Control of anterior anchorage with miniscrews and sliding mechanics in an adolescent with missing second premolars: A clinical report with biomechanical validation.

Congenital missing second premolars in growing patients should be accurately evaluated in order to establish a suitable treatment plan. Concerning the decision of whether to close or maintain spaces in the dental arches, it shall also be based on biomechanical aspects and the aesthetic traits of individual patients. Accordingly, the option of closing tooth spaces requires an adequate application of biomechanical principles aimed at avoiding detrimental effects on dental arches and facial profile. An effective use of titanium miniscrews for immediate loading, associated with efficient sliding mechanics, can represent an elective way to successfully treat such cases. Herein, the objective is to describe the procedure and underscore the advantages of the mentioned approach by presenting a clinical case along with long-term follow-up.

A Comparative Analysis of Arch Widths in Class I and Class II Malocclusion: Extraction vs. Non-extraction Treatment.

INTRODUCTION: This study aimed to assess and compare dental arch widths in the anterior and posterior regions among patients undergoing extraction and non-extraction treatments for Class I and Class II malocclusions. MATERIALS AND METHODOLOGY: A total of 40 patients were selected, with 10 in each of the categorized groups based on malocclusion type and treatment status. Dental arch widths were meticulously measured using a digital Vernier caliper at the canine and molar regions to ensure precise data collection. RESULTS: Statistically significant differences were noted when comparing mean inter-canine and molar widths between pre- and post-treatment periods among extraction cases in Class I malocclusion (p < 0.001). Conversely, there were no significant changes observed in arch widths among non-extraction cases in Class I malocclusion. Similarly, significant changes were observed in both extraction and non-extraction cases of Class II malocclusion when comparing mean inter-canine and molar widths between pre- and post-treatment periods (p < 0.05). CONCLUSION: After treatment, both Class I and Class II extraction cases showed an increase in inter-canine arch width, while intermolar arch width remained unchanged, suggesting that the treatment did not significantly alter the buccal corridor. Additionally, there were no notable changes in inter-canine arch widths between pre- and post-treatment in Class I non-extraction cases. However, the Class II non-extraction group exhibited increased upper and lower inter-canine arch widths after treatment.

Biomechanical effects of clear aligner with different shape design at extraction space area during anterior teeth retraction.

OBJECTIVE: This study aimed to investigate the biomechanical effects of clear aligner (CA) with different shape designs at extraction space (CAES) area during space closing. MATERIALS AND METHODS: A finite-element method (FEM) model of mandibular dentition, periodontal ligaments, attachments, and corresponding CA was established. The connecting rod design of CAES was modelled for the control group. Eight test groups with different heights of CAES from -4 mm to +4 mm were designed. Tooth displacement tendencies were calculated. The maximum principal stress in PDLs, teeth, and CAs was analysed. Both global coordinate system and local coordinate system were also used to evaluate individual tooth movements. RESULTS: Across all groups, stresses concentrated on the lingual outer surface of CAESs. For the lowered CAES groups, both the stress value and the stress distribution area at CAESs were increased. The lowered CAES groups showed reduced movement in anterior teeth and less tipping tendency of the canines. CONCLUSION: The shape of CAES has a biomechanical impact on anterior teeth movement and should be considered in aligner design. The results suggest that increasing the height of CAES can enhance anterior teeth retraction, while lowered CAES may facilitate controlled root movement. Changes in the shape of CAES represent a potential direction for biomechanical improvement of clear aligner in extraction cases and are worth exploring.

Reconsidering the role of nasolabial angle in premolar extraction decision-making: A case-series study.

OBJECTIVES: To evaluate the impact of changes in upper incisor inclination and position on the alteration of the nasolabial angle (NLA) in a series of cases involving the extraction of four first premolars. MATERIALS AND METHODS: The study included 41 patients who underwent orthodontic treatment with premolar extractions. The patients were divided into two groups based on their pretreatment NLA values: Group 1 (NLA ≤ 100°) and Group 2 (NLA > 100°). Measurements of NLA, U1.NA and U1-NA were obtained before and after treatment and U1-Ls pretreatment measure was registered. Statistical analyses were performed to compare the differences in NLA, U1.NA and U1-NA between the two groups and to evaluate the influence of these variables added to U1-Ls (T1) on NLA changes. RESULTS: The results showed that Group 1 exhibited significant changes in NLA, while Group 2 did not. However, both groups showed significant changes in U1.NA and U1-NA. In Group 1, 80% of the individuals presented an increase in NLA and 20% no changes. In Group 2, 10% presented a decrease, 57% no changes and 33% an increase in NLA values. Multiple linear regression analysis indicated that the group factor had a statistically significant influence on NLA variation. Additionally, in Group 2, a negative correlation was observed between changes in U1.NA and NLA. CONCLUSIONS: The findings suggest that individuals with higher pretreatment NLA values tend to maintain their NLA values even after the correction of upper incisor inclination.

