ABSTRACT
OBJECTIVE@#To develop a digital workflow of orthodontic-prosthodontic multidisciplinary treatment plan which can be applied in complicated anterior teeth esthetic rehabilitation, in order to enhance the efficiency of communication between dentists and patients, and improve the predictability of treatment outcome.@*METHODS@#Twenty patients with the potential needs of orthodontic-prosthodontic multidisciplinary treatment to solve their complicated esthetic problems in anterior teeth were recruited in this study. Digital models of patients' both dental arches and soft tissues were captured using intra oral scanner. Direct prosthodontic (DP) treatment plan and orthodontic-prosthodontic (OP) treatment plan were carried out for each patient. For DP treatment plans, digital wax-up models were directly designed on original digital models using prosthodontic design system. For OP treatment plans, virtual-setups were performed using orthodontic analyze system according to orthodontic and esthetic criteria and imported to prosthodontic design system to finalize the digital wax-up models. These two treatment plans were shown to the patients and demonstrated elaborately. Each patient rated two treatment plans using visual analogue scales and the medians of scores of two treatment plans were analyzed using signed Wilcoxon test. Having taken into consideration various related factors, including time, costs of treatment, each patient chose a specific treatment plan. For the patients chose DP treatment plans, digital wax-up models were exported and printed into resin diagnostic models which would be utilized in the prosthodontic treatment process. For the patients chose OP treatment plans, virtual-setups were used to fabricate aligners or indirect bonding templates and digital wax-up models were also exported and printed into resin diagnostic models for prosthodontic treatment after orthodontic treatment completed.@*RESULTS@#The medians of scores of DP treatment plan and OP treatment plan were calculated and analyzed by IBM SPSS 20. The median of scores of DP treatment plan was 8.4, the minimum value was 6.9 and the maximum value was 9.3. The median of scores of OP treatment plan was 9.0, the minimum value was 7.9 and the maximum value was 9.6. The median of scores of OP was significantly higher than that of DP (Z=-3.23, P<0.01). Finally, 12 patients chose OP treatment plans and 8 patients chose DP treatment plans.@*CONCLUSION@#For cases with complex esthetic problems in anterior teeth, a digital workflow can demonstrate final treatment outcome and help patients make suitable treatment decisions. In our study, the orthodontic-prosthodontic multidisciplinary treatment plan is feasible which can provide predictions of treatment outcome and improve esthetic outcome with patients' satisfaction.
Subject(s)
Humans , Dental Arch , Esthetics, Dental , Prosthodontics , ToothABSTRACT
The purpose of this study was to investigate the cortical bone thickness of the inter-dental area of both jaws for orthodontic miniscrew placement. The cone-beam computerized tomography images of 32 non-orthodontic adults with normal occlusion were taken to measure the cortical bone thickness in both jaws. One-way analysis of variance (ANOVA) was used to analyze the differences in cortical bone thickness. Buccal cortical bone in the mandible was thicker than that in the maxilla. In the maxilla, cortical bone thickness was thicker in the buccal side than in the palatal side. Buccal cortical bone thickness in the mandible was thickest at the site distal to the first molar, and in the maxilla it was thickest at the site mesial to the first molar, while in the palatal side of maxilla it was thickest at the site mesial to the second premolar. The changing pattern of cortical bone thickness varies at different sites. In the buccal side of maxilla, the thinnest cortical bone thickness was found to be at 4 mm level from the alveolar crest, while the thickest was at 10 mm level (except for the site mesial to the first premolar). The buccal cortical bone thickness at the sites mesial or distal to the first molar in the mandible and palatal cortical bone thickness of maxilla tended to increase with increasing distance from the alveolar bone.
ABSTRACT
The aim of this retrospective study was to quantitatively evaluate the treatment effects of intrusion of overerupted maxillary molars using miniscrew implant anchorage and to investigate the apical root resorption after molar intrusion. The subjects included 30 patients whose average ages were 35.5±9.0 years. All patients had received intrusion treatments for overerupted maxillary molars with miniscrew anchorage. There were 38 maxillary first molars and 26 maxillary second molars to be intruded. Two miniscrews were inserted in the buccal and palatal alveolar bone mesial to the overerupted molar. Force of 100-150 g was applied by the elastic chains between screw head and attachment on each side. Lateral cephalograms and panoramic radiographs taken before and after intrusion were used to evaluate dental changes and root resorption of molars. Only 6 of the 128 miniscrews failed. The first and second molars were significantly intruded by averages of 3.4 mm and 3.1 mm respectively (P<0.001). The average intrusion time was more than 6 months. The crown of the molars mesially tilted by averages of 3.1 degrees and 3.3 degrees (P<0.001) for first and second molars. The amounts of root resorption were 0.2-0.4 mm on average. The intrusion treatment of overerupted molars with miniscrew anchorages could be used as an efficient and reliable method to recover lost restoration space for prosthesis. Radiographically speaking, root resorption of molars was not clinically significant after application of intrusive forces of 200 to 300 g.
ABSTRACT
The purpose of this study was to investigate the cortical bone thickness of the inter-dental area of both jaws for orthodontic miniscrew placement. The cone-beam computerized tomography images of 32 non-orthodontic adults with normal occlusion were taken to measure the cortical bone thickness in both jaws. One-way analysis of variance (ANOVA) was used to analyze the differences in cortical bone thickness. Buccal cortical bone in the mandible was thicker than that in the maxilla. In the maxilla, cortical bone thickness was thicker in the buccal side than in the palatal side. Buccal cortical bone thickness in the mandible was thickest at the site distal to the first molar, and in the maxilla it was thickest at the site mesial to the first molar, while in the palatal side of maxilla it was thickest at the site mesial to the second premolar. The changing pattern of cortical bone thickness varies at different sites. In the buccal side of maxilla, the thinnest cortical bone thickness was found to be at 4 mm level from the alveolar crest, while the thickest was at 10 mm level (except for the site mesial to the first premolar). The buccal cortical bone thickness at the sites mesial or distal to the first molar in the mandible and palatal cortical bone thickness of maxilla tended to increase with increasing distance from the alveolar bone.
