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Van de Velde AS, De Boodt L, Cadenas de Llano-Pérula M, Laenen A, Willems G. Long-term effects of orthodontic interceptive expansion treatment : A retrospective study. J Orofac Orthop 2024; 85:371-380. [PMID: 37115290 DOI: 10.1007/s00056-023-00467-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 01/24/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE The aim of this retrospective cohort study was to evaluate the long-term effects of interceptive orthodontic treatment with a removable expansion plate, based on transversal, sagittal, and vertical parameters. METHODS A total of 90 patients needing interceptive treatment due to a crossbite or space deficiency were included. Records consisting of clinical photos, radiographs, and digital dental casts were collected for evaluation at two time points: the start of interceptive treatment (T0) and the start of comprehensive treatment (T1). Molar occlusion, overjet, overbite, presence and type of crossbite, mandibular shift, and transversal measurements were recorded for comparison. RESULTS After expansion with removable appliances, a significant increase in intermolar width was achieved and could be maintained over the observation period (p < 0.001). However, no significant changes regarding overjet, overbite, or molar sagittal occlusion were observed. Crossbite correction was successful in 86.9% of patients with unilateral crossbite and in 75.0% of patients with bilateral crossbite (p < 0.001). CONCLUSION Early expansion with a removable expansion plate is a successful method to correct crossbites and increase intermolar width in the early mixed dentition phase. Results remain stable until the start of comprehensive treatment in the permanent dentition.
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Affiliation(s)
- Anne-Sophie Van de Velde
- Department of Oral Health Sciences-Orthodontics, Katholieke Universiteit Leuven (KU Leuven), Kapucijnenvoer 7, 3000, Leuven, Belgium
- Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Laura De Boodt
- Department of Oral Health Sciences-Orthodontics, Katholieke Universiteit Leuven (KU Leuven), Kapucijnenvoer 7, 3000, Leuven, Belgium
- Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Maria Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, Katholieke Universiteit Leuven (KU Leuven), Kapucijnenvoer 7, 3000, Leuven, Belgium.
- Dentistry, University Hospitals Leuven, Leuven, Belgium.
| | - Annoushka Laenen
- Interuniversity Institute for Biostatistics and statistical Bioinformatics, KU Leuven, Leuven, Belgium
- University Hasselt, Hasselt, Belgium
| | - Guy Willems
- Department of Oral Health Sciences-Orthodontics, Katholieke Universiteit Leuven (KU Leuven), Kapucijnenvoer 7, 3000, Leuven, Belgium
- Dentistry, University Hospitals Leuven, Leuven, Belgium
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Pamukçu H, Özsoy S, Aksoy PC, Polat Özsoy Ö. Evaluation of maxillary dimensional changes in the mixed dentition: clear aligners vs acrylic expanders. Angle Orthod 2024; 94:392-399. [PMID: 39229950 PMCID: PMC11210520 DOI: 10.2319/121523-833.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/01/2024] [Indexed: 09/05/2024] Open
Abstract
OBJECTIVES To compare changes in upper arch dimension and molar inclination between Invisalign First (IF) and removable acrylic expander (RE) treatments during the mixed dentition period. MATERIALS AND METHODS Seventeen patients meeting inclusion criteria underwent IF treatment and were age matched with a group that received treatment with a removable acrylic expander (RE). Intercanine width (ICW), intermolar width, arch depth, buccolingual inclination of the first molars (MI), surface area (SA) and volume (VAP) of the anterior palate, and expansion were compared before and after treatment. The predictability of expansion was calculated for the IF group. Analysis of variance and Kruskal-Wallis tests were used to assess differences. RESULTS The ICW increased significantly by 2.14 mm in the IF group and 3.49 mm in the RE group, with no significant intergroup difference. Both groups exhibited significant increases in intermolar width (P < .05), except for intermolar distopalatal width in the IF group (P = .246). Mesiobuccal rotation of the first molar was observed with IF treatment. Although SA and VAP increased in both groups, the changes were not significant for the IF group (P > .05). The RE group exhibited significantly higher increases (P < .05), with an SA increase of 34.32 mm2 and VAP increase of 119.15 mm3. MI changes were in the opposite directions. The prediction accuracy of expansion was 70.28% for canines and 34.12% for first molars. CONCLUSIONS Both appliances effectively expanded the intercanine region in growing patients. Expansion predictability was lower in first molars than in canines for the IF group. Removable acrylic expanders could be a choice of preference for expansion targeted to the molar region.