The effect of increasing the gaps between the front teeth on torque and intrusion control of the incisors for anterior retraction with clear aligners: a prospective study.

OBJECTIVE: To investigate the effect of sequential distalization on increasing gaps in the maxillary anterior teeth, focusing on the control of torque and three-dimensional teeth movement during anterior retraction with clear aligners in extraction cases. METHODS: We recruited 24 patients who were undergoing extraction bilateral maxillary first premolars with clear aligners. According to a predetermined increment in the spaces between the maxillary anterior teeth, the patients were divided into three groups: those with no gap (9 cases), a 0.5 mm gap (6 cases) and a 1.0 mm gap (9 cases). In each group, a 2.0 mm en-mass retraction was applied on the anterior teeth. Plaster casts of the upper full dentition were obtained both before and after a 2 mm retraction. The palatal folds were used to overlap each pair of models. The three-dimensional movement of the teeth and the change of torque for the anterior teeth were subsequently analyzed using Geomagic Studio 2014 software. RESULTS: The change in torque in the groups with added gaps was significantly smaller than that in the group with no gaps (P < 0.05). There was no significant difference in this respect when comparing the group with a 0.5 mm gap added to the group with a 1.0 mm gap was added (P > 0.05). In the labial-lingual and vertical directions, the displacements of the central and lateral incisors were smaller in the groups with additional gaps compared to those in the groups without gaps (P < 0.05). However, there was no significant difference observed when comparing the group with a 0.5 mm added gap to the group with a 1.0 mm added gap (P > 0.05). Then, a comparison was made between the displacement of the second premolar to the second molar in the mesial-distal direction across all groups. The study revealed that the anchorage molars in the group without gaps demonstrated significantly smaller displacement compared to those in the group with additional gaps (P < 0.05). CONCLUSION: Advantages were observed in controlling the torque of the anterior teeth and achieving a desired pattern closer to normal bodily movement by sequentially distalizing the maxillary anterior teeth gaps. Increasing the gaps between the maxillary anterior teeth also resulted in improved control of the vertical direction of the anterior teeth. However, this retraction strategy necessitates substantial protection of the anchorage molars.

Effects of premolar extraction and orthodontic treatment in adolescents - a retrospective cephalometric study.

OBJECTIVES: To evaluate the cephalometric effects of premolar extraction on skeletal and dental parameters, and on the soft tissues, in patients subsequently treated with fixed appliances. Prevalence and severity of external apical root resorption due to premolar extraction were also examined. MATERIALS AND METHODS: The dental records of 79 patients treated with fixed appliances were retrieved (groups: extraction, n = 19; non-extraction, n = 60). Pre- and post-treatment statuses of skeletal, dentoalveolar, and soft tissue variables were analyzed on lateral cephalograms to determine change. Periapical radiographs of the maxillary incisors were assessed for external apical root resorption using the Levander & Malmgren index. The t-test, Mann-Whitney U test, chi-squared test, and Kruskal-Wallis test were used to analyze the data. Significance was set at p < .05. RESULTS: Changes in the protrusion and proclination of the incisors and in lip position were significantly different between the groups. Prevalence of external apical root resorption in the two groups was similar. CONCLUSIONS: Our findings suggest that extraction therapy affects dentoalveolar traits but not jaw position, nor the risk of root resorption, in patients treated with fixed appliances.

Changes in condylar position during orthodontic treatment depending on the amount of incisor retraction: a cone-beam computed tomography study.

