1
|
Palone M, Averta F, Poma G, Cremonini F, Degl'Innocenti ML, Lombardo L. Short-term dentoalveolar effects of aesthetic lip bumper appliance: A longitudinal cases-series and pilot study. Saudi Dent J 2024; 36:301-307. [PMID: 38419990 PMCID: PMC10897584 DOI: 10.1016/j.sdentj.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/03/2023] [Accepted: 11/05/2023] [Indexed: 03/02/2024] Open
Abstract
Background To investigate the short-term dentoalveolar effects on the mandibular arch of a modified, aesthetic lip bumper (ALBAa). The study sample comprised 23 patients (13 boys and 10 girls, with a mean age of 9.5 ± 1.8 years) in mixed dentition, with no previous orthodontic treatment. For each patient, a scan of the mandibular arch was digitally acquired pre-treatment (T0), and at 3 months (T1), 6 months (T2) and 9 months (T3) post-treatment. Linear intra-arch measurements, Little's irregularity index of the amount of mandibular anterior crowding, and the crown tipping values on all mandibular teeth were measured and compared statistically between time points. ANOVA and subsequent post-hoc tests were performed, considering a p-value of < 0.05 as significant. Results Linear intra-arch distances and crown tipping values on the mandibular teeth increased between the following time points: T0vsT1, T1vsT2, T0vsT2 and T0vsT3 (p < 0.05), although in the last three months of observation (T2vsT3) they only reached statistical significance at the lower incisors and lower left premolar concerning crown tipping values. There was a statistically significant decrease in anterior crowding throughout the observational period (p < 0.05), and this effect was equally distributed across the different time points investigated. Conclusions ALBAa therapy led to an increase in both linear intra-arch distances and crown tipping values, with a reduction in Little's index. The distribution of the effects reported across the observational period depended on the mechanism of action (mechanical vs. functional).
Collapse
Affiliation(s)
- M Palone
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - F Averta
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - G Poma
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | - F Cremonini
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| | | | - L Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Ferrara, Italy
| |
Collapse
|
2
|
Eslamian L, Ebadifar A, Mohebbi Rad M, Motamedian SR, Badiee MR, Mohammad Rahimi H, Farahani MH. Comparison of Single and Multiple Low-Level Laser Applications After Rapid Palatal Expansion on Bone Regeneration in Rats. J Lasers Med Sci 2021; 11:S37-S42. [PMID: 33995967 DOI: 10.34172/jlms.2020.s6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: This study was performed to compare the effects of single and multiple irradiations of low-level laser therapy (LLLT) on bone regeneration in a mid-palatal suture following rapid palatal expansion (RPE). Methods: In this animal study, 40 male Wistar rats underwent RPE for 7 days and were divided into 4 groups including A: single LLLT on day 7, B: Multiple LLLT on days 7, 9, 11, 13 and 15, C: control (no LLLT), and D: sacrificed on day 7. Animals in group D were used to determine the amount of suture expansion. LLLT was done by a diode laser set at an 808 nm wavelength with a useful power output of 100 mW and duration of 0.1 ms. LLLT was applied to three points. After three weeks of retention, the rats were sacrificed and beheaded and the maxilla was evaluated by occlusal radiography, µ-CT, and histomorphometric analyses. A comparison of the mean measurements between the groups was performed using ANOVA and the Tukey post hoc test. Results: Based on occlusal radiography and µCT, bone density in group B was significantly higher than group A and group C (P<0.05). There was no significant difference in bone density between group A and group C (P>0.05). Mean suture width (MSW) in group B was significantly lesser than the control group (P=0.027) while there was no significant difference between MSWnin groups A and B (P=0.116) and groups A and C (P=0.317). Conclusion: It may be concluded that multiple low-power laser irradiation improves bone regeneration after RPE while single irradiation does not have a positive effect.
Collapse
Affiliation(s)
- Ladan Eslamian
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aliasghar Ebadifar
- Dentofacial Deformities Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Saeed Reza Motamedian
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Badiee
- Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hossein Mohammad Rahimi
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Hosein Farahani
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
3
|
Zhao B, Zhao G, Shen T, Wang C, Xiao Y, Han Y, Ke J. A pilot study of mandibular expansion in combination with a fixed-appliance for increasing the effective space of the mandibular arch: Finite element analysis and three-dimensional cone-beam computed tomography. Medicine (Baltimore) 2021; 100:e24869. [PMID: 33663114 PMCID: PMC7909137 DOI: 10.1097/md.0000000000024869] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 10/14/2020] [Indexed: 01/05/2023] Open
Abstract
Techniques for enhancing the effective space of the mandibular arch are urgently needed. Therefore, this study aimed to perform mandibular expansion in combination with a fixed-appliance technique, with preliminary monitoring by finite element analysis and 3-dimensional cone-beam computed tomography (CBCT).Finite element models were structured according to CBCT images of a 14-year-old girl. The von Mises stress of the alveolar bone and tooth displacement were assessed in different models. The technique was also applied in an 11-year-old boy. CBCT was performed at post-expansion, post-retention, post-treatment and 2 years after treatment. Tooth movement and alveolar bone stress were assessed by the CAD software.Finite element analysis suggested that the teeth tended to stand upright in the buccal side in the expander model compared with the expander-remove model. However, minimum tooth change was observed in the normal model, indicating highest stability. The von Mises stress of the alveolar bone was decreased in the normal model compared with the expander model, suggesting that buccal-inclined teeth could more easily lead to alveolar bone stress than normal ones. Based on CBCT data and the 3D mandibular dentition model fitting, mandibular teeth tended to be upright in the buccal side after retention compared with the post-expansion condition, which somewhat differed from finite element analysis results. Furthermore, dehiscence and fenestration were not observed.This expansion technique is expected to increase the effective space after mandibular expansion and reduce buccal alveolar bone stress.
Collapse
Affiliation(s)
- Bingjing Zhao
- Department of Stomatology, Air Force Medical Center. PLA
| | - Guizhi Zhao
- Department of Stomatology, Air Force Medical Center. PLA
| | - Tao Shen
- Department of Stomatology, General Hospital of the PLA, Beijing
| | - Chao Wang
- Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Yihan Xiao
- Department of Stomatology, Air Force Medical Center. PLA
| | - Yichen Han
- Department of Stomatology, General Hospital of the PLA, Beijing
| | - Jie Ke
- Department of Stomatology, Air Force Medical Center. PLA
| |
Collapse
|
4
|
ANDRADE JR. I, PASCHOAL MAB, FIGUEIREDO NC. Modified Arnold expander: an alternative for mandibular arch expansion. Dental Press J Orthod 2021; 26:e21spe5. [PMID: 35640085 PMCID: PMC8576860 DOI: 10.1590/2177-6709.26.5.e21spe5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 08/23/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction: Due to the anatomical constraints of the mandible, mandibular dental arch usually serves as a guideline to determine the required changes in the maxillary transverse dimension. The Schwarz appliance and the Lip Bumper are the traditional orthodontic appliances for mandibular arch expansion in patients with borderline amounts of crowding, and/or transverse discrepancy. However, they often require patient cooperation, which may be a concern for orthodontists in daily practice. Objectives: This article illustrates a simple fixed orthodontic device as an alternative to achieve mandibular arch expansion in patients with moderate tooth-size/arch-length discrepancy. The four reported cases refer to 8 to 10-year-old patients in the mixed dentition, with an Angle Class I or Class II malocclusion, transverse deficiency in both arches, moderate crowding and/or posterior crossbite, combined with compromised smile aesthetics. The patients were treated with rapid maxillary expansion (RME) using Hass expander appliance and the modified Arnold expander (MAE). Conclusion: This low-cost compliance-free orthodontic appliance provided dentoalveolar decompensation by means of uprighting the posterior teeth, with minimal or no adjustments during treatment. The final results were achieved in only three to four months, and fulfilled all treatment objectives, such as an increase in the arch perimeter and width, and a better teeth alignment.
