were recruited on the basis of the following inclusion criteria: apnea-hypopnea index (AHI) > 5, age between 18 and 75 years, body mass index (BMI) < 25, and PSG data available at baseline (T0). All were treated with the new NOA^® MAD by OrthoApnea (NOA^®) for at least 3 months; PSG with NOA in situ was performed after 3 months of treatment (T1). The following parameters were calculated at T0 and T1: AHI, supine AHI, oxygen desaturation index (ODI), percentage of recording time spent with oxygen saturation <90% (SpO2 < 90%), and mean oxygen desaturation (MeanSpO2%). Data were submitted for statistical analysis. The baseline values were AHI = 21.33 ± 14.79, supine AHI = 35.64 ± 12.80, ODI = 17.51 ± 13.5, SpO2 < 90% = 7.82 ± 17.08, and MeanSpO2% = 93.45 ± 1.86. Four patients had mild OSA (5 > AHI < 15), one moderate OSA (15 > AHI < 30), and three severe OSA (AHI > 30). After treatment with NOA^®, statistically significant improvements in AHI (8.6 ± 4.21) and supine AHI (11.21 ± 7.26) were recorded. OrthoApnea NOA^® could be an effective alternative in the treatment of OSA: the device improved the PSG parameters assessed. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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Review

Jump to: Research, Other

12 pages, 236 KiB

Open AccessReview

Maintaining Hygiene in Orthodontic Miniscrews: Patient Management and Protocols—A Literature Review

by Riccardo Favero, Martina Fabiane, Andrea Zuccon, Diego Conte and Francesco Saverio Ludovichetti

Dent. J. 2024, 12(7), 227; https://doi.org/10.3390/dj12070227 - 19 Jul 2024

Viewed by 1067

Abstract

Background: Oral hygiene is crucial for the success of orthodontic therapy involving temporary anchoring devices like miniscrews. Plaque buildup, exacerbated by orthodontic appliances, causes inflammation that can undermine treatment outcomes. Individualized prevention plans based on patient risk factors are essential. This review emphasizes [...] Read more.

Background: Oral hygiene is crucial for the success of orthodontic therapy involving temporary anchoring devices like miniscrews. Plaque buildup, exacerbated by orthodontic appliances, causes inflammation that can undermine treatment outcomes. Individualized prevention plans based on patient risk factors are essential. This review emphasizes the importance of oral hygiene in orthodontic therapy with miniscrews, identifies optimal devices for ensuring long-term stability, and explores protocols for high-risk patients. Materials And Methods: A comprehensive search was conducted on two primary databases, PubMed and Google Scholar, for relevant articles on oral hygiene and inflammation. Fourteen articles meeting the inclusion criteria were selected, covering topics such as “orthodontic miniscrew”, “miniscrew and laser”, “miniscrew and mouthwash”, “electric toothbrush”, and “GBT”. Results: Inflammation can compromise miniscrew stability by damaging surrounding bone. Miniscrews of 10 mm length have lower failure rates due to better bone contact and stability. Chlorhexidine reduces inflammation risk and inhibits epithelialization around the implant head. Laser therapy enhances miniscrew stability and reduces inflammation. Chitosan effectively suppresses inflammatory mediators and prevents microorganism adhesion. Both sonic and roto-oscillating electric toothbrushes remove plaque effectively, with roto-oscillating brushes showing superior results. The Guided Biofilm Therapy (GBT) protocol offers professional hygiene benefits similar to traditional methods, with improved patient engagement and motivation. Conclusions: Home oral hygiene maintenance is paramount for preventing inflammatory complications. Professional interventions such as diode laser usage, particularly in adult patients with a history of periodontitis or underlying systemic conditions, can mitigate orthodontic therapy failure risks. The GBT protocol fosters a more comfortable and participatory professional hygiene experience for patients, promoting better oral health awareness and compliance. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

Other

Jump to: Research, Review

14 pages, 20532 KiB

Open AccessCase Report

Biomechanically and Periodontally-Based Orthodontic Treatment of a Patient with Upper Canine Affected by External Cervical Resorption (ECR): A Case Report

by Marino Musilli, Morena Tina Iuorio, Emanuele Vaia, Enzo Vaia, Luca Ramaglia and Vincenzo D’Antò

Dent. J. 2023, 11(12), 278; https://doi.org/10.3390/dj11120278 - 30 Nov 2023

Cited by 1 | Viewed by 2361

Abstract

(1) Background: Orthodontic treatment may be a potential predisposing factor for ECR. The affected tooth goes to ankylosis, which could lead to a malocclusion. Although teeth severely affected by ECR (class IV Heithersay) are usually extracted, this case report aims to present the [...] Read more.