OBJECTIVES: Orthodontic treatment may be associated with temporomandibular disorders through changes in the condylar position. This study aimed to evaluate changes in the condylar position among different amounts of maxillary incisor retraction during orthodontic treatment using cone-beam computed tomography images. MATERIALS AND METHODS: Fifty-four participants were enrolled and divided into minimal (n = 14), moderate (n = 20), and maximal (n = 20) retraction groups based on the amount of incisor retraction (< 1, 1-6, and > 6 mm, respectively). Changes in condylar position before (T0) and after (T1) orthodontic treatment were assessed for the superior, anterior, posterior, and medial joint spaces (SJS, AJS, PJS, and MJS, respectively). Changes in joint spaces were compared between T0 and T1 in each group using paired t-tests and among the three groups using analysis of variance. RESULTS: Anterior movement of the condyle was observed in the maximal retraction group with a 0.2 mm decrease in ΔAJS and a 0.2 mm increase in ΔPJS, significantly greater than those in the minimal retraction group. The AJS and PJS showed statistically significant differences between T0 and T1 (P < 0.05) in the maximal retraction group. CONCLUSIONS: The condyle may show a statistically significant but clinically insignificant forward movement in the maximal incisor retraction group, whereas it was relatively stable in the minimal and moderate incisor retraction groups. CLINICAL RELEVANCE: More attention should be paid to the signs and symptoms of the condyle in patients with excessive incisor retraction during orthodontic treatment.

Relative anchorage loss under reciprocal anchorage in mandibular premolar extraction cases treated with clear aligners.

OBJECTIVES: To compare mandibular relative anchorage loss (RAL) under reciprocal anchorage between first and second premolar extraction cases in bimaxillary protrusion mild crowding cases treated using clear aligner therapy (CAT). MATERIALS AND METHODS: Adult patients who met the following criteria were included: treated using CAT with bilateral mandibular premolar extractions and space closure using intra-arch reciprocal anchorage. RAL was defined as the percent molar mesial movement relative to the sum of molar mesial plus canine distal movement. Movements of the mandibular central incisor (L1), canine (L3), and first molar (L6) were measured based on superimposition of the pre- and post-treatment dentition and jaw models. RESULTS: Among the 60 mandibular extraction quadrants, 38 had lower first premolar (L4) and 22 had lower second premolar (L5) extracted. L6 mesial movement was 2.01 ± 1.11 mm with RAL of 25% in the L4 extraction group vs 3.25 ± 1.19 mm with RAL of 40% in the L5 extraction group (P < .001). Tooth movement efficacy was 43% for L1 occlusogingival movement, 75% for L1 buccolingual inclination, 60% for L3 occlusogingival movement, and 53% for L3 mesiodistal angulation. L1 had unwanted extrusion and lingual crown torquing whereas L3 had unwanted extrusion and distal crown tipping, on which the power ridges or attachments had little preventive effect. CONCLUSIONS: The average mandibular reciprocal RAL is 25% or 40% for extraction of L4 or L5, respectively, in CAT cases. A RAL-based treatment planning workflow is proposed for CAT extraction cases.

Evaluation of root resorption in the lower incisors after orthodontic treatment of skeletal Class III malocclusion by three-dimensional volumetric measurement with cone-beam computed tomography.

OBJECTIVES: To investigate the volumetric changes of the lower incisor roots in skeletal Class III orthodontic patients with anterior crossbite after premolar extraction therapy. MATERIALS AND METHODS: Thirty-six adults, aged 18-28 years, had four-premolar extraction treatment. Pre- and posttreatment cone-beam computed tomography (CBCT) images were used to assess the thickness and height of alveolar bone, root volume, and length. A paired t-test was used to detect changes in root volume and length before and after treatment. Pearson's correlation analysis was applied to estimate the correlation between root volume and dentoskeletal morphology. RESULTS: Both the central and lateral incisors had intrusion and tipping movement after treatment. Compared with pretreatment data, root length decreased significantly. The lingual root volume of root cervical, apical third, and the labial root volume of the root apical third decreased significantly (P < .05), among which the percentage of tooth loss at the tip volume was the highest. The pretreatment height of the alveolar ridge crest, thickness of the alveolar bone, and type of incisor movement were related to the volume and length loss. CONCLUSIONS: Volume and length loss in the apical third of the lower incisor roots in skeletal Class III patients treated with a Class III bicuspid extraction pattern is common. The pretreatment height of the alveolar ridge crest, thickness of the alveolar bone, and type of tooth movement are related to the loss.

Does the floor of the maxillary sinus affect tooth movement for premolar extraction space closure?