Collapse
|
5
|
Effects of lip bumper therapy on the mandibular arch dimensions of children and adolescents: A systematic review. Am J Orthod Dentofacial Orthop 2020; 157:454-465.e1. [PMID: 32241352 DOI: 10.1016/j.ajodo.2019.10.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 10/01/2019] [Accepted: 10/01/2019] [Indexed: 01/21/2023]
Abstract
INTRODUCTION The aim of this systematic review was to identify, evaluate, and provide a synthesis of the available literature on the effects of lip bumper (LB) therapy on the mandibular dental arch of children and adolescents. METHODS MEDLINE, Scopus, Web of Science, Cochrane Library, and Lilacs were systematically searched without restrictions up to May 2019. Risk-of-bias assessment was performed using Cochrane's tool for randomized controlled trials (RCTs) and the Risk of Bias in Nonrandomized Studies of Interventions tool for non-RCTs. The Grading of Recommendations, Assessment, Development and Evaluation tool was used to assess the quality of the evidence. RESULTS After examination of the full texts, 6 studies were included. One RCT presented unclear risk of bias, and 5 non-RCTs presented serious to moderate risk of bias. LB therapy resulted in a buccal inclination of the incisors, distalization of the permanent first molars, and distal inclination of the permanent first molars, which increased perimeter and arch length. An increase in the arch width with greater gain in the interpremolar and/or deciduous molar distance and less gain in intercanine and intermolar distances was also reported. LB therapy increased the risk of second molar impaction with inclination >30° and the risk of ectopic eruption when treatment time was >2 years. The level of the evidence was graded as very low for variable arch length and second molar eruption disturbances. All other outcomes were graded as having low level of evidence. CONCLUSIONS Owing to the low level of certainty identified, the conclusions should be considered cautiously. Increase in arch perimeter and width was attributed to the proclination of the incisors, buccalization of the deciduous molar and premolar areas, and distal inclination of the molars. However, there was an increased chance of impaction and ectopic eruption of permanent second molar after treatment with LB.
Collapse
|
6
|
Efficacy of different designs of mandibular expanders: A 3-dimensional finite element study. Am J Orthod Dentofacial Orthop 2020; 157:641-650. [PMID: 32354437 DOI: 10.1016/j.ajodo.2019.05.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Nonsurgical mandibular expansion has been increasingly performed in recent years because it can effectively expand the mandibular dental arch. However, many types of mandibular expanders have been used in previous studies. No relevant studies have compared the biomechanical responses of different designs of mandibular expansion appliances with screws. Therefore, the purpose of this study was to analyze the stress distribution and displacement of the dentoalveolar structures according to different designs of mandibular screw expanders. METHODS Cone-beam computed tomography scans were used for 3-dimensional reconstruction of the mandibular finite element model. Four different designs of mandibular expanders, 1 removable expander (type A) and 3 fixed expanders (types B, C, and D), were added to the finite element models. Expanders were activated transversely for 0.2 mm. The initial tooth displacement and von Mises stress distribution were evaluated. RESULTS All the expanders enlarged the arch dimensions. In types A and B, the stress was mainly concentrated in the region of the anterior teeth, along with greater tooth displacement, whereas in types C and D, greater stress and displacement occurred in the region of the posterior teeth. Type A showed the greatest amount of transverse displacement. Type D was more efficient in the region of the posterior teeth. CONCLUSIONS Types A and B should be used with great caution in the clinic because of their incompatible expansion pattern. Type D is the recommended mandibular expansion appliance because of its appropriate expansion pattern.
Collapse
|
7
|
Grassia V, Nucci L, Marra PM, Isola G, Itro A, Perillo L. Long-Term Outcomes of Nonextraction Treatment in a Patient with Severe Mandibular Crowding. Case Rep Dent 2020; 2020:1376472. [PMID: 32850153 PMCID: PMC7439177 DOI: 10.1155/2020/1376472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 04/15/2020] [Accepted: 04/21/2020] [Indexed: 02/07/2023] Open
Abstract
OBJECTIVE To describe a clinical case with a severe mandibular crowding treated without extraction and showing a long-term outcome. METHODS A 14-year-old boy in permanent dentition showed a class I molar and cuspid relationship, a severe deep bite of 8 mm, a constricted V-shaped upper arch with moderate crowding, and a severe crowding of about 12 mm in the lower arch. The panoramic X-ray showed an impacted upper right canine. The treatment started with the placement of a transpalatal bar and 0.022 × 0.028 in standard edgewise appliances in the upper arch and a lip bumper bonded on the second lower molars. Initial leveling of the teeth was accomplished with light Australian round wires. Finishing was then performed with rectangular wires. The phase with fixed appliances lasted 2 years and 9 months, and the patient was motivated and cooperative throughout the treatment, although with poor oral hygiene. The patient was treated without extractions. RESULTS The space was gained with the first and second upper molar derotations using the transpalatal bar and the gingival lip bumper in the lower arch. The upper right canine was well positioned, and the maxillary arch form was improved. The severe lower crowding was completely corrected, and a good overbite was achieved. CONCLUSION A conservative, nonextraction treatment approach for this patient with class I malocclusion with severe mandibular crowding was effective, and the results have remained stable after a long-term follow-up (10 years).
Collapse
Affiliation(s)
- Vincenzo Grassia
- 1Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Ludovica Nucci
- 1Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Paola Martina Marra
- 1Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Gaetano Isola
- 2Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Italy
| | - Angelo Itro
- 3Complex Operative Unit of Stomatological Surgery in Developmental Age, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Letizia Perillo
- 1Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| |
Collapse
|
8
|
Levels of Cytokines in Gingival Crevicular Fluid during Rapid Maxillary Expansion and the Subsequent Retention Period. J Clin Pediatr Dent 2019; 43:137-143. [PMID: 30730797 DOI: 10.17796/1053-4625-43.2.12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To monitor the effects of rapid maxillary expansion (RME) on bone metabolic activities during and after 3 months of retention. STUDY DESIGN Fifteen patients with a mean age of 12.9 ± 0.6 years were treated with a bonded expansion device, activated 2 turns per day. The retention period was 3 months. Clinical periodontal parameters were recorded at baseline and after retention. Gingival crevicular fluid (GCF) samples were collected from maxillary first molars from the compression sides at baseline, then at 1 and 10 days and after retention. Tension side samples were obtained at baseline and after retention. Interleukin-1beta (IL-1β), transforming growth factor beta1 (TGF-β1), prostaglandin E2 (PGE2) and nitric oxide (NO) levels were specifically measured. RESULTS Periodontal parameters increased significantly after retention relative to baseline values. Levels of IL-1β, TGF-β1 and PGE2 increased on day 10, and decreased after retention on the compression side. NO levels were elevated on day 10, and remained higher after retention on the compression side. Tension side cytokine levels remained higher relative to baseline values after retention. CONCLUSIONS The results of this study indicate the importance of ongoing adaptive bone activities after 3 months of retention with RME, which should be considered questionable as an effective retention period.
