Root resorption after leveling with super-elastic and conventional steel arch wires: a prospective study.

BACKGROUND: The aim of this prospective study was to compare root resorption after the leveling phase of treatment, performed by either super-elastic or conventional multi-stranded stainless steel arch wires. METHODS: From a total of 156 future orthodontic patients in a private clinic, 82 were included in the study after excluding those who earlier had orthodontic or endodontic treatment or signs of resorption. Patients were equally arbitrary allocated into two groups, where leveling was performed either with super-elastic heat-activated or conventional multi-stranded stainless steel arch wires. Root length loss was calculated using pre-treatment and post-leveling periapical radiographs. RESULTS: The use of super-elastic arch wires did not significantly increase the severity of root resorption, except for tooth 31, while it reduced leveling time compared to conventional stainless steel wires. Crossbite of maxillary lateral incisors seemed to be a risk factor for resorption. CONCLUSION: Incisor root resorption after leveling did not differ significantly between patients treated with super-elastic and conventional stainless steel arch wires, except for a mandibular incisor.

Relapse and stability after mandibular setback surgery one year postoperatively: a retrospective study.

PURPOSE: A retrospective evaluation was performed of dentoalveolar and skeletal stability 1 year after mandibular setback surgery using intraoral vertical subcondylar osteotomy (IVSO) combined with intermaxillary fixation. PATIENTS AND METHODS: Twenty-eight patients (16 men, 12 women) with skeletal Angle Class III malocclusions were included. Mean age at start of treatment was 23.9 years. All patients underwent combined surgical and orthodontic treatment. Dental casts and cephalometric measurements were performed for each patient before orthodontic treatment and at 8 weeks and 1 year after surgery. RESULTS: Treatment changes from 8 weeks to 1 year after surgery were small but significant for the angular relationship between the maxilla and the mandible in the sagittal plane (ANB) (mean difference, -0.5 mm; P = .021), Wits appraisal (mean difference, -0.7 mm; P = .044), the inclination of the mandible in relation to the nasion-sella line (ML-NSL) (mean difference, -0.8 mm; P = .010), and the inclination of the lower incisors in relation to the nasion-point B line (Li-NB) (mean difference, -0.6 mm; P < .001). These findings for cephalometric values indicated a small skeletal relapse in sagittal and vertical relations. No significant dentoalveolar relapse occurred according to the dental cast evaluations. CONCLUSION: The results clearly show that orthodontic treatment combined with IVSO provides a stable dental and skeletal result 1 year after treatment.

Denture wearer's perception of ambient care. Part 2. Analyses of data.

OBJECTIVE: The aim was to investigate to what extent denture wearers were satisfied with the ambient care (care) received. MATERIALS AND METHODS: A study sample of 117 completely edentulous and 56 partially edentulous patients, who had received their dentures in the period 1997-2005 at Bergen School of Dentistry, completed a questionnaire containing eight specific items regarding different aspects of care, each with two positive (a and b) and two negative (c and d) categories, and four global items. The care items, including confidence in the dental team, information, waiting time and cost, constitute the Ambient Care Scale; the global items were concerned with overall care, satisfaction with dentures, self-reported oral and general health. RESULTS: Between 91-100% of Ambient Care Scale responses were in the two positive categories. The completely edentulous group was significantly more satisfied than the partially edentulous group regarding several Ambient Care Scale items and oral health. Also, ratios between categories b and a showed systematic higher degrees of satisfaction for the completely edentulous group than the partially edentulous group. Fifty-six per cent in the completely edentulous group and 36% in the partially edentulous group were very satisfied, i.e. with ≥ 6 of 8 possible responses in category a. Analysis of the very satisfied showed that the highest degrees of satisfaction for both groups were found regarding students and staff, the lowest regarding cost and waiting times. CONCLUSIONS: Patient satisfaction with care was very high. Completely edentulous patients were systematically more satisfied than partially edentulous ones.

Apical root resorption of incisors after orthodontic treatment of impacted maxillary canines: a radiographic study.

INTRODUCTION: The purpose of the study was to evaluate impacted maxillary canines as risk factor for orthodontic apical root resorption. METHODS: The sample comprised 66 patients treated with fixed appliances. Thirty-two patients with a unilateral impacted maxillary canine, which was distanced from the roots of the incisors at a preliminary phase of treatment before bonding, formed the impaction group, and 34 patients without impactions served as the controls. Root shortening was calculated by using pretreatment and posttreatment intraoral radiographs. Inclination of the eruption path of the impacted canine relative to the midline, axis of the lateral incisor, and nasal line, root development, and the medial and vertical positions of the impacted tooth were recorded on orthopantomograms and lateral cephalometric films. The follicle/tooth ratio was evaluated by using periapical radiographs. RESULTS: No significant difference in apical resorption of the maxillary incisors was detected between the impaction and control groups, or between the incisors of the impacted and contralateral sides in the same subject. Likewise, no difference in the severity of root resorption was found between the incisors of impacted side alone and the incisors of the control group. Mesial and vertical inclinations of the impacted canines were negatively related to a lateral incisor's root resorption. No correlations were found between resorption and medial or vertical position of the crown of the canine. The follicle/tooth ratio was significantly related to the mesial inclination of the impacted canine, but not to root resorption. CONCLUSIONS: An impacted maxillary canine, after being distanced from the incisor roots, does not seem to be a risk factor for apical root resorption during orthodontic treatment.

Patients' perceptions of improvements after bilateral sagittal split osteotomy advancement surgery: 10 to 14 years of follow-up.