OBJECTIVE: The study investigated orthodontic tooth movement by comparing various horizontal and angular measures of the teeth having different sinus-root relationship (SRR) of patients undergoing first premolar extraction treatment protocols. MATERIALS AND METHODS: This retrospective cross-sectional study included 45 Taiwanese adult patients, classified as the control group (n = 15) and the sinus group (n = 30) according to SRR. The control group had type I SRR (sinus floor above the level connecting the buccal and palatal root apices), whereas the sinus group included patients with type V SRR (the buccal and palatal root displayed apical protrusion into the sinus floor). Morphology was identified using pretreatment orthopantomograms. Lateral cephalometric measurements were conducted before treatment (T1) and at debonding (T2). RESULTS: Post debonding, there were no statistically significant difference in the two groups. However, the incisors in the control group became marginally more upright than those of the sinus group, and the molars demonstrated tipping movement with minimal anchorage loss in the sinus group than in the control group. The total treatment time was not significantly different between the 2 groups. CONCLUSION: The study revealed that the sinus-root relationship does not affect the orthodontic tooth movement. However, a more extensive 3-D study with larger sample size is strongly recommended before coming to any conclusion. CLINICAL RELEVANCE: The lining of the floor of the maxillary sinus does not affect the orthodontic tooth movement.

Research progress on anterior alveolar bone changes after orthodontic treatment involving extractions / 口腔疾病防治

@#It has been traditionally believed that a 1:1 cortical bone remodeling/tooth movement ratio has been preserved during orthodontic treatment for tooth movement, with the alveolar bone on the tension side growing and the alveolar bone on the pressure side resorbing to maintain the balance of the alveolar bone. However, recent studies have shown that alveolar bone loss has been found in patients who have undergone orthodontic treatment, suggesting that the alveolar bone does not change as the teeth change over time. Whether the morphology of the alveolar bone will change when the anterior teeth are moved has been the clinical focus. The changes of anterior alveolar bone in patients who have undergone tooth extraction after orthodontic treatment were summerized by literature review in this paper. The results of the review showed that the alveolar bone at the lingual/palatal root-cervical site of the anterior root is more prone to bone loss after extensive movement of the anterior teeth. With the development of imaging technology, CBCT is now more commonly used for analysis instead of two-dimensional images for measurement, as its results are more accurate. However, there are few multifactorial studies in which CBCT has been used to assess the morphological changes in the alveolar bone. The focus of future research is to compare the long-term changes in the anterior alveolar bone of patients of different ages based on three-dimensional imaging, and to study the correlation between different skeletal features, tooth movement patterns and alveolar bone remodeling.

Comparative study of two types of pre-extraction treatment (drying or non-drying) on physicochemical, structural and functional properties of extracted insect proteins from Tenebrio molitor larvae.

Microwave drying (MD) or freeze drying (FD) was commonly used as a drying treatment prior to the extraction of edible insect proteins. However, some quality defects (e.g., lipid oxidation or protein denaturation) were probably occurred via the drying step. To this end, the effect of drying or non-drying treatments (ND) after slaughtering by liquid nitrogen freezing on the physicochemical characteristics, structural and functional properties of Tenebrio molitor larvae protein (TMP) was investigated. The results indicate that TMP extracted from the ND group showed higher essential/total amino acid content, total/free sulfhydryl content, surface hydrophobicity, solubility, water/oil holding capacities, and emulsifying/foaming properties than those extracted from the MD or FD groups (P < 0.05). Moreover, the ND group had minimal impact on the structural changes of TMP which was associated with protein denaturation. Therefore, it can be concluded that a non-drying strategy prior to TMP extraction can improve functional properties and retard protein denaturation, while also conserving energy.

A construction strategy for conservative adaptive Kriging surrogate model with application in the optimal design of contaminated groundwater extraction-treatment.