Collapse
|
9
|
Swidi AJ, Griffin AE, Buschang PH. Mandibular alignment changes after full-fixed orthodontic treatment: a systematic review and meta-analysis. Eur J Orthod 2019; 41:609-621. [DOI: 10.1093/ejo/cjz004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
SummaryBackgroundAlthough post-treatment mandibular alignment has been extensively investigated, the findings remain controversial.ObjectivesThe objective was to assess mandibular alignment changes, as measured by the irregularity index, of patients who underwent full-fixed orthodontic treatment and were followed up at least 1 year after retention.Search methodsMEDLINE, EMBASE, and Cochrane library, in addition, the reference lists of included studies, were screened. The search was conducted up to April 2018.Selection criteriaThe study designs included both interventional and observational studies of orthodontic patients who received either extraction or non-extraction treatment.Data collection and analysisThe interventional studies were assessed using the Cochrane Collaboration’s risk of bias assessment tool. The quality of the observational studies was evaluated using National Institution of Health quality assessment tools. The first two authors independently applied the eligibility criteria, extracted the data, and assessed the risk of bias. Any conflicts were resolved with consensus discussion with the third author.ResultsThe search retrieved 11 326 articles, 170 of which were assessed for eligibility. There were 44 studies included in the qualitative assessments and 30 in the meta-analyses. The studies included 1 randomized control trial (RCT) and 43 observational studies. The RCT was judged to have a high risk of bias and all of the observational studies had either fair or poor quality. The meta-analysis was based on studies judged to be of fair quality, including a total of 1859 patients. All meta-analyses were performed using random-effect models. The standardized mean difference between post-treatment and post-retention irregularity was 1.22 (95% CI, 1.04–1.40) and 0.85 (95% CI, 0.63–1.07) after extraction and non-extraction treatments, respectively. There was a substantial heterogeneity for the extraction (I2 = 75.2%) and non-extraction (I2 = 70.1%) studies. The follow-up duration (1–10 versus 10–20 years) explained 33% of the heterogeneity, with longer follow-up studies showing more irregularity.LimitationsThe quality of evidence provided by the studies was low. There was a risk of publication bias, and the search was limited to English language.Conclusions and implicationsPost-treatment mandibular irregularity increases are limited. Irregularity increases are slightly greater in patients treated with mandibular premolars extractions, and in patients followed up over longer periods of time.RegistrationThe study protocol was not registered.
Collapse
Affiliation(s)
- Ahmad J Swidi
- Orthodontic Department, College of Dentistry, Texas A&M University, Dallas, TX, USA
- Orthodontic Department, College of Dentistry, Jazan University, Saudi Arabia
| | - Andreea E Griffin
- Public Health Sciences Department, College of Dentistry, Texas A&M University, Dallas, TX, USA
| | - Peter H Buschang
- Orthodontic Department, College of Dentistry, Texas A&M University, Dallas, TX, USA
| |
Collapse
|
10
|
Ben Mohimd H, Bahije L, Zaoui F, Halimi A, Benyahia H. Faut-il prescrire systématiquement une contention mandibulaire ? Revue systématique. Int Orthod 2018; 16:114-132. [DOI: 10.1016/j.ortho.2018.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
11
|
|
12
|
Steinnes J, Johnsen G, Kerosuo H. Stability of orthodontic treatment outcome in relation to retention status: An 8-year follow-up. Am J Orthod Dentofacial Orthop 2017; 151:1027-1033. [PMID: 28554448 DOI: 10.1016/j.ajodo.2016.10.032] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 10/01/2016] [Accepted: 10/01/2016] [Indexed: 10/19/2022]
Abstract
INTRODUCTION Our aim was to evaluate the stability of orthodontic treatment outcome and retention status 7 or more years after active treatment in relation to posttreatment or postretention time, type of retention appliance, and duration of retainer use. METHODS The subjects were former patients who completed orthodontic treatment with fixed appliances from 2000 to 2007. The pretreatment eligibility criteria were anterior crowding of 4 mm or more in the maxilla or the mandible and Angle Class I or Class II sagittal molar relationship. Acceptable pretreatment and posttreatment dental casts were required. A total of 67 patients participated, 24 men and 43 women, with a mean age of 24.7 years (range, 20.0-50.0 years). All participants had a follow-up clinical examination, which included impressions for follow-up casts, and each completed a questionnaire. Data were obtained from pretreatment, posttreatment, and follow-up (T2) casts as well as from the patients' dental records. Treatment stability was evaluated with the peer assessment rating (PAR) index and Little's irregularity index. RESULTS The participation rate was 64%. The average posttreatment time was 8.5 years (range, 7.0-11.0). All participants had received a retainer in the mandible, maxilla, or both after active treatment. At T2, the PAR score showed a mean relapse of 14%. The majority (78%) of participants still had a fixed retainer at T2 (retainer group), and 22% had been out of retention for at least 1 year (postretention group). The relapse according to the PAR did not differ significantly between participants with and without a retainer at T2. From posttreatment to T2, the irregularity of the mandibular incisors increased almost 3 times more in participants with no retainer in the mandible compared with those with an intact retainer at T2 (P = 0.001). In the maxilla, no corresponding difference was found. CONCLUSIONS Our results suggest that occlusal relapse can be expected after active orthodontic treatment irrespective of long-term use of fixed retainers. Fixed canine-to-canine retainers seem effective to maintain mandibular incisor alignment, whereas in the maxilla a fixed retainer may not make any difference in the long term.
Collapse
Affiliation(s)
- Jeanett Steinnes
- Institute of Clinical Dentistry, Faculty of Health Sciences, Arctic University of Norway, Tromsø, Norway; Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway.
| | - Gunn Johnsen
- Institute of Clinical Dentistry, Faculty of Health Sciences, Arctic University of Norway, Tromsø, Norway; Public Dental Health Service Competence Centre of Northern Norway, Tromsø, Norway
| | - Heidi Kerosuo
- Institute of Clinical Dentistry, Faculty of Health Sciences, Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
13
|
|
14
|
|
15
|
Blumber-Franco K, Rossouw PE, Buschang PH, Campbell PM, Ceen RF. Post-retention assessment of the transverse dimension in Class I crowding alignment utilizing the Damon System—A pilot study. Semin Orthod 2017. [DOI: 10.1053/j.sodo.2016.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
16
|
Bigliazzi R, Magalhães ADOS, Magalhães PE, Bertoz APDM, Faltin K, Arita ES, Bertoz FA. Cone-beam computed tomography evaluation of bone density of midpalatal suture before, after, and during retention of rapid maxillary expansion in growing patients. J World Fed Orthod 2017. [DOI: 10.1016/j.ejwf.2017.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
|
17
|
Raucci G, Pachêco-Pereira C, Elyasi M, d'Apuzzo F, Flores-Mir C, Perillo L. Predictors of postretention stability of mandibular dental arch dimensions in patients treated with a lip bumper during mixed dentition followed by fixed appliances. Angle Orthod 2016; 87:209-214. [PMID: 27654628 DOI: 10.2319/051216-379.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To identify which dental and/or cephalometric variables were predictors of postretention mandibular dental arch stability in patients who underwent treatment with transpalatal arch and lip bumper during mixed dentition followed by full fixed appliances in the permanent dentition. MATERIALS AND METHODS Thirty-one patients were divided into stable and relapse groups based on the postretention presence or absence of relapse. Intercuspid, interpremolar, and intermolar widths; arch length and perimeter; crowding; and lower incisor proclination were evaluated before treatment (T0), after lip bumper treatment (T1), after fixed appliance treatment (T2), and a minimum of 3 years after removal of the full fixed appliance (T3). Logistic regression analyses were performed to evaluate the effect of changes between T0 and T1, as predictive variables, on the occurrence of relapse at T3. RESULTS The model explained 53.5 % of the variance in treatment stability and correctly classified 80.6 % of the sample. Of the seven prediction variables, intermolar and interpremolar changes between T0 and T1 (P = .024 and P = .034, respectively) were statistically significant. For every millimeter of increase in intermolar and interpremolar widths there was a 1.52 and 2.70 times increase, respectively, in the odds of having stability. There was also weak evidence for the effect of sex (P = .047). CONCLUSIONS The best predictors of an average 4-year postretention mandibular dental arch stability after treatment with a lip bumper followed by full fixed appliances were intermolar and interpremolar width increases during lip bumper therapy. The amount of relapse in this crowding could be considered clinically irrelevant.
