Effect of Conventional Versus Passive Self-Ligating Vestibular Appliances on Torque, Tip and Transverse Dental Changes in Patients Affected by Class I Malocclusion: A Retrospective Study

ABSTRACT Objective: To evaluate the effects of passive self-ligating appliances (PSLAs) and conventional ligating appliances (CLAs) during orthodontic treatment regarding torque, tip, and transversal dental changes. Material and Methods: Dental parameters were digitally acquired from pre- and post-treatment models of each subject belonging to two groups of patients treated with PSLAs (23 patients; 11 females and 12 males with a mean age of 14.2 ± 1.6 years) and CLAs (18 patients; 10 females and 8 males with a mean age of 14.3 ± 1.9 years), respectively. All subjects had Class I or slight Class II malocclusion (= 2mm), permanent dentition and no previous orthodontic treatment. After normality of data was assumed, a paired sample t-test rejected any side differences at T0 and, therefore, the data were grouped by tooth group. Statistical analyses were performed using a linear mixed-effect framework, assuming the appliance, time, and interactions as fixed effects and the tooth type as random effects. Finally, post-hoc effect analysis was used to contrast modeled marginal effects (p<0.05). Results: For both appliances, there is a general increase of both torque and transverse values at T1, especially for PSLAs. Tip shows a general reduction in the lateral sectors for both appliances is registered. The only significant statistical difference referred to appliances' efficacy is located to mandibular intermolar width. Conclusion: Both appliances have an expansive potential for both torque and transverse dental changes. No evident differences are detectable between appliances except for the rate of the mandibular intermolar width increase.

Cervical vertebral anomalies in skeletal malocclusions: A cross-sectional study on orthodontic patients at the Aga Khan University Hospital, Pakistan.

Introduction: Morphological deviations of the cervical vertebral column have been described in relation to craniofacial aberrations and syndromes. Furthermore, it has recently been shown that abnormal morphology of upper cervical vertebrae is associated with malformation of the jaws and occlusion. Accordingly, it is relevant to focus on similar associations in patients with skeletal malocclusions. Therefore, the objectives of this study are to: • Identify the anomalies of the cervical column in patients with skeletal malocclusions • Determine the association between cervical vertebral anomalies and skeletal malocclusions. Materials and Methods: This cross‑sectional study was conducted on a total of 90 subjects at the Aga Khan University Hospital, Pakistan. The inclusion criteria were: (1) Pakistani origin; (2) standardized pretreatment profile radiograph with first six cervical vertebrae visible; and (3) accessibility of the second‑profile radiograph (mid‑ or posttreatment). The exclusion criteria were: (1) A prior history of orthodontic treatment; (2) any craniofacial anomaly; and (3) systemic muscle or joint disorder. Lateral cephalograms of all subjects (n = 90) were traced by the principal investigator and sagittal jaw relationship was assessed. A total of 30 subjects each with skeletal Class I, Class II, and Class III malocclusions were selected and the cervical vertebral anomalies were observed on their cephalometric radiographs. The frequencies of cervical vertebral anomalies according to skeletal malocclusion categories and gender were analyzed with the Chi‑square test, whereas association of cervical vertebral anomalies with skeletal malocclusions was assessed with logistic regression analysis. The level of significance (P ≤ 0.05) was used for the statistical tests. Results: Most common anomaly observed in the three groups was fusion between C2 and C3 (P = 0.006). This anomaly was found in 20% of subjects with skeletal Class I, 50% of subjects with skeletal Class II and 53.3% with skeletal Class III malocclusions. The highest frequencies of partial cleft at the level of C1 and occipitalization were observed in subjects with skeletal Class II and III malocclusions, respectively. However, none of the subjects showed fusion between C1 and C2 or dehiscence. No statistically significant gender difference was found in the occurrence of morphological deviations of the cervical column. The association of cervical vertebral anomaly was found to be the highest with skeletal Class III and lowest with skeletal Class I malocclusions. Conclusion: Fusion between C2 and C3 seems to be the most commonly occurring anomaly. This anomaly seems to be more often associated with skeletal Class III than skeletal Class I or Class II malocclusions.