(1) Background: Orthodontic treatment may be a potential predisposing factor for ECR. The affected tooth goes to ankylosis, which could lead to a malocclusion. Although teeth severely affected by ECR (class IV Heithersay) are usually extracted, this case report aims to present the use of an ECR class IV upper canine, both as ankylosed to solve the malocclusion and the occlusal plane canting, as well as not ankylosed to correct its ridge defect with orthodontic extrusion. (2) Methods: A 14-year-old male, complaining of an ugly smile and a failed orthodontic attempt to recover an impacted canine, was referred to the orthodontic clinic. He was diagnosed with class II right subdivision, midline deviation, both upper and lower occlusal plane canting, and an upper left canine, previously impacted, showing ECR class IV. The treatment first included canting resolution with a cantilever and a spring, exploiting the anchorage offered by the ankylosed ECR canine. Then, a coronectomy, endodontic treatment, and orthodontic extrusion of that canine were performed to obtain the implant site development. (3) Results: Clinical and radiographic outcomes showed normocclusion and better bony conditions for safer implant placement in the aesthetic zone. (4) Conclusions: The high aesthetics and the periodontal and bony conditions obtained are probably not achievable by other therapeutic alternatives. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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11 pages, 4658 KiB

Open AccessCase Report

Orthodontic Treatment of Palatally Impacted Maxillary Canines with the Use of a Digitally Designed and 3D-Printed Metal Device

by Georgios Vasoglou, Ioannis Lyros, Athanasia Patatou and Michail Vasoglou

Dent. J. 2023, 11(4), 102; https://doi.org/10.3390/dj11040102 - 12 Apr 2023

Cited by 4 | Viewed by 4279

Abstract

The purpose of this article is to present a computer designed and 3D-printed metal device, which was used for the surgical exposure and orthodontic treatment of maxillary palatally impacted canines. In two cases which presented a palatally impacted canine, a Cone-Beam Computed Tomography [...] Read more.

The purpose of this article is to present a computer designed and 3D-printed metal device, which was used for the surgical exposure and orthodontic treatment of maxillary palatally impacted canines. In two cases which presented a palatally impacted canine, a Cone-Beam Computed Tomography (CBCT) was acquired and an intraoral scanning was performed, to determine the exact location of the canine. Based on a digital model, a device leaning on the teeth and mucosa was designed to serve as a guiding tool for the oral surgeon to expose the crown of the canine and help the orthodontist to provide proper traction. The device was then 3D-printed in biocompatible dental alloy and placed in the patients’ mouth. After the surgical exposure of the canine’s crown in both cases, a gold chain apparatus was bonded on and it was mounted on the metal projection of the device through an elastic chain. Within 3 months of traction, the crown of the canines appeared in the patients’ palate to the exact location that was predicted and guided. A 3D-designed and manufactured metal device, with information acquired by CBCT and intraoral scanning, can be used for the exposure and traction of palatally impacted canines. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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12 pages, 1292 KiB

Open AccessSystematic Review

Evaluation of the Changes of the Intercanine and Intermolar Widths Following Palatal Expansion in the Mixed Dentition Patients with Bilateral Posterior Crossbite: A Systematic Review

by Yen Nie Lim, Fadzlinda Baharin, Galvin Sim Siang Lin, Rozita Hassan, Milton Hongli Tsai, Lim Chia Wei, Suzanne Yeoh and Mark Ko Xiang Ping

Dent. J. 2023, 11(2), 52; https://doi.org/10.3390/dj11020052 - 13 Feb 2023

Cited by 1 | Viewed by 2456

Abstract

This systematic review aimed to identify the intercanine and intermolar width changes following palatal expansion in bilateral posterior crossbite (PXB) in mixed dentition. This review was registered in the PROSPERO database (CRD42021275833). All randomized controlled trials (RCT) and non-RCT articles between 1980 and [...] Read more.

This systematic review aimed to identify the intercanine and intermolar width changes following palatal expansion in bilateral posterior crossbite (PXB) in mixed dentition. This review was registered in the PROSPERO database (CRD42021275833). All randomized controlled trials (RCT) and non-RCT articles between 1980 and August 2022 on the palatal expansion of bilateral PXB in mixed dentition were searched in seven online databases (Google Scholar, Ovid, Web of Science, Scopus, EBSCOHost, Cochrane Library and PubMed). The risk of bias (RoB) of the articles included was analyzed using the Joanna Briggs Institute (JBI) critical appraisal tool. Three non-RCT studies were included and showed a low risk of bias. Meta-analysis on the changes in intercanine and intermolar widths was not performed due to study design heterogeneity. One study reported an over-correction of the bilateral PXB. There is a need for more RCT studies with standardized landmark measurements, outcome assessment methods and retention periods to investigate the interdental changes following palatal expansion. Full article

(This article belongs to the Special Issue Orthodontics and New Technologies)

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