Collapse
|
18
|
Valladares-Neto J, Evangelista K, Miranda de Torres H, Melo Pithon M, Alves Garcia Santos Silva M. A 22-year follow-up of the nonsurgical expansion of maxillary and mandibular arches in a young adult: Are the outcomes stable, relapsed, or unstable with aging? Am J Orthod Dentofacial Orthop 2016; 150:521-32. [PMID: 27585782 DOI: 10.1016/j.ajodo.2015.10.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 10/01/2015] [Accepted: 10/01/2015] [Indexed: 02/07/2023]
Abstract
Adult maxillary and mandible arch expansion without a surgical approach can be uncertain when long-term stability is considered. This case report describes the treatment of a 19-year-old woman with an Angle Class I malocclusion with constricted maxillary and mandibular arches. The patient's main complaint was mandibular anterior crowding. The treatment plan included expansion of the mandibular arch concurrent with semirapid maxillary expansion. An edgewise appliance was used to adjust the final occlusion. Smile esthetics and dental alignment were improved without straightening the profile. This outcome was followed up with serial dental casts for 22 years after treatment. At the end of that period, the occlusion and tooth alignment were clinically satisfactory, further supported by mandibular fixed retention. However, the transverse widths were continuously and gradually reduced over time, superposing orthodontic transverse relapse and natural arch constriction caused by aging.
Collapse
Affiliation(s)
- José Valladares-Neto
- Adjunct professor, Division of Orthodontics, School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil.
| | - Karine Evangelista
- Postgraduate student (PhD), School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Hianne Miranda de Torres
- Postgraduate student (PhD), School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil
| | - Matheus Melo Pithon
- Professor, Department of Orthodontics, School of Dentistry, Southwest Bahia State University, Jequié, Bahia, Brazil
| | | |
Collapse
|
19
|
Gökalp H. Alternate rapid maxillary expansion-constriction and tooth-borne symphyseal distraction osteogenesis : A case report demonstrating treatment of a patient with severe crowding. J Orofac Orthop 2016; 77:203-13. [PMID: 27145939 DOI: 10.1007/s00056-016-0025-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 01/30/2015] [Indexed: 10/21/2022]
Abstract
Surgically assisted rapid mandibular expansion is a contemporary treatment alternative to enable genuine skeletal mandibular widening. Mandibular widening via a tooth-borne distractor is a practical and noninvasive clinical approach. Recently, to expand and protract the maxilla, the alternate rapid maxillary expansion-and-constriction procedure was suggested. In this case report, we describe a female patient (12 years 7 months old) having severe maxillary and mandibular crowding who underwent repeated alternate rapid maxillary expansion and constriction in combination with tooth-borne symphyseal distraction osteogenesis.
Collapse
Affiliation(s)
- Hatice Gökalp
- Department of Orthodontics, School of Dentistry, University of Ankara, Besevler, 06500, Ankara, Turkey.
| |
Collapse
|
20
|
Moralis A, Zitzmann K, Gosau M, Schlegel D. The effects of surgical expansion of the maxillary arch and its consequences for the incisor axis. J Craniomaxillofac Surg 2016; 44:569-73. [PMID: 26976697 DOI: 10.1016/j.jcms.2016.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/22/2016] [Accepted: 02/01/2016] [Indexed: 10/22/2022] Open
Abstract
PURPOSE Reduced transverse maxillary dental arch width may be treated either by surgically supported rapid maxillary expansion (SRME) with conservative orthodontic appliances or by means of Le Fort I osteotomy (LFIO). Both are means of transverse maxillary expansion. METHODS Both surgical methods (SRME and LFIO) were evaluated with regard to the presurgical and postsurgical form of the maxillary dental arch and its consequences for the incisor axis by means of 32 dental casts and cephalometric analysis. RESULTS In both groups, anterior and posterior dental arch width showed significant changes after surgery, but changes in anterior dental arch width were less significant after LFIO (p = 0.004) than after SRME (p < 0.000; t-test). Cephalometric analysis (OK1/N1) did not show any significant differences between the two surgical methods (p = 0.1266; t-test). Anterior arch length was not reduced after LFIO but significantly reduced after SRME. Thus, the ideal elliptical shape of the dental arch was lost in the SRME group, which may impede esthetic outcome of the maxillary dental arch. CONCLUSION Le Fort I osteotomy achieving direct transverse expansion should be favored over surgically supported rapid maxillary expansion if transverse expansion does not exceed 7 mm.
Collapse
Affiliation(s)
- A Moralis
- Department of Cranio-Maxillo-Facial Surgery, Paracelsus Medical University Nuermberg, Breslauerstr. 201, 90471 Nuermberg, Germany; Department of Cranio-Maxillo-Facial Surgery, University Medical Center, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - K Zitzmann
- Department of Cranio-Maxillo-Facial Surgery, University Medical Center, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - M Gosau
- Department of Cranio-Maxillo-Facial Surgery, Paracelsus Medical University Nuermberg, Breslauerstr. 201, 90471 Nuermberg, Germany.
| | - D Schlegel
- Department of Cranio-Maxillo-Facial Surgery, Paracelsus Medical University Nuermberg, Breslauerstr. 201, 90471 Nuermberg, Germany
| |
Collapse
|
21
|
Raucci G, Pachêco-Pereira C, Elyasi M, d'Apuzzo F, Flores-Mir C, Perillo L. Short- and long-term evaluation of mandibular dental arch dimensional changes in patients treated with a lip bumper during mixed dentition followed by fixed appliances. Angle Orthod 2016; 86:753-60. [PMID: 26771718 DOI: 10.2319/073015-519.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate short- and long-term mandibular dental arch changes in patients treated with a lip bumper during the mixed dentition followed by fixed appliances, compared with a matched control sample. MATERIALS AND METHODS Dental casts and lateral cephalograms obtained from 31 consecutively treated patients before (T0) and after (T1) lip bumper, after fixed appliances (T2), and a minimum of 3 years after fixed appliances (T3) were analyzed. The control group was matched as closely as possible. Arch width, arch perimeter, arch length, and incisor proclination were evaluated. Repeated measures ANOVA was used to analyze changes in measurements over all four time points between treatment and control groups. RESULTS Arch widths and crowding were always significantly different except at T2-T1. At T1-T0, only crowding decreased 3.2 mm while intercanine, interpremolar, and intermolar widths increased by 3.8, 3.3, and 3.9 mm, respectively. Changes at T3-T2 showed a significant decrease of 2.1 mm for crowding and an increase of 3.5, 2.9, 2.7, and 0.8 mm for intercanine, interpremolar, and intermolar widths and arch perimeter, respectively. Finally, at T3-T0, the reduction in crowding of 5.03 mm was significant and clinically important in the treated group. The differences between intercanine, interpremolar, and intermolar widths were also significant (2.1, 3.8, and 3.6 mm, respectively). All those differences favored the treated group. CONCLUSIONS Mandibular dental arch dimensions were significantly changed after lip bumper treatment. At follow-up, all arch widths were slightly decreased, generating an increase of 0.4 mm in crowding, considered clinically irrelevant. Overall changes remained stable after an average 6.3-year follow-up.