Etiology and treatment of anterior open bite / Etiologia e tratamento da mordida aberta anterior

The term anterior open bite, which means no contact between anterior teeth, stands out in current orthodontic by the complexity of the treatment, associated with high levels of instability and recurrence. The purpose of this study is to emphasize that early etiological diagnosis is essential to the successful outcome of the technical intervention. The bibliographical study shows that, once the malocclusion in deciduous and mixed dentition is diagnosed, it simplifies the aparatology that is used, decreases the treatment time and conditions are created for a possible self-correction. In the permanent dentition, the authors recommend the removal of the etiological factor and the control of the vertical growth. The diversity of causes requires a multidisciplinary therapeutic approach.

A expressão mordida aberta anterior, que designa ausência de contato entre os dentes anteriores, destaca-se na ortodontia atual pela complexidade do tratamento, associada a altos níveis de instabilidade e recidiva. O objetivo deste trabalho é enfatizar que o diagnóstico etiológico precoce é fundamental para o bom resultado da intervenção técnica. O estudo bibliográfico mostra que, diagnosticada a maloclusão na dentadura decídua e mista, simplifica-se a aparatologia utilizada, diminui-se o tempo de tratamento e criam-se condições para uma possível autocorreção. Na dentadura permanente, os autores recomendam a remoção do fator etiológico e o controle do crescimento vertical. A diversidade de causas requer abordagem terapêutica multidisciplinar.

Má oclusão Classe I de Angle, com mordida aberta anterior, tratada com extração de dentes permanentes / Angle Class I malocclusion, with anterior open bite, treated with extraction of permanent teeth

A mordida aberta é uma anomalia com características distintas que, além da complexidade dos múltiplos fatores etiológicos, traz consequências estéticas e funcionais. Muitas alternativas têm sido utilizadas em seu tratamento, entre elas a grade palatina, forças ortopédicas, ajuste oclusal, camuflagem com ou sem exodontias, mini-implantes ou miniplacas e cirurgia ortognática. O diagnóstico preciso e a determinação da etiologia permitem estabelecer os objetivos e o plano de tratamento ideal para essa má oclusão. O presente relato descreve o tratamento de uma má oclusão Classe I de Angle, com padrão esquelético de Classe II e mordida aberta anterior, realizado em duas fases e que foi apresentado à diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), representando a categoria 2, como parte dos requisitos para a obtenção do título de Diplomado pelo BBO.

Open bite is an anomaly with distinct characteristics which, in addition to involving complex, multiple etiologic factors, entails aesthetic and functional consequences. Many alternative approaches have been employed to treat open bite, including palatal crib, orthopedic forces, occlusal adjustment, camouflage with or without extractions, mini-implants or mini-plates, and orthognathic surgery. By determining accurate diagnosis and etiology professionals can set the goals and ideal treatment plan for this malocclusion. This report, describing the two stages treatment of a Angle Class I malocclusion with Class II skeletal pattern and anterior open bite, was presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics (BBO), representative of category 2, as partial fulfillment of the requirements for obtaining the title of BBO Diplomate.

Distribution of malocclusion types among thumb suckers seeking orthodontic treatment.

The present study was conducted to evaluate the influence of thumb sucking and its duration on the type of malocclusion. A total of 410 North Indian individuals between ages 12-30 years, 161 males and 249 females were examined. A specially designed proforma was used to record the detailed history of the individual. Among the etiological factors it was found that history of thumb sucking was present in 13.9% and significantly related to Class II div 1 malocclusion. When thumb sucking exceeded 18 months, it was found statistically significant (P < 0.1) in Class II skeletal malocclusion, in open bite (P < 0.1) and in extreme overjet (P < 0.5). CONCLUSION: If thumb sucking is not treated early, it can cause skeletal Class II malocclusion, anterior open bite and excessive overjet.