When the simulation-optimization model to optimize the groundwater extraction-treatment schemes is used, the construction of a surrogate model for the numerical simulation model has become an effective means to overcome the large calculation load of repeatedly calling the numerical model. However, there are still some problems in using the surrogate model, such as large training sample size, low accuracy, and poor optimization results. In this paper, a conservative adaptive Kriging surrogate model (CAKSM) was proposed by coupling the Kriging surrogate model, optimal solution adaptive sampling method (OSAS), and conservative prediction idea. Firstly, an initial Kriging surrogate model (IKSM) was built for the numerical simulation model of groundwater flow and solute transport. Then, the IKSM was coupled with the optimization model to construct the adaptive Kriging surrogate model (AKSM) by using OSAS. A safety margin was added to the AKSM to build the CAKSM. Finally, the simulation-optimization models based on IKSM, AKSM, and CAKSM were solved by the genetic algorithm, respectively. The results showed that the IKSM could well substitute for the simulation model. The AKSM significantly improved the approximation degree between the surrogate model and the simulation model at the optimal solution by supplementing a small number of new samples. CAKSM could effectively constrain the pollutant mass concentrations within the controlled value, improving the reliability of the optimization scheme. The optimal extraction wells based on different surrogate models were all well 5, well 6, and well 9. They were concentrated in the middle and lower reaches of the contaminated plume's central axis. The sequence for the remediation effects by different surrogate models from high to low was as follows: CAKSM, AKSM, and IKSM. The risk rate of the optimal remediation scheme from the hydraulic conductivity random fields was as high as 12.12%, and the risks were mainly located upstream of the pollution plume's central axis.

Morphological changes of the anterior alveolar bone due to retraction of anterior teeth: a retrospective study.

BACKGROUD: To analyze the morphological changes of the anterior alveolar bone after the retraction of incisors in premolar extraction cases and the relationship between incisor retraction and remodeling of the alveolar base represented by points A and B displacements. METHODS: Pre- (T0) and post-treatment (T1) lateral cephalograms of 308 subjects in the maxilla and 154 subjects in the mandible who underwent the orthodontic treatment with extraction of 2 premolars in upper or lower arches were included. Alveolar bone width and height in both the maxillary and mandible incisor area were measured at T0 and T1 respectively. By superimposing the T0 and T1 cephalometric tracings, changes of points A and B, and the movement of the incisors were also measured. Then the correlation between incisor movement and the displacements of points A and B was analyzed. RESULTS: The alveolar bone width (ABW) showed a significant decrease in both maxilla and mandible (P < 0.001) except the labial side of the mandible (P > 0.05). The alveolar bone height (ABH) showed a significant increase in the labial side of maxilla and a significant decrease in the lingual side of maxilla and mandible. A strong positive correlation was verified between incisor movement and position changes of points A and B in both horizontal and vertical directions. CONCLUSIONS: Anterior alveolar bone width and height generally decreased after orthodontic treatment. Incisor retraction led to significant position changes of points A and B. The decrease of anterior alveolar bone due to significant incisor retraction should be taken into account in treatment planning.

Measurement of three-dimensional changes in lip vermilion in adult female patients after orthodontic extraction: a retrospective longitudinal study.

BACKGROUND: 3D facial scanning has changed the way facial aesthetic is evaluated and has numerous advantages for facial analysis. The specific relationship between lip vermilion morphological changes after orthodontic extraction treatment has not been fully explained. The objective of this study was to evaluate 3D morphological changes after orthodontic extraction treatment in lip vermilion of adult females with dentoalveolar protrusion using a structured light-based scanner. METHODS: Forty-two female subjects (25.2 ± 1.9 years) were recruited as the treatment group; these patients had undergone extraction treatment and achieved better sagittal profiles. Twenty female subjects (25.5 ± 2.1 years) were enrolled in the non-treatment group; these patients did not require any orthodontic treatment. The follow up time for the treatment group was more than 24 months and for the non-treatment group was more than 12 months. 3D facial scans were captured using 3D CaMega. Six landmarks (Ls, Li, R.Chp, L.Chp, R.Ch, and L.Ch), three linear measurements (mouth height, philtrum width, and mouth width), and three area measurements (upper, lower, and total vermilion area) were measured. The spatial deviations of three volumetric measurements (upper, lower, and total vermilion) were constructed for quantitative analysis. Color-coded displacement map were constructed for visualization of the soft-tissue displacement as qualitative evaluation. RESULTS: Mouth height and philtrum width decreased (-0.93 mm and - 1.08 mm, respectively) significantly (p = 0.008 and p = 0.027, respectively), and no significant (p = 0.488) change in mouth width was observed in the treatment group. The lower and total vermilion surface areas decreased (-51.00mm2 and - 69.82mm2, respectively) significantly (p = 0.003 and p = 0.031, respectively) in the treatment group, but no statistically significant (p = 0.752) change was detected in the upper vermilion. In the treatment group, significant retractions were observed in the color-coded displacement map, and three volumetric measurements of vermilion changed significantly (p = 0.012, p = 0.001 and p = 0.004, respectively). Significant differences were found between the treatment group and the non-treatment group in the linear, area and volumetric measurements. CONCLUSIONS: This study established a method for qualitative and quantitative evaluation of the lip vermilion. Significant 3D retraction of the lip vermilion after the extraction treatment was found, with morphological variation between upper and lower vermilion.