Collapse
Affiliation(s)
- Gaetana Raucci
- a Postgraduate Orthodontic Student, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - Camila Pachêco-Pereira
- b Assistant Clinical Professor, Department of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Maryam Elyasi
- c PhD Student, Orthodontic Graduate Program, Department of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Fabrizia d'Apuzzo
- d PhD Student, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| | - Carlos Flores-Mir
- e Professor and Orthodontic Graduate Program Director, Department of Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Letizia Perillo
- f Associate Professor, Head of Orthodontic Unit and Chair of Postgraduate Program, Multidisciplinary Department of Medical-Surgical and Dental Specialties, Second University of Naples, Naples, Italy
| |
Collapse
|
22
|
Guirro WJG, Freitas KMS, Janson G, de Freitas MR, Quaglio CL. Maxillary anterior alignment stability in Class I and Class II malocclusions treated with or without extraction. Angle Orthod 2015; 86:3-9. [PMID: 25844507 DOI: 10.2319/112614-847.1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To compare the postretention stability of maxillary incisors alignment in subjects with Class I and II malocclusion treated with or without extractions. MATERIALS AND METHODS The sample comprised 103 subjects with initial maxillary anterior irregularity greater than 3 mm and was divided into four groups: group 1 comprised 19 patients with Class I malocclusion treated with nonextraction (mean initial age = 13.06 years); group 2 comprised 19 patients with Class II malocclusion treated with nonextraction (mean initial age = 12.54 years); group 3 comprised 30 patients with Class I malocclusion treated with extractions (mean initial age = 13.16 years); group 4 comprised 35 patients with Class II malocclusion treated with extractions (mean initial age = 12.99 years). Dental casts were obtained at three different stages: pretreatment (T1), posttreatment (T2), and long-term posttreatment (T3). Maxillary incisor irregularity and arch dimensions were evaluated. Intergroup comparisons were performed by one-way analysis of variance followed by Tukey tests. RESULTS In the long-term posttreatment period, relapse of maxillary crowding and arch dimensions was similar in all groups. CONCLUSION Changes in maxillary anterior alignment in Class I and Class II malocclusions treated with nonextractions and with extractions were similar in the long-term posttreatment period.
Collapse
Affiliation(s)
- Willian Juarez Granucci Guirro
- a Orthodontic graduate student, Department of Orthodontics, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | | | - Guilherme Janson
- c Professor, Department of Orthodontics, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | - Marcos Roberto de Freitas
- c Professor, Department of Orthodontics, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| | - Camila Leite Quaglio
- a Orthodontic graduate student, Department of Orthodontics, Bauru Dental School, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
23
|
D'Souza IM, Kumar HCK, Shetty KS. Dental arch changes associated with rapid maxillary expansion: A retrospective model analysis study. Contemp Clin Dent 2015; 6:51-7. [PMID: 25684912 PMCID: PMC4319346 DOI: 10.4103/0976-237x.149292] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction: Transverse deficiency of the maxilla is a common clinical problem in orthodontics and dentofacial orthopedics. Transverse maxillary deficiency, isolated or associated with other dentofacial deformities, results in esthetic and functional impairment giving rise to several clinical manifestations such as asymmetrical facial growth, positional and functional mandibular deviations, altered dentofacial esthetics, adverse periodontal responses, unstable dental tipping, and other functional problems. Orthopedic maxillary expansion is the preferred treatment approach to increase the maxillary transverse dimension in young patients by splitting of the mid palatal suture. This orthopedic procedure has lately been subject of renewed interest in orthodontic treatment mechanics because of its potential for increasing arch perimeter to alleviate crowding in the maxillary arch without adversely affecting facial profile. Hence, the present investigation was conducted to establish a correlation between transverse expansion and changes in the arch perimeter, arch width and arch length. Methods: For this purpose, 10 subjects (five males, five females) were selected who had been treated by rapid maxillary expansion (RME) using hyrax rapid palatal expander followed by fixed mechanotherapy (PEA). Pretreatment (T1), postexpansion (T2), and posttreatment (T3) dental models were compared for dental changes brought about by RME treatment and its stability at the end of fixed mechanotherapy. After model measurements were made, the changes between T1–T2, T2–T3 and T1–T3 were determined for each patient. The mean difference between T1–T2, T2–T3 and T1–T3 were compared to assess the effects of RME on dental arch measurements. Results are expressed as mean ± standard deviation and are compared by repeated measures analysis of variance followed by a post-hoc test. Arch perimeter changes are correlated with changes in arch widths at the canine, premolar and molar regions. Results: The intercanine arch width increased by 2.9 mm, inter first premolar width increased by 3.2 mm, inter second premolar width increased by 4.6 mm, intermolar width increased by 4.4 mm, arch perimeter increased by 3.2 mm, arch length decreased by 1.8 mm from pretreatment to posttreatment. There is a strong positive correlation of arch perimeter with intercanine width (r2 = 0.99), interpremolar width (r2 = 0.99) and intermolar width (r2 = 0.98), indicating that there is a significant increase in arch perimeter with increase in arch width at the canine, premolars and molar regions. Conclusion: Findings of this study demonstrate that there was a significant increase in the intercanine, inter first premolar, inter second premolar intermolar arch width and arch perimeter from pretreatment to postexpansion, which was stable at the end of fixed mechanotherapy (PEA). There was a nonsignificant decrease in arch length from pretreatment to postexpansion that further decreased nonsignificantly from postexpansion to posttreatment.
Collapse
Affiliation(s)
- Ivor M D'Souza
- Department of Orthodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - H C Kiran Kumar
- Department of Orthodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - K Sadashiva Shetty
- Department of Orthodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| |
Collapse
|
24
|
Jacob HB, LeMert S, Alexander RG, Buschang PH. Second molar impaction associated with lip bumper therapy. Dental Press J Orthod 2014; 19:99-104. [PMID: 25628086 PMCID: PMC4347417 DOI: 10.1590/2176-9451.19.6.099-104.oar] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 02/02/2014] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION: Although lip bumpers (LBs) provide significant clinical gain of mandibular arch
perimeter in mixed-dentition patients, orthodontists are reluctant to use them due
to the possibility of permanent second molar eruptive disturbances. OBJECTIVE: The present study was conducted to assess second molar impaction associated with
the use of LBs, and to investigate how they can be solved. MATERIAL AND METHODS: Lateral and panoramic radiographs of 67 patients (34 females and 33 males) were
assessed prior (T1) and post-LB treatment (T2). LB therapy
lasted for approximately 1.8 ± 0.9 years. Concomitant rapid palatal expansion
(RPE) was performed in the maxilla at LB treatment onset. Impaction of mandibular
second molars was assessed by means of panoramic radiographs in relation to the
position of first mandibular molars. Horizontal and vertical movements of first
and second molars were assessed cephalometrically on lateral cephalometric
radiographs based on mandibular superimpositions. RESULTS: Eight (11.9%) patients had impacted second molars at the end of LB therapy. Two
patients required surgical correction, whereas five required spacers and one
patient was self-corrected. Mandibular first molar tip and apex migrated forward
1.3 mm and 2.3 mm, respectively. Second molar tip showed no statistically
significant horizontal movement. CONCLUSION: Although LB therapy increased the risk of second molar impaction, impactions
were, in most instances, easily solved.
Collapse
Affiliation(s)
| | - Shawn LeMert
- Texas A&M University Baylor College of Dentistry
| | - Richard G Alexander
- Department of Orthodontics, Texas A&M University Baylor College of Dentistry
| | | |
Collapse
|
25
|
Pinheiro FHDSL, Garib DG, Janson G, Bombonatti R, de Freitas MR. Longitudinal stability of rapid and slow maxillary expansion. Dental Press J Orthod 2014; 19:70-7. [PMID: 25628082 PMCID: PMC4347413 DOI: 10.1590/2176-9451.19.6.070-077.oar] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 02/25/2014] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE: The aim of this retrospective study was to compare the longitudinal stability of
two types of posterior crossbite correction: rapid maxillary expansion (RME) and
slow maxillary expansion (SME). METHODS: Study casts of 90 adolescent patients were assessed for interdental width changes
at three different periods: pretreatment (T1), post-treatment
(T2) and at least, five years post-retention (T3). Three
groups of 30 patients were established according to the treatment received to
correct posterior crossbite: Group A (RME), group B (SME) and group C (control-
Edgewise therapy only). After crossbite correction, all patients received fixed
edgewise orthodontic appliances. Paired t-tests and one-way ANOVA were used to
identify significant intra and intergroup changes, respectively (P < 0.05).
