ABSTRACT
INTRODUCTION: The objectives of this prospective clinical study were to evaluate the quality of treatment outcomes achieved with a complex orthodontic finishing protocol involving serpentine wires and a tooth positioner, and to compare it with the outcomes of a standard finishing protocol involving archwire bends used to detail the occlusion near the end of active treatment. METHODS: The complex finishing protocol sample consisted of 34 consecutively treated patients; 1 week before debonding, their molar bands were removed, and serpentine wires were placed; this was followed by active wear of a tooth positioner for up to 1 month after debonding. The standard finishing protocol group consisted of 34 patients; their dental arches were detailed with archwire bends and vertical elastics. The objective grading system of the American Board of Orthodontics was used to quantify the quality of the finish at each time point. The Wilcoxon signed rank test was used to compare changes in the complex finishing protocol; the Mann-Whitney U test was used to compare changes between groups. RESULTS: The complex finishing protocol group experienced a clinically significant improvement in objective grading system scores after treatment with the positioner. Mild improvement in posterior space closure was noted after molar band removal, but no improvement in the occlusion was observed after placement of the serpentine wires. Patients managed with the complex finishing protocol also had a lower objective grading system score (14.7) at the end of active treatment than did patients undergoing the standard finishing protocol (23.0). CONCLUSIONS: Tooth positioners caused a clinically significant improvement in interocclusal contacts, interproximal contacts, and net objective grading system score; mild improvement in posterior band space was noted after molar band removal 1 week before debond.
Subject(s)
Malocclusion/therapy , Tooth Movement Techniques/standards , Adolescent , Child , Clinical Protocols , Dental Occlusion , Female , Follow-Up Studies , Humans , Image Processing, Computer-Assisted/methods , Longitudinal Studies , Male , Models, Dental , Orthodontic Appliance Design , Orthodontic Retainers , Orthodontic Space Closure/instrumentation , Orthodontic Space Closure/standards , Orthodontic Wires , Prospective Studies , Software , Tooth Movement Techniques/instrumentation , Treatment OutcomeABSTRACT
An article of Czochrowska, Skaare, Stenvik and Zachrisson was published about the possibilities of orthodontic treatment of missing upper central incisors, in the American Journal of Orthodontics, in July 2003. This article generated a heavy discussion among the readers of this periodical. A lot of orthodontists published their pros and cons about the advantages and disadvantages of orthodontic space closure. The purpose of this review is to collect the opinions and arguments about the topic from the orthodontic literature. There are some long-term, follow-up studies which compared the results of the orthodontic and prosthetic solutions after the treatment of missing upper incisors. The better-known studies are Nordquist and McNeil' s work published in the Journal of Periodontology (1975) and the publication of Robertsson and Mohlin published in the European Journal of Orthodontics (2000). The long-term studies argued that from the aspect of patients' satisfaction and periodontal or functional evaluation the orthodontic treatments ensured better results than either the prosthodontic or implantological approaches. These statements are contentious by a lot of experts and so it is important to review all the aspects of this topic.