Subject(s)
Adult , Female , Humans , Male , Young Adult , Bone Screws , Cone-Beam Computed Tomography , Methods , Dental Implantation, Endosseous, Endodontic , Methods , Mandible , Diagnostic Imaging , General Surgery , Maxilla , Diagnostic Imaging , General Surgery , Radiography, Dental , Methods , Reproducibility of Results , Sensitivity and Specificity , Surgery, Computer-Assisted , MethodsABSTRACT
The aim of this retrospective study was to quantitatively evaluate the treatment effects of intrusion of overerupted maxillary molars using miniscrew implant anchorage and to investigate the apical root resorption after molar intrusion. The subjects included 30 patients whose average ages were 35.5±9.0 years. All patients had received intrusion treatments for overerupted maxillary molars with miniscrew anchorage. There were 38 maxillary first molars and 26 maxillary second molars to be intruded. Two miniscrews were inserted in the buccal and palatal alveolar bone mesial to the overerupted molar. Force of 100-150 g was applied by the elastic chains between screw head and attachment on each side. Lateral cephalograms and panoramic radiographs taken before and after intrusion were used to evaluate dental changes and root resorption of molars. Only 6 of the 128 miniscrews failed. The first and second molars were significantly intruded by averages of 3.4 mm and 3.1 mm respectively (P<0.001). The average intrusion time was more than 6 months. The crown of the molars mesially tilted by averages of 3.1 degrees and 3.3 degrees (P<0.001) for first and second molars. The amounts of root resorption were 0.2-0.4 mm on average. The intrusion treatment of overerupted molars with miniscrew anchorages could be used as an efficient and reliable method to recover lost restoration space for prosthesis. Radiographically speaking, root resorption of molars was not clinically significant after application of intrusive forces of 200 to 300 g.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Bone Screws , Cephalometry , Dental Implantation , Maxilla , Molar , Diagnostic Imaging , General Surgery , Orthodontic Anchorage Procedures , Methods , Radiography, Dental , Methods , Retrospective Studies , Root Resorption , Diagnostic Imaging , General Surgery , Tooth Movement Techniques , MethodsABSTRACT
<p><b>OBJECTIVE</b>To investigate the palatal bone thickness in adult with normal occlusion.</p><p><b>METHODS</b>The cone beam computerized tomography records of 32 adults with normal occlusion (16 males and 16 females), mean age (30.1 ± 6.5) years, were used to measure the bone thickness at midpalatal area and the right and left palatal sides. Coronal slices at 3 mm intervals were generated. Slice 1 was the coronal slice through the posterior border to the incisive foramen, while Slice 7 was the coronal slice 18 mm away from the incisive foramen. At each coronal slice, the midpalatal sites were Site M and the sites on the exterior margin of the hard palatal were Site D. Four equally divided parts on the line linking Site M to Site D were named Site A, B, C from the interior to the exterior respectively. Palatal bone thickness were measured at these sites.</p><p><b>RESULTS</b>Significant differences were noted from Slice 1 to Slice 7, the bone thickness of palate tended to decrease from the front to the back. The thickest site at hard palatal was 12.6 mm, locating at Site D of Slice 1, while the thinnest site was 2.7 mm, locating at Site B of Slice 7. The palatal bone thickness ranged from 10.5 mm (maximum) to 5.8 mm (minimum) at Slice 2 and Slice 3. No statistical significance was found between the left and right sides (P > 0.05).</p><p><b>CONCLUSIONS</b>The favorable sites for miniscrew placement were the anterior region of the hard palate in adult. The length of miniscrew ranged from 5 mm to 10 mm can be placed from 6 mm posterior to the incisive foramen.</p>
Subject(s)
Adult , Female , Humans , Male , Bone Screws , Cone-Beam Computed Tomography , Dental Occlusion , Orthodontic Anchorage Procedures , Palate, Hard , Diagnostic Imaging , Statistics, NonparametricABSTRACT
<p><b>OBJECTIVE</b>The purpose of this study was to evaluate the efficiency of the self-drilling miniscrew implant for maximum anchorage cases.</p><p><b>METHODS</b>The study comprised 5 patients whose ages ranged from 14 to 31 years. All patients presented with. Class II skeletal pattern, maxillary protrusion or bimaxillary protrusion. Maximum molar anchorage and first premolar extraction were required. In the stage of anterior teeth retraction, self-drilling miniscrew implants were inserted into the buccal alveolar bone between maxillary second premolar and first molar. Sliding mechanics with 150 - 200 g force was used to retract anterior teeth. The cephalometric films before and after retraction were measured.</p><p><b>RESULTS</b>Dental protrusion and facial profile were improved significantly in all patients. The edge of upper incisors was retracted 6.4 mm and anchor molar moved anteriorly 0.3 mm averagely. All miniscrew implants remained stable during treatment and peri-implant soft tissue remained healthy.</p><p><b>CONCLUSIONS</b>Self-drilling minisrcew implant could be used as an efficient method for anchorage control and an alternative choice of extra-oral forces.</p>