RESULTS: Except for intercanine distance, all widths increased in groups A and B from
T1 to T2. In the long-term, the amount of relapse was not
different for groups A and B, except for 3-3 widths which showed greater decrease
in group A. However, the percentage of clinically relapsed cases of posterior
crossbite was similar for rapid and slow maxillary expansion. CONCLUSION: Rapid and slow maxillary expansion showed similar stability in the long-term.
Collapse
Affiliation(s)
| | | | - Guilherme Janson
- Department of Orthodontics, School of Dentistry, University of São Paulo/Bauru
| | | | | |
Collapse
|
26
|
Schauseil M, Ludwig B, Zorkun B, Hellak A, Korbmacher-Steiner H. Density of the midpalatal suture after RME treatment - a retrospective comparative low-dose CT-study. Head Face Med 2014; 10:18. [PMID: 24884771 PMCID: PMC4032485 DOI: 10.1186/1746-160x-10-18] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 05/13/2014] [Indexed: 11/19/2022] Open
Abstract
Introduction Rapid maxillary expansion (RME) is a common technique to improve the dental and skeletal transverse width in cases of constricted maxillary arches. Although retention after RME has been widely examined, there is still no clear statement about the minimal retention time in postpubertal patients and many practitioners have retention concepts varying between three and six months. Methods This retrospective study consisted of 14 patients who were either treated with a Haas-type RME (6 patients) or a Hybrid-RME (8 patients). The average age was 15.8 years (min. 13.5 years, max. 23.0 years). Low-dose CT scans were taken initially before placement of the RME (T0), directly after maximal activation (T1) and (in six cases) also in retention after 6 months (T2). Using a 3D-software (“OnDemand3D”/Cybermed Inc.) in analogy to the method published by Franchi et al. (AJODO Volume 137/ Number 4) all values were measured twice at an interval of 1 month to assess the method error and the intraoperator reliability. Statistical analysis was performed using SPSS 21 for Mac. Possible influences of the RME-type were assessed using the univariate ANOVA. Changes in the sutural density between the different points of time were examined using paired t-tests. Results The density of the suture decreased significantly after expansion (T0-T1) with both types of RME (p = 0.000). In the retention period there was a significant increase of the sutural density (p = 0.007) although it did not achieve the initial level (p = 0.002). Conclusions 1. The midpalatal suture was opened in all analysed patients. 2. In postpubertal patients a retention time of six months does not allow sufficient reorganization of the suture. 3. Therefore, a retention period longer than six months seems to be beneficial to prevent relapses in postpubertal patients.
Collapse
|
27
|
|
28
|
|
29
|
Long-term stability: Postretention changes of the mandibular anterior teeth. Am J Orthod Dentofacial Orthop 2013; 144:420-9. [DOI: 10.1016/j.ajodo.2013.05.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2012] [Revised: 05/01/2013] [Accepted: 05/01/2013] [Indexed: 11/22/2022]
|
30
|
Canuto LFG, Freitas MRD, Freitas KMSD, Cançado RH, Neves LS. Long-term stability of maxillary anterior alignment in non-extraction cases. Dental Press J Orthod 2013; 18:46-53. [DOI: 10.1590/s2176-94512013000300009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE: The purpose of this retrospective study was to evaluate long-term stability of maxillary incisors alignment in cases submitted to non-extraction orthodontic treatment. METHODS: The sample comprised 23 patients (13 female; 10 male) at a mean initial age of 13.36 years (SD = 1.81 years), treated with fixed appliances. Dental cast measurements were obtained at three different time points (T1 - pretreatment, T2 - posttreatment and T3 - long-term posttreatment). Variables assessed in maxillary arch were Little Irregularity Index, intercanine, interpremolar and intermolar widths, arch length and perimeter. The statistical analysis was performed by one-way ANOVA and Tukey tests when necessary. Pearson' correlation coefficients were used to investigate possible associations between the evaluated variables. RESULTS: There was no significant change in most arch dimension measurements during and after treatment, however, during the long-term posttreatment period, it was observed a significant maxillary incisors crowding relapse. CONCLUSION: The maxillary incisors irregularity increased significantly (1.52 mm) during long-term posttreatment. None of the studied clinical factors demonstrated to be predictive of the maxillary crowding relapse.
Collapse
|
31
|
Rastegar-Lari T, Al-Azemi R, Thalib L, Årtun J. Dental arch dimensions of adolescent Kuwaitis with untreated ideal occlusion: Variation and validity of proposed expansion indexes. Am J Orthod Dentofacial Orthop 2012; 142:635-44. [DOI: 10.1016/j.ajodo.2012.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 05/01/2012] [Accepted: 05/01/2012] [Indexed: 11/29/2022]
|
32
|
King JW, Wallace JC, Winter DL, Niculescu JA. Long-term skeletal and dental stability of mandibular symphyseal distraction osteogenesis with a hybrid distractor. Am J Orthod Dentofacial Orthop 2012; 141:60-70. [DOI: 10.1016/j.ajodo.2011.06.030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2010] [Revised: 06/01/2011] [Accepted: 06/01/2011] [Indexed: 10/14/2022]
|
33
|
Guirro WJG, Freitas KMSD, Freitas MRD, Henriques JFC, Janson G, Canuto LFG. Recidiva do apinhamento anterossuperior nas más oclusões de Classe I e Classe II tratadas ortodonticamente sem extrações. Dental Press J Orthod 2011. [DOI: 10.1590/s2176-94512011000500007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: o presente estudo objetivou comparar retrospectivamente a estabilidade pós-contenção do alinhamento dos incisivos anterossuperiores em pacientes com Classe I e Classe II. MÉTODOS: a amostra consistiu de 38 pacientes de ambos os sexos, tratados sem extrações e com mecânica Edgewise, divididos em dois grupos - Grupo 1, constituído por 19 pacientes, com idade inicial média de 13,06 anos, portadores da má oclusão de Classe I com apinhamento anterossuperior inicial maior que 3mm; Grupo 2, constituído por 19 pacientes, com idade inicial de 12,54 anos, portadores da má oclusão de Classe II e, também, com apinhamento anterossuperior inicial maior que 3mm. Foram medidos nos modelos de estudo, das fases pré- e pós-tratamento e pós-contenção, o índice de irregularidade de Little, as distâncias intercaninos e entre os primeiros e segundos pré-molares, a distância intermolares e o comprimento da arcada superior. Para a comparação intragrupo nos 3 tempos de avaliação, utilizou-se os testes ANOVA e Tukey. A comparação intergrupos foi realizada pelo teste t independente. Para verificação da presença de correlação, utilizou-se o teste de correlação de Pearson. RESULTADOS: os resultados evidenciaram maior estabilidade do tratamento no Grupo 2 (Classe II), pois, durante o período pós-contenção, foi observada recidiva do apinhamento dos dentes anterossuperiores menor no Grupo 2 (0,80mm) do que no Grupo 1 (1,67mm). CONCLUSÃO: concluiu-se que o tratamento do apinhamento dos dentes anterossuperiores é mais estável na má oclusão de Classe II do que na má oclusão de Classe I.