Temporary deterioration of oral health-related quality of life (OHRQoL) in nonextraction and extraction modalities of comprehensive orthodontic treatment in adolescents.

OBJECTIVE: To evaluate the effects of nonextraction and all first premolar extraction modalities of orthodontic treatment on oral health-related quality of life (OHRQoL) among adolescents. MATERIALS AND METHODS: Sixty-eight adolescents of aged 12-18 years were chosen. Subjects who required nonextraction orthodontic treatment were included in group I, and those who required all first premolar extractions for orthodontic treatment were included in group II. Baseline OHRQoL data (T0) were recorded before the start of treatment. To evaluate the impact of orthodontic treatment on OHRQoL, the Oral Health Impact Profile-14 (OHIP-14) questionnaire was presented to all subjects for retrospective evaluation at 1 month (T1), 3 months (T2), 6 months (T3) and 1 year (T4) after the start of orthodontic treatment and 1 week after completion of orthodontic treatment (T5). RESULTS: At T1 and T2, the physical pain and physical disability domains of OHIP-14 were impacted significantly by comprehensive orthodontic treatment in both groups (P < .001). The negative impact of orthodontic treatment on OHRQoL was maximum at T1 and then slowly recovered to the pretreatment level at T3 in both groups. Recovery of OHIP-14 scores was relatively faster in group I subjects compared to group II subjects. At T1 and T2, social disability and handicap domains were deteriorated significantly in group II subjects compared to group I subjects (P < .01). CONCLUSIONS: The severity of OHRQoL deterioration was similar in both modalities of orthodontic treatment, but recovery from negative impacts was relatively slower in the first premolar extraction subjects.

Evaluating Therapy Treatments in Patients with Mental Disorders in Relation to Oral Health.

AIM: The purpose of this study was to find the correlation between dental caries and teeth loss in relation to gender, age, treatments with different therapies, time period being hospitalized, sugar consumption, smoking, and oral hygiene in mental disordered patients. OBJECTIVE: Evaluating therapeutic treatments in patients with mental illnesses, focusing on the effects on oral health. MATERIALS AND METHODS: This is a longitudinal cohort study conducted on patients who have been hospitalized from 5 years to 30 years. Patients were observed for 7 months (January 2019-July 2019) in the psychiatric hospital "Ali Mihali", in Vlora, Albania. In our study, 200 patients participated, of which 103 were females (51.5%) and 97 were males (48.5%). RESULTS: In the present study, we analyzed the oral health of patients within the age class of 30-70 years. We divided them into four age groups: 30-40, 41-50, 51-60, and 61-70 years. According to the ANOVA test, a strongest influence on caries manifestation and missing teeth was noticed during the time the patient was being hospitalized, with p values = 0.000 in both cases. The treatments done with different therapies also had a strong influence on the teeth loss with a p value = 0.001, while in carious teeth the p value was 0.004. This study showed that there is a strong statistically significant correlation between sugar consumption and smoking, in relation to caries manifestation and teeth loss, with p values = 0.000, respectively. CONCLUSION: These patients are a vulnerable group, if we consider their oral health. The present study proved that the most important reasons for their poor dental health are: bad oral hygiene, smoking, sugar consumption, adverse effects of medications, and the time period that these patients have been hospitalized. CLINICAL SIGNIFICANCE: By knowing the factors that have worsened the oral health of mental disordered patients, we can try to raise the awareness about caries reduction and to avoid teeth loss. How to cite this article: Canga M, Malagnino I, Malagnino G, et al. Evaluating Therapy Treatments in Patients with Mental Disorders in Relation to Oral Health. J Contemp Dent Pract 2019;20(10):1179-1183.

Cone-beam computed tomography-guided three-dimensional evaluation of treatment effectiveness of the Frog appliance.