INTRODUCTION: The aims of this study were to determine reasons for orthodontic-surgical treatment, to quantify the perceptions of possible improvement 10 to 14 years after treatment, and to assess factors that affect treatment satisfaction and socio-dental impacts on quality of life. METHODS: The participation rate was 36 of 78 patients; their mean age was 45.7 years (SD, 10.7 years; range, 29-62 years). The presurgical anatomic occlusions were measured on dental casts. Visual analog scales allowed the participants to rate their perceived treatment outcome on 7 oral health-related items. A 3-point scale rated satisfaction with orthodontic-surgical treatment. The oral impact of daily performances index was included to assess socio-dental impacts on quality of life. RESULTS: Most responders reported improvements on the 7 items. The most significant change was reported for chewing. "Very satisfied" with the treatment was reported by 13 responders; 19 of 36 persons were "reasonably satisfied." Reporting "very satisfied with treatment" was 8 times more likely when peers had noticed a changed in the participant's appearance after surgery. Sex was significantly associated with quality of life. CONCLUSIONS: The most frequently reported reason for treatment was to improve chewing, and the item that showed the most pronounced improvement was also chewing. Most responders were only reasonably satisfied with the treatment. Whether peers noticed a change in appearance after treatment was a significant factor affecting both treatment satisfaction and reporting a good quality of life.

Dental or skeletal relapse after sagittal split osteotomy advancement surgery? Long-term follow-up.

PURPOSE: To evaluate the short- and long-term stability of mandibular advancement surgery with sagittal split osteotomy (SSO), and to investigate when relapse occurs and identify variables contributing to relapse. PATIENTS AND METHODS: Thirty-six patients with Class II anomalies were included; the mean age at surgery was 33.0 years. All underwent SSO surgery and clinical and radiologic follow-up at 8 weeks, 1 year, and 13 years. Model analysis, cephalometric analysis, and clinical examinations were performed at each control. RESULTS: Mean overjet relapse from 8 weeks to 13 years was 2.3 mm (range, 0 to 7.0 mm). Between 8 weeks and 1 year, mean overjet relapse was 0.6 mm (range, -1.0 to 4.0 mm), and it was 1.7 mm (range, -1.0 to 6.0 mm) between 1 year and 13 years. Overjet relapse greater than 4 mm was found in 13.9% of the patients. Mean overjet 1 year after surgery was 2.6 mm and was significantly increased compared with 8 weeks (P = .006). Mean overjet 13 years after surgery was 4.3 mm and was significantly increased compared with 1 year (P < .001). Inferior incisor line to nasion-B-point was 29.0° at 8 weeks after surgery and 25.4° at 13 years (P = .001). Insignificant changes in the other cephalometric variables were found at follow-up. CONCLUSION: SSO advancement surgery is a relatively stable technique over time. Mean overjet relapse was found to be 2.3 mm after 13 years, following a continuous pattern over time. The cephalometric variables showed insignificant changes during follow-up, indicating that relapses are mainly of dental and not skeletal origin.

Three-year split-mouth randomized clinical comparison between crowns fabricated in a titanium-zirconium and a gold-palladium alloy.

PURPOSE: The aim of this study was to compare the clinical performance of metal-ceramic crowns made with an experimental alloy prepared by the Nordic Institute of Dental Materials, containing 15% zirconium and 85% titanium (Ti-15% Zr), and a high noble gold-palladium alloy (Mattikraft). MATERIALS AND METHODS: Twenty patients who satisfied the inclusion criteria were selected sequentially from the departmental waiting list. Each patient received 2 crowns in the premolar or molar region. Which tooth was to receive a crown based on gold-palladium alloy or Ti-15% Zr alloy was randomly decided. A number of aspects indicating the clinical performance of the crowns were recorded at baseline and after 1, 2, and 3 years. RESULTS: No statistically significant differences between the 2 types of crowns were demonstrated regarding overall technical evaluation, occurrence of plaque, bleeding on probing, or patient satisfaction. Periodontal pocket measurements around Ti-15% Zr crowns were significantly higher than those around gold alloy crowns. However, a similar difference also existed at baseline. Periodontal pocket measurements increased and patient satisfaction improved significantly over time. CONCLUSIONS: Within the limitations of this study, the results indicate that there is no difference in the clinical performance of crowns based on Ti-15% Zr or gold-palladium alloy.

Changes in root length during orthodontic treatment: advantages for immature teeth.

The purpose of the study was to investigate root lengthening during orthodontic treatment in relation to the age of the patient, the developmental stage of the root, and the anticipated growth. Specifically, the potential benefit of treating young teeth was addressed. The sample consisted of 80 patients with Angle Class II division 1 malocclusions, treated with extraction of at least two maxillary first premolars, and edgewise technique with 0.018-inch slot brackets. Additionally, a cross-sectional control group of 66 untreated individuals matched to gender, and pre- and post-treatment age of the experimental group was included. Crown and root lengths of the maxillary incisors were measured on peri-apical radiographs before and after treatment, and corrected for image distortion. The stage of root development before treatment was recorded. Root elongation during treatment was found for 50 out of the 280 examined teeth. Age at treatment start was significantly higher among the patients showing root shortening of the lateral incisors during treatment than among those showing root elongation (P < 0.05). The stage of root development was significantly related to the direction of root length change, i.e. shortening or elongation. Roots elongated during treatment did not differ in length from untreated teeth of similarly aged individuals. There was no significant difference in the extent of root lengthening between the roots elongated during treatment and the normal root lengthening in age-matched untreated individuals. Post-treatment root length was significantly related to pre-treatment age. Roots that were incompletely developed before treatment reached a significantly greater length than those that were fully developed at the start of treatment. The results of this study show a definite advantage for younger teeth with regard to post-treatment root length. This finding may influence treatment planning strategy.