Collapse
|
34
|
Ferro F, Funiciello G, Perillo L, Chiodini P. Mandibular lip bumper treatment and second molar eruption disturbances. Am J Orthod Dentofacial Orthop 2011; 139:622-7. [PMID: 21536205 DOI: 10.1016/j.ajodo.2009.07.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2009] [Revised: 06/01/2009] [Accepted: 07/01/2009] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Mandibular lip-bumper (LB) nonextraction treatment, usually started before complete second molar (M2) eruption, inevitably interacts with the development of the dentition. Yet, its effects on M2 eruption are still unknown. The first aim of this study was to retrospectively investigate whether LB therapy (260 patients) enhances the risk for M2 ectopic eruptions and impactions in comparison with 135 untreated subjects. The second aim was to assess, among treated patients (n = 197), the main potential determinants of M2 impaction and ectopic eruption. METHODS M2 eruption and impaction were determined on panoramic radiographs. To assess the predictive role of M2 inclination in relation to the first molar, a panoramic radiograph suitable for this measurement before treatment was required. The data were analyzed by using software (version 8.2, SAS, Cary, NC). RESULTS LB treatment significantly enhanced M2 impaction and ectopic eruption. Negative prognostic factors were found. An initial inclination of the M2 greater than 30° was significantly associated with a higher impaction risk compared with an angulation less than 10°. LB treatment duration longer than 2 years increased the risk of ectopic eruptions. CONCLUSIONS While gaining space in the anterior arch, unwanted effects might be produced in the posterior arch. To be informed about these unplanned events is necessary to better optimize treatment.
Collapse
|
35
|
Mandibular lip bumper for molar torque control. Prog Orthod 2011; 12:90-2. [PMID: 21515237 DOI: 10.1016/j.pio.2011.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2010] [Revised: 02/15/2011] [Accepted: 02/18/2011] [Indexed: 11/24/2022] Open
Abstract
Treatment effects of lip bumpers alone include flaring of the mandibular incisors, distalization and uprighting of the mandibular first molars, and buccal expansion of the canines, premolars, and molar. Lip forces are transmitted through this appliance onto the molars. Moreover the lip bumper is able to derotate, expand or constrict, upright and reinforce the anchorage whereas torque control is lacking. Aim of this paper is the presentation of a new type of lip bumper that allows the molar torque control.
Collapse
|
36
|
Al-Azemi R, Årtun J. Posteroanterior cephalometric norms for an adolescent Kuwaiti population. Eur J Orthod 2011; 34:312-7. [PMID: 21402735 DOI: 10.1093/ejo/cjr007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The aim of the study was to establish posteroanterior (PA) cephalometric norms for adolescent Kuwaitis of an age comparable with the start of comprehensive orthodontic treatment, and to compare these with similar normative data, considering a difference of 2.0 mm or degrees as clinically significant. Digital PA cephalograms of 159 13- to 14-year-old Kuwaitis (81 boys and 78 girls) with untreated ideal occlusions were evaluated. Anatomic landmarks were identified directly on digital computer images and linear and angular measurements were calculated electronically. Mean values (norms), standard deviations, and ranges were calculated for the parameters. Student's t-tests were employed to test for gender differences. The dental norms were clinically similar to those of Ricketts' analysis, but the ranges of the skeletal dental width and relationship measurements were clinically larger. Only the ranges of skeletal symmetry measurements were larger. Regarding the four dental to skeletal relationships, the norms were larger only for the molar to jaw relationship, while the ranges were larger for all. No gender differences were detected after Bonferroni adjustments. The findings suggest clinically significant racial differences in PA cephaolometric norms with minimal gender differences at adolescence. The ranges of the various parameters in adolescent subjects with natural development of an ideal occlusion are considerably larger than those suggested in Ricketts' analysis system.
Collapse
Affiliation(s)
- Rashed Al-Azemi
- Department of Developmental and Preventive Sciences, Faculty of Dentistry, Kuwait University, Kuwait City, Kuwait.
| | | |
Collapse
|
37
|
Jonsson T, Magnusson TE. Crowding and spacing in the dental arches: Long-term development in treated and untreated subjects. Am J Orthod Dentofacial Orthop 2010; 138:384.e1-384.e7. [PMID: 20889033 DOI: 10.1016/j.ajodo.2010.03.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2009] [Revised: 03/01/2010] [Accepted: 03/01/2010] [Indexed: 11/25/2022]
|
38
|
Treatment of a severe arch-length deficiency with anteroposterior and transverse expansion: long-term stability. Am J Orthod Dentofacial Orthop 2010; 137:401-11. [PMID: 20197181 DOI: 10.1016/j.ajodo.2007.08.040] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Revised: 08/01/2007] [Accepted: 08/01/2007] [Indexed: 11/23/2022]
Abstract
This article describes the nonextraction treatment of a girl in the late mixed dentition with a severe arch-length deficiency. Rapid maxillary expansion and molar distalization were combined with a lip bumper in the mandible, followed by fixed appliances. Although the literature has reported a high rate of relapse with this method of treatment, excellent stability was achieved at 5 years 3 months posttreatment. The merits of extraction vs nonextraction treatment and stability are discussed.
Collapse
|
39
|
Canuto LFG, de Freitas MR, Janson G, de Freitas KMS, Martins PP. Influence of rapid palatal expansion on maxillary incisor alignment stability. Am J Orthod Dentofacial Orthop 2010; 137:164.e1-6; discussion 164-5. [PMID: 20152665 DOI: 10.1016/j.ajodo.2009.06.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Revised: 06/01/2009] [Accepted: 06/01/2009] [Indexed: 10/19/2022]
Abstract
INTRODUCTION The purpose of this retrospective study was to compare the long-term stability of maxillary incisor alignment in patients treated with and without rapid maxillary expansion (RME). METHODS The sample comprised 48 subjects with Class I and Class II malocclusions, treated without extractions with fixed edgewise appliances, divided into 2 groups according to the treatment protocol: group 1 comprised 25 patients (15 girls, 10 boys) at a mean initial age of 13.53 years (SD, 1.63), who had RME during orthodontic treatment. Group 2 comprised 23 patients (13 girls, 10 boys) at a mean initial age of 13.36 years (SD, 1.81 years), treated with fixed appliances without RME. Maxillary dental cast measurements were obtained at the pretreatment, posttreatment, and long-term posttreatment stages. Variables assessed were the irregularity index and maxillary arch dimensions. Intergroup comparisons were made with independent t tests. RESULTS Greater transverse increases were found during treatment in the group treated with RME. However, during the long-term posttreatment period, no significant difference was observed in the amount of incisor crowding relapse between the groups. CONCLUSIONS RME did not influence long-term maxillary anterior alignment stability.
Collapse
|
40
|
Pandis N, Polychronopoulou A, Makou M, Eliades T. Mandibular dental arch changes associated with treatment of crowding using self-ligating and conventional brackets. Eur J Orthod 2009; 32:248-53. [PMID: 19959610 DOI: 10.1093/ejo/cjp123] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The purpose of this study was to investigate the effect of treatment of mandibular crowding with self-ligating and conventional brackets on dental arch variables. Fifty-six patients were selected from a pool of subjects satisfying the following inclusion criteria: non-extraction treatment in the mandibular or maxillary arches, eruption of all mandibular teeth, no spaces and an irregularity index greater than 2 mm in the mandibular arch, and no adjunct treatment such as etxra- or intraoral appliances. The patients were assigned to two groups: one group received treatment with the self-ligating bracket and the other with a conventional edgewise appliance, both with a 0.022 inch slot. Lateral cephalometric radiographs obtained at the beginning (T1) and end (T2) of treatment were used to assess the alteration in mandibular incisor inclination, and measurements of intercanine and intermolar widths were made on dental casts to investigate changes associated with the correction. The results were analysed with bivariate and multivariate linear regression analysis in order to examine the effect of the bracket systems on arch width or lower incisor inclination, adjusting for the confounding effect of demographic and clinical characteristics. An alignment-induced increase in the proclination of the mandibular incisors was observed for both groups; no difference was identified between self-ligating and conventional brackets with respect to this parameter. Likewise, an increase in intercanine and intermolar widths was noted for both bracket groups; the self-ligating group showed a higher intermolar width increase than the conventional group, whereas the amount of crowding and Angle classification were not significant predictors of post-treatment intermolar width.