[ dentoskeletal effect of mandibular tongue guard in Cl II/I malocclusion]

The prevalence of Cl II malocclusion with tongue thrust and open bite is high. The pressure of the tongue during swallowing and its physiological activity could be transferred to the maxillary complex by the tongue crib and might advance the maxilla to an unfavorable position. This study aimed to evaluate the dentoskeletal change in the Cl II division 1 patients with anterior tongue thrust and mandibular deficiency treated by mandibular tongue guard, from a private office and orthodontic department of Azad University in Tehran. The sample consisted of 23 patients, [14 females aged 8 years and 9 months and 9 males aged 10 years and 6 months], with Cl II div 1 malocclusion in late mixed dentition with anterior tongue thrust. The patients were treated by mandibular tongue guard. Lateral Cephalograms were obtained and traced before and after treatment and certain angular and linear variables were measured. The pretreatment and post treatment measurements were compared using Paired t test to evaluate the significance of the results. The findings indicated that SNB, facial angle, the distance between B and Pogonion to the reference line and Interincisal angle were significantly increased [P<0.05]. The changes were mainly caused by mandibular growth, were observed after treatment by mandibular tongue guard. Decrease of IMPA, 1-SN, ANB, Wits were significant [P<0.05]. The changes of Jarabak index, SN-MP, SNA, Y-axis were not significant. In Cl II div 1 patients with mandibular deficiency combined with tongue thrust, mandibular tongue guard caused slight increase in mandibular growth

Avaliação do índice de Peck Peck em pacientes portadores de maloclusão Classe I e Classe II, primeira divisão de Angle / Evaluation of Peck and Peck index in patients with Angle Class I and Class II division 1 malocclusions

Alterações no tamanho mésio-distal e vestibulo-lingual dos dentes podem significar dificuldade no correto posicionamento dos incisivos na arcada. Este estudo propôs avaliar o equilíbrio dentário através do índice de PECK PECK (1975) em pacientes leucodermas portadores de maloclusão Classe I e Classe II, 1ª divisão de Angle. Foram selecionados 100 modelos de gesso da arcada inferior com apinhamento anterior em graus variados de pacientes não tratados ortodonticamente. As dimensões mésio-distal e véstibulo-lingual dos incisivos inferiores foram mensuradas com auxílio de paquímetro digital com graduação 0,01mm. Os resultados mostraram que o Grupo I apresentou discrepância nos incisivos centrais e laterais esquerdos em 86,67 por cento dos casos, os incisivos centrais direitos apresentaram discrepância em 82,23 por cento e os incisivos laterais direitos em 84,45 por cento dos casos. O Grupo II, 1 apresentou discrepância nos incisivos centrais esquerdos em 89,10 por cento e os incisivos centrais direitos em 87,28 por cento dos casos, os incisivos laterais esquerdos apresentaram discrepância em 83,64 por cento dos casos, uma incidência menor que os incisivos laterais direitos, com 85,46 por cento. Pode-se concluir que os incisivos laterais e centrais esquerdos apresentaram maior incidência de discrepância dentária para a maioria dos casos, quando comparados aos homólogos em ambos os grupos, e houve ausência de correlação total entre homólogos em ambos os grupos.

Mal oclusiones clase I / Class I malocclusions

El ejercicio de la ortodoncia incluye diagnóstico, prevención, intercepción y tratamiento de todas las formas clínicas de maloclusión y anomalías óseas circundantes; además el diseño, aplicación y control de la aparatología terapéutica; cuidado, guía de la dentición y estructuras de soporte con el fin de obtener manteniendo una relaciones dentoesqueleticas óptimas en equilibrio funcional - estético con las estructuras craneofaciales. El objetivo de este trabajo es describir la maloclusión clase I, para transmitir estos conocimientos a todos los profesionales relacionado al área de ortodoncia.

Influência da hipertrofia amigdaliana nas más-oclusöes de Classe I e Classe II, Divisäo 1, de Angle: estudo cefalométrico / Influence of the enlarged tonsils in the Angle Class I and Angle Class II, Division 1 malocclusion: cephalometric study

Foi realizado um estudo cefalométrico em uma amostra composta de 120 adolescentes leucodermas na faixa etária de 7 a 10 anos da regiäo de Araraquara. Destes, 60 tinham amigdalas hipertrofiadas em grau severo, sendo 30 portadores de más-oclusöes de classe I e 30 de más-oclusöes de classe II divisäo 1 de Angle. Um grupo de 60 pacientes com amigdalas normais e sem obstruçäo nasal respiratória, divididos em 30 más-oclusöes de classe I e 30 de más-oclusöes de classe II divisäo 1, serviu de controle. Telerradiografias cefalométricas foram medidas e os dados foram analisados através do modelo estatístico de análise de variância multidimensional e teste de Duncan, tomando-se por base o nível de significância de 5 por cento...