Efficiency of compensatory orthodontic treatment of mild Class III malocclusion with two different bracket systems

ABSTRACT Objective: The purpose of this study was to assess the efficiency of compensatory orthodontic treatment of patients with mild Class III malocclusion with two preadjusted bracket systems. Method: Fifty-six matched patients consecutively treated for mild Class III malocclusion through compensatory dentoalveolar movements were retrospectively evaluated after analysis of orthodontic records. The sample was divided into two groups according to the brackets used: Group 1 = non-Class III compensated preadjusted brackets, Roth prescription (n = 28); Group 2 = compensated Class III preadjusted brackets, Capelozza III prescription (n = 28). Cephalometric analysis, number of appointments and missed appointments, months using Class III elastics, and bond/band failures were considered. Treatment time, Peer Assessment Rating (PAR) index at the beginning (PAR T1) and end of treatment (PAR T2) were used to calculate treatment efficiency. Comparison was performed using a MANOVA at p< 0.05. Results: Missed appointments, bond or band failures, number of months using the Class III intermaxillary elastics, and cephalometric measurements showed no statistically significant difference (p> 0.05) between groups. Patients treated with Roth brackets had a treatment time 7 months longer (p= 0.01). Significant improvement in the patient's occlusion (PAR T2-T1) was observed for both groups without difference (p= 0.22). Conclusions: Orthodontic brackets designed for compensation of mild Class III malocclusions appear to be more efficient than non-compensated straight-wire prescription brackets. Treatment time for Class III patients treated with brackets designed for compensation was shorter than with Roth prescription and no difference in the quality of the occlusal outcome was observed. A prospective randomized study is suggested to provide a deeper look into this subject.

RESUMO Objetivo: o objetivo desse estudo foi avaliar a eficiência do tratamento ortodôntico compensatório de pacientes com má oclusão de Classe III suave usando dois diferentes sistemas de braquetes pré-ajustados. Métodos: foram avaliados retrospectivamente, após análise de registros ortodônticos, cinquenta e seis pacientes tratados consecutivamente de má oclusão de Classe III, por meio de movimentos de compensação dentária. A amostra foi dividida em dois grupos, de acordo com os braquetes utilizados: Grupo 1 - braquetes pré-ajustados não compensatórios para Classe III, prescrição Roth (n = 28); Grupo 2 - braquetes pré-ajustados para tratamento compensatório de Classe III, prescrição Capelozza Padrão III (n = 28). Considerou-se a análise cefalométrica, número de consultas realizadas e de consultas perdidas, meses de uso dos elásticos intermaxilares de Classe III e quebras de braquetes/bandas. Foram utilizados para calcular a eficiência do tratamento: tempo de tratamento, índice PAR (Peer Assessment Rating) ao início (PAR T1) e fim de tratamento (PAR T2). A comparação intergrupos foi realizada com o teste MANOVA, a p< 0,05. Resultados: não houve diferença estatisticamente significativa (p> 0,05) entre os grupos quanto às medidas cefalométricas, número de consultas perdidas, quebras de braquetes/bandas e tempo de uso dos elásticos de Classe III. Os pacientes tratados com braquetes Roth tiveram tempo de tratamento sete meses maior (p= 0,01). Observou-se melhora significativa na oclusão dos pacientes (PAR T2-T1) para ambos os grupos, sem diferença estatística significativa (p= 0,22). Conclusão: os braquetes ortodônticos projetados para compensação das más oclusões de Classe III parecem ser mais eficientes do que os pré-ajustados não compensatórios. O tempo de tratamento para pacientes Classe III tratados com braquetes projetados para compensação foi menor do que com a prescrição Roth, e nenhuma diferença na qualidade da oclusão final foi observada. Sugere-se um estudo prospectivo randomizado, para fornecer uma visão mais profunda sobre esse assunto.

Efficiency of compensatory orthodontic treatment of mild Class III malocclusion with two different bracket systems.

OBJECTIVE: The purpose of this study was to assess the efficiency of compensatory orthodontic treatment of patients with mild Class III malocclusion with two preadjusted bracket systems. METHOD: Fifty-six matched patients consecutively treated for mild Class III malocclusion through compensatory dentoalveolar movements were retrospectively evaluated after analysis of orthodontic records. The sample was divided into two groups according to the brackets used: Group 1 = non-Class III compensated preadjusted brackets, Roth prescription (n = 28); Group 2 = compensated Class III preadjusted brackets, Capelozza III prescription (n = 28). Cephalometric analysis, number of appointments and missed appointments, months using Class III elastics, and bond/band failures were considered. Treatment time, Peer Assessment Rating (PAR) index at the beginning (PAR T1) and end of treatment (PAR T2) were used to calculate treatment efficiency. Comparison was performed using a MANOVA at p< 0.05. RESULTS: Missed appointments, bond or band failures, number of months using the Class III intermaxillary elastics, and cephalometric measurements showed no statistically significant difference (p> 0.05) between groups. Patients treated with Roth brackets had a treatment time 7 months longer (p= 0.01). Significant improvement in the patient's occlusion (PAR T2-T1) was observed for both groups without difference (p= 0.22). CONCLUSIONS: Orthodontic brackets designed for compensation of mild Class III malocclusions appear to be more efficient than non-compensated straight-wire prescription brackets. Treatment time for Class III patients treated with brackets designed for compensation was shorter than with Roth prescription and no difference in the quality of the occlusal outcome was observed. A prospective randomized study is suggested to provide a deeper look into this subject.

Validity and reliability of intraoral scanners compared to conventional gypsum models measurements: a systematic review.

BACKGROUND: The development of 3D technology and the trend of increasing the use of intraoral scanners in dental office routine lead to the need for comparisons with conventional techniques. OBJECTIVE: To determine if intra- and inter-arch measurements from digital dental models acquired by an intraoral scanner are as reliable and valid as the similar measurements achieved from dental models obtained through conventional intraoral impressions. SEARCH METHODS: An unrestricted electronic search of seven databases until February 2015. SELECTION CRITERIA: Studies that focused on the accuracy and reliability of images obtained from intraoral scanners compared to images obtained from conventional impressions. DATA COLLECTION AND ANALYSIS: After study selection the QUADAS risk of bias assessment tool for diagnostic studies was used to assess the risk of bias (RoB) among the included studies. RESULTS: Four articles were included in the qualitative synthesis. The scanners evaluated were OrthoProof, Lava, iOC intraoral, Lava COS, iTero and D250. These studies evaluated the reliability of tooth widths, Bolton ratio measurements, and image superimposition. Two studies were classified as having low RoB; one had moderate RoB and the remaining one had high RoB. Only one study evaluated the time required to complete clinical procedures and patient's opinion about the procedure. Patients reported feeling more comfortable with the conventional dental impression method. LIMITATIONS: Associated costs were not considered in any of the included study. CONCLUSIONS AND IMPLICATIONS: Inter- and intra-arch measurements from digital models produced from intraoral scans appeared to be reliable and accurate in comparison to those from conventional impressions. This assessment only applies to the intraoral scanners models considered in the finally included studies. Digital models produced by intraoral scan eliminate the need of impressions materials; however, currently, longer time is needed to take the digital images. REGISTRATION: PROSPERO (CRD42014009702). FUNDING: None.