RESUMO
Background: Extraction of all 1st premolars in the orthodontic treatment of Class II div 1 malocclusion has been associated with a decrease in vertical dimension of occlusion thus predisposing the patient to TMJ disorders. Objectives: To evaluate the vertical changes occurring in patients having class II div 1 malocclusion, treated orthodontically with 1st premolar extractions & compare these changes with those occurring in patients treated orthodontically without extractions. Method: Pre-treatment & Post-treatment Lateral Cephalogram radiograph of 11 patients having CL-II div1 malocclusion treated without extraction and 16 patients treated with the extraction of all 1st premolars were analyzed and compared to observe the changes in the anterior facial height. Result: the orthodontic treatment of Cl-II div 1 malocclusion cases treated with a non-extraction approach leads to a statistically significant increase in the anterior facial height due to the downward & backward rotation of the mandible. The cases treated with the extraction of all 1st premolars also show the statically significant increase in the anterior facial height but this increase was less than that observed for the non-extraction group. Conclusion: this study does not support the theory that the first premolar extractions reduce the vertical dimension of occlusion and predispose the extraction patients to TMJ disorders.
RESUMO
Introducción: el objetivo fue evaluar la severidad de maloclusión y necesidad de tratamiento ortodóntico enadolescentes de Pasto, Colombia, usando el índice de estética dental (IED). Métodos: un total de 387 adolescentes fueron seleccionados aleatoriamente de 20.175 estudiantes de 13 a 16 años de edad. Este estudio transversal se hizo en los colegiosChampagnat, San Francisco de Asís y San Juan Bosco. Se excluyeron del estudio los estudiantes que tenían aparatos ortodónticos o informaron una historia de tratamientos de ortodoncia. El examen clínico se hizo con el IED. Se utilizaron las pruebas estadísticasMann-Whitney y Kruskall-Wallis para comparar los valores del IED de acuerdo con el sexo y el estrato socioeconómico (ESE) respectivamente. Resultados: el promedio del IED fue 34,37 ± 14,71. El 52,7% presentó maloclusión entre severa y muy severa, lo cual implica la necesidad de tratamiento de ortodoncia. Se encontraron diferencias estadísticamente significativas entre losvalores del IED de acuerdo con el ESE (p < 0,001). Conclusiones: la mitad de los adolescentes evaluados necesitarían tratamiento de ortodoncia. En este grupo de estudio, el ESE fue una variable importante que está relacionada con los valores del índice deestética dental.
Introduction: the objective was to assess the severity of malocclusion and orthodontic treatment needs in adolescents from Pasto, Colombia adolescents by using the Dental Aesthetic Index (DAI). Methods: a total of 387 adolescents were randomlyselected from a population of 20175 students between 13 and 16 years of age. This cross-sectional study was carried out at Champagnat, San Francisco de Asís and San Juan Bosco high schools. Students wearing orthodontic appliances or reporting ahistory of orthodontic treatment were excluded from the study. Clinical examination was conducted with the DAI. Mann-Whitney and Kruskall-Wallis analyses were used to compare the DAI scores according to gender and socioeconomic status (SES), respectively. Results: the DAI mean was 34.37 ± 14.71. The 52.7% had between a severe and very severe malocclusion which implies an orthodontic treatment need. Statistically significant differences were found between the DAI scores according to SES (p < 0.001). Conclusions: half of the evaluated adolescents would need orthodontic treatment. In this study, SES was an important variable that is related to the Dental Aesthetic Index scores.
Assuntos
Adolescente , Estética , Má Oclusão , Prevalência , Adolescente , DiagnósticoRESUMO
Las alternativas de tratamiento de las maloclusiones de clase II esqueléticas y dentales incluyen las extracciones de dientes permanentes y la distalización de los molares maxilares con aparatos extraorales e intraorales. Estos últimos, no necesitan la cooperación del paciente, además, en ellos se han hecho variaciones importantes en su mecánica y diseño a lo largo de los años. Con el uso de los minitornillos se ha podido eliminar, en gran parte, los efectos de reacción como la vestibularización de los incisivos y la mesialización de los premolares. Este artículo sintetiza una revisión de la literatura de los últimos 20 años de los diferentes diseños y sistemas mecánicos que se han usado con éxito en la distalización de los molares maxilares.
The alternatives of treatment of class II skeletal and dental maloclussions included the extractions of permanent teeth and the maxillary molars distalization by extraoral devices and intraoral devices. The above mentioned, does not need cooperation of the patient. In addition, important variations have been mechanics and design throughout the years. With the miniscrews one could have eliminated, largely, the effects of reaction as the vestibularization of the incisor teeth and the mesialization of the bicuspid. This article is a synthesis of a review of the literature of last 20 years of the different designs and mechanical systems that have been used successfully in the distalization of the maxillary molars.