Collapse
Affiliation(s)
- Nicholas Pandis
- Department of Community and Preventive Dentistry, School of Dentistry, University of Athens, Athens, Greece
| | | | | | | |
Collapse
|
41
|
Midsymphyseal distraction osteogenesis: A new alternative for the treatment of dental crowding. Am J Orthod Dentofacial Orthop 2009; 135:530-5. [DOI: 10.1016/j.ajodo.2007.04.046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2006] [Revised: 04/28/2007] [Accepted: 04/30/2007] [Indexed: 11/17/2022]
|
42
|
Hashish DI, Mostafa YA. Effect of lip bumpers on mandibular arch dimensions. Am J Orthod Dentofacial Orthop 2009; 135:106-9. [PMID: 19121509 DOI: 10.1016/j.ajodo.2007.10.038] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Revised: 10/01/2007] [Accepted: 10/01/2007] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this systematic review was to examine the effects of lip bumper therapy on mandibular arch dimensions. METHODS A literature survey of PubMed, EMBASE, Cochrane Central, and Cochrane Database of Systematic Reviews (www.cochrane.org) was conducted from December 1968 to January 2007. Human studies, randomized clinical trials, prospective and retrospective studies, and studies discussing the effect of lip bumpers on the arch and teeth were included. Two reviewers independently selected and extracted the data. RESULTS Of the 52 studies found in the search, only 1 met the inclusion criteria. CONCLUSIONS The results showed increases in arch dimensions that included an increase in arch length. This was attributed to incisor proclination, distalization, and distal tipping of the molars. There was also an increase in the arch width seen in the intercanine and deciduous intermolar and premolar distances. The long-term stability of the effects of the lip bumper need to be elucidated.
Collapse
Affiliation(s)
- Dena Ibrahim Hashish
- Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | | |
Collapse
|
43
|
Martin AJ, Buschang PH, Boley JC, Taylor RW, McKinney TW. The impact of buccal corridors on smile attractiveness. Eur J Orthod 2007; 29:530-7. [DOI: 10.1093/ejo/cjm063] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
|
44
|
Li W, Lin J. Dental Arch Width Stability after Quadhelix and Edgewise Treatment in Complete Unilateral Cleft Lip and Palate. Angle Orthod 2007; 77:1067-72. [DOI: 10.2319/070506-272.1] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2006] [Accepted: 12/01/2006] [Indexed: 11/23/2022] Open
Abstract
Abstract
Objective: To evaluate the transverse stability of the dental arch in unilateral cleft lip and palate (UCLP) patients after orthodontic treatment with quadhelix and edgewise appliances.
Materials and Methods: Twenty repaired complete UCLP patients with posterior crossbites were chosen as the study subjects. All had ceased retention at least 15 months previously. Measurements were carried out directly on the pretreatment, posttreatment, and postretention study models using a three-dimensional dental cast analyzer. The interdental widths were measured for the canines, first premolars, second premolars, first molars, basal bone, and the alveolar arch. Two-way analysis of variance and Fisher's LSD was performed in comparing the difference between intervals.
Results: Lower inter-first-premolar width and upper arch widths of each region increased significantly (P < .05) after orthodontic treatment. The expansion was greater in the anterior than the posterior region in the upper arch, and the greatest increase was in the upper first premolar region. The upper arch width decreased after retention, with the decrease of the arch width in the upper canine (1.3 ± 0.8 mm) and first premolar (1.5 ± 0.8 mm) regions being statistically significant. The increased upper arch width in each region and the lower inter-first-premolar width maintained significant expansion after retention.
Conclusions: The widths of the dental arch increased significantly after expansion with a quadhelix followed by preadjusted edgewise treatment. Relapse occurred, especially in the upper canine and first premolar region, but most of the treatment effect on the upper arch remained after retention.
Collapse
Affiliation(s)
- Weiran Li
- a Clinical Professor, Orthodontic Department, School of Stomatology, Peking University, PR China
| | - Jiuxiang Lin
- b Professor, Orthodontic Department, School of Stomatology, Peking University, PR China
| |
Collapse
|
45
|
|
46
|
Vargo J, Buschang PH, Boley JC, English JD, Behrents RG, Owen AH. Treatment effects and short-term relapse of maxillomandibular expansion during the early to mid mixed dentition. Am J Orthod Dentofacial Orthop 2007; 131:456-63. [PMID: 17418711 DOI: 10.1016/j.ajodo.2005.06.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2005] [Revised: 06/01/2005] [Accepted: 06/01/2005] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The treatment effects and the short-term (0.9 +/- 0.45 years) relapse potential of phase I slow maxillary expansion, with a bonded palatal expander or a quad-helix appliance combined with a mandibular banded Crozat/lip bumper and followed by 12 to 15 months of retention, were examined. METHODS Pretreatment (8.8 +/- 1.7 years) and posttreatment (11.1 +/- 1.7 years) models of 54 patients were used to evaluate treatment effects. Posttreatment (11.0 +/- 1.3 years) and follow-up (11.9 +/- 1.4 years) models of 23 patients who returned for phase II treatment were used to evaluate relapse over the 11 months, during which no retention was used. The models were digitized, and 15 measures were computed. RESULTS Significant treatment increases were observed for all measurements in both arches. Treatment gains in arch perimeter (6%-8%) were due more to increases in intermolar width (11%-15%) than to increases in arch depth (5%). Posttreatment relapse was significant (P <.05) for all measures except mandibular intercanine width and maxillary molar arch depth. After accounting for normal growth, net changes (pretreatment to follow-up) indicated significant increases for all measures except maxillary molar arch depth. In addition to maintaining leeway space, the maxilla and the mandible showed net perimeter gains of 2.9 and 1.0 mm, respectively. CONCLUSIONS Slow maxillary expansion combined with a mandibular banded Crozat/lip bumper during the early mixed dentition produced clinically useful increases in arch dimensions that subsequently underwent mild-to-moderate amounts of relapse after removal of all retention appliances.
Collapse
Affiliation(s)
- Julie Vargo
- Department of Orthodontics, Baylor College of Dentistry, Texas A&M University System, Dallas, Tex 75246, USA
| | | | | | | | | | | |
Collapse
|
47
|
Wahl N. Orthodontics in 3 millennia. Chapter 11: the golden age of orthodontics. Am J Orthod Dentofacial Orthop 2006; 130:549-53. [PMID: 17045157 DOI: 10.1016/j.ajodo.2006.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2006] [Revised: 06/02/2006] [Accepted: 06/02/2006] [Indexed: 11/30/2022]
Abstract
For orthodontists, the post-World War II era was characterized by the introduction of fluoridation, sit-down dentistry, and an upswing in extractions. Postwar prosperity, the baby boom, and increased enlightenment of parents contributed to what was later called the "golden age of orthodontics." The subsequent clamor for more orthodontists led to a proliferation of graduate departments and inauguration of the AAO Preceptorship Program. There was also an increase in mixed-dentition treatment, requiring improved methods of analyzing arch lengths.
Collapse
|
48
|
Buschang PH. Maxillomandibular expansion: Short-term relapse potential and long-term stability. Am J Orthod Dentofacial Orthop 2006; 129:S75-9. [PMID: 16644423 DOI: 10.1016/j.ajodo.2005.09.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Peter H Buschang
- Department of Orthodontics, Baylor College of Dentistry, Dallas, Texas, USA
| |
Collapse
|