OBJECTIVE: To evaluate the effectiveness of the Frog appliance in three dimensions by using cone-beam computed tomography (CBCT) images. METHODS: Forty patients (21 boys and 19 girls), averaged 11.7 years old, with an Angle Class II division 1 malocclusion were included in our study. They had either late mixed dentition or early permanent dentition, and the maxillary second molars had not yet erupted. All patients underwent CBCT before and after the treatment for measuring changes in the maxillary first molars, second premolars, central incisors, and profile. Paired-samples t-test was used to compare the mean difference in each variable before treatment and after the first phase of treatment. RESULTS: The maxillary first molars were effectively distalized by 4.25 mm (p < 0.001) and 3.53 mm (p < 0.05) in the dental crown and root apex, respectively. The tipping increased by 2.25°, but the difference was not significant. Moreover the teeth moved buccally by 0.84 mm (p < 0.05) and 2.87 mm (p < 0.01) in the mesiobuccal and distobuccal cusps, respectively, whereas no significant changes occurred in the root apex. Regarding the anchorage parts, the angle of the maxillary central incisor's long axis to the sella-nasion plane increased by 2.76° (p < 0.05) and the distance from the upper lip to the esthetic plane decreased by 0.52 mm (p = 0.01). CONCLUSIONS: The Frog appliance effectively distalized the maxillary molars with an acceptable degree of tipping, distobuccal rotation, and buccal crown torque, with only slight anchorage loss. Furthermore, CBCT image demonstrated that it is a simple and reliable method for three-dimensional analysis.

Comparison of achieved and predicted tooth movement of maxillary first molars and central incisors: First premolar extraction treatment with Invisalign.

OBJECTIVES: To compare achieved and predicted tooth movements of maxillary first molars and central incisors in first premolar extraction cases treated with Invisalign. MATERIALS AND METHODS: The present study included 30 patients who received maxillary first premolar extraction treatment with Invisalign. The actual posttreatment model was registered with the pretreatment model on the palatal stable region and superimposed with the virtual posttreatment model. Achieved and predicted tooth movements of maxillary first molars and central incisors were compared using paired t-test. Linear mixed-effect model analyses were used to explore the influence of age (adolescents vs adults), attachment (G6-optimized vs 3-mm vertical, 3-mm horizontal, and 5-mm horizontal), and initial crowding on the differences between predicted and achieved tooth movement (DPATM). RESULTS: First molars achieved greater mesial tipping, mesial translation, and intrusion than predicted. Central incisors achieved less retraction and greater lingual crown torque and extrusion than predicted. Adolescents showed greater DPATM in the mesiodistal translation of first molars and labiolingual translation of central incisors and smaller DPATM in the occlusogingival translation of the first molars and crown torque of the central incisors than adults. The 3-mm vertical attachment group showed greater DPATM in the mesiodistal translation of the first molars vs the G6-optimized attachment group. Initial crowding had an inverse correlation with DPATM in angulation and mesiodistal translation of the first molars. CONCLUSIONS: First molar anchorage control and central incisor retraction were not fully achieved as predicted in first premolar extraction treatment with Invisalign. Age, attachment, and initial crowding affected the differences between predicted and achieved tooth movement.

The influence of orthodontic non-extraction treatment on the change in the inclination and position of incisors in the Europoid race.

AIM: To detect post-treatment change in the inclination and position of incisors in cases treated with orthodontic non- extraction therapy. MATERIALS AND METHODS: The group consisted of 102 patients without extractions in lower and upper dental arch during orthodontic treatment. Cephalogram examination evaluated the position of the lower incisor to point A by Downs-pogonion line (-1 to APo) and inclination of the lower incisor to mandibular line (-1 to ML), position of the upper incisor to nasion-pogonion line (+1 to NPo), inclination of the upper incisor to nasion-sella line (+1 to NS) and the size of the inter-incisival angle between upper and central lower incisor (-1 to +1). RESULTS: In 58 % of cases, the difference in post-treatment and pre-treatment changes in the position of the (-1 to Apo) was within ± 2 mm, which we considered stable. Statistically significantly higher values after treatment were in unstable rather than in stable cases with values (-1 to Apo), (-1 to ML), (+1 to NPo). Statistically significantly lower value after the treatment was measured in unstable cases rather than in stable cases with a value (-1 to +1). There was no statistically significantly different value in stable and unstable cases after treatment in values (+1 to NS). CONCLUSION: The number of stable post-treatment cases was only 16 % higher than the number of unstable cases. With the increasing value (-1 to Apo), the value (-1 to ML) and (+1 to NPo) increased, the value (+1 to -1) decreased. The value (-1 to NS) not after treatment was not statistically significantly different in stable and unstable cases (Tab. 6, Fig. 4, Ref. 27).