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Affiliation(s)
- Hande Pamukçu
- Corresponding author: Dr Hande Pamukçu, Department of Orthodontics, Faculty of Dentistry, Başkent University, Yukarıbahçelievler Mah. 82. Sokak No:26 06490 Bahçelievler, Ankara, Turkey (e-mail: )
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Ugolini A, Abate A, Donelli M, Gaffuri F, Bruni A, Maspero C, Lanteri V. Spontaneous Mandibular Dentoalveolar Changes after Rapid Maxillary Expansion (RME), Slow Maxillary Expansion (SME), and Leaf Expander-A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2024; 11:501. [PMID: 38671718 PMCID: PMC11049362 DOI: 10.3390/children11040501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 04/13/2024] [Accepted: 04/14/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND This systematic review aims to analyze the spontaneous dentoalveolar changes in the mandibular arch after maxillary expansion in growing patients obtained with different expansion protocols: Rapid Maxillary Expansion (RME), Slow Maxillary Expansion (SME), and Leaf Expander. METHODS The study adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Eligibility criteria were established in the PICO format, involving patients who underwent slow, rapid, or leaf maxillary expansion during the mixed or early permanent dentitions. A comprehensive search of electronic databases and manual searches was conducted up to December 2023. The outcome measures included inter-mandibular first permanent molar width, inter-deciduous molar and canine width, arch perimeter, and arch length; both short- and long-term results were considered. The articles that met the inclusion criteria were included in this systematic review and were qualitatively evaluated using a methodological quality scoring system with a 13-point scale. To assess the inter-examiner agreement concerning the article selection and the qualitative assessment of the included studies, Kappa statistics were computed. RESULTS A total of 1184 articles were identified through electronic and manual searches. After the removal of duplicates and the initial examination of the titles and abstracts, 57 articles were considered for the full text analysis, and according to the eligibility and exclusion criteria, 22 studies were finally selected, composed of 8 randomized controlled trials (RCTs) and 14 retrospective/case-control studies. The qualitative assessment of the included studies showed the following scores: 6 papers have high research quality, 5 have moderate quality, and 11 have low quality. SME demonstrated negligible mandibular changes, with less than 1 mm variation on average (range 0.46-2.00 mm) in the selected parameters and relapses observed in the long term. RME induced more significant increases, particularly in intermolar width greater than 1 mm, which ranged between 0.93 and 3.3 mm, and good stability over the long term. Leaf Expander exhibited promising short-term lower intermolar width increases greater than 1 mm and ranged from 0.5 to 1.69 mm, but long-term stability was not thoroughly evaluated. CONCLUSIONS SME results in negligible short- and long-term effects, while RME, especially with Haas-type appliances, exhibits significant intermolar width increases that remain stable over the years. Leaf Expander shows short-term lower intermolar width increases, requiring further investigation into long-term stability.
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Affiliation(s)
- Alessandro Ugolini
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16145 Genova, Italy;
| | - Andrea Abate
- Department of Sciences Integrated Surgical and Diagnostic, University of Genova, 16145 Genova, Italy;
| | - Margherita Donelli
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
- Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico, 20142 Milan, Italy
| | - Francesca Gaffuri
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
| | - Alessandro Bruni
- Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.B.); (V.L.)
| | - Cinzia Maspero
- Department of Biomedical Surgical and Dental Sciences, University of Milan, 20129 Milan, Italy; (M.D.); (F.G.); (C.M.)
| | - Valentina Lanteri
- Surgical, Medical and Dental Department, University of Modena and Reggio Emilia, 41125 Modena, Italy; (A.B.); (V.L.)
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Beltrami F, Kiliaridis S, Antonarakis GS. Long-term stability of posterior crossbite correction, treated in the mixed or permanent dentition of growing children: A systematic review and meta-analysis. Orthod Craniofac Res 2024; 27:1-14. [PMID: 38169092 DOI: 10.1111/ocr.12690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/16/2023] [Accepted: 06/22/2023] [Indexed: 01/05/2024]
Abstract
When treating posterior crossbite, the primary goal is to achieve long-term crossbite correction. The majority of studies however focus on relapse of the increase in the transverse dimension, but not relapse of the crossbite itself, which is an essential outcome. The aim of the present study was to determine long-term stability (2 years minimum post-treatment) of posterior crossbite correction, treated in mixed or early permanent dentitions of growing children. Following registration in PROSPERO (CRD42022348858), an electronic literature search including PubMed, Embase, Web of Science, the Cochrane Library, and a manual search were conducted up to January 2023, to identify longitudinal studies looking into the long-term stability of crossbite correction in growing children. Data extraction and risk of bias assessment were carried out, and subsequently, a random-effects meta-analyses models were used to calculate estimates for relapse of the crossbite and relapse at the transverse level. Twenty-two studies were included, of varying designs and quality, representing 1076 treated patients, with different expansion appliances and protocols. Meta-analysis results showed that 19.5% (95% CI: 15%; 25%) of patients present with relapse of posterior crossbite at long-term follow-up. At the transverse level, 19.3% of the total expansion (including overexpansion) relapsed (95% CI: 13%; 27%) regardless of whether there a was relapse of the crossbite itself. Data from existing studies, with a moderate level of evidence, indicate that the long-term stability of posterior crossbite correction in growing children is unfavourable in roughly 1 in 5 growing children, with crossbite relapse long-term. On average, 19% of the maxillary expansion performed (including overexpansion) relapses long-term, which may occur in cases with or without relapse of the crossbite.
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Affiliation(s)
- Fara Beltrami
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
| | - Stavros Kiliaridis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
- Department of Orthodontics and Dentofacial Orthopedics, Dental School/Medical Faculty, University of Bern, Bern, Switzerland
| | - Gregory S Antonarakis
- Division of Orthodontics, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
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Curto A, Albaladejo A, Alvarado-Lorenzo A, Zubizarreta-Macho Á, Curto D. Cross-Bite and Oral-Health-Related Quality of Life (OHRQoL) in Preadolescents Aged 11 to 14 Years Old: A Pilot Case-Control Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1311. [PMID: 37628310 PMCID: PMC10453585 DOI: 10.3390/children10081311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023]
Abstract
INTRODUCTION Malocclusions have a negative impact on oral-health-related quality of life (OHRQoL). Posterior cross-bite is one of the most prevalent malocclusions in the preadolescent population. This study investigated the influence of posterior cross-bites (unilateral or bilateral) on OHRQoL in an 11- to 14-year-old population. MATERIALS AND METHODS A pilot case-control study was carried out at the Dental Clinic of the University of Salamanca between 2021 and 2023. A consecutive sample of 120 preadolescent patients aged 11 to 14 years old was recruited. Three groups were analyzed: a control group (no posterior cross-bite) (n = 40), a group with unilateral posterior cross-bite (n = 40), and a group with bilateral posterior cross-bite (n = 40). To analyze the OHRQoL, the Spanish version of the Child Perception Questionnaire (CPQ-Esp11-14) was used. RESULTS The mean age of the sample was 12.2 years old (±0.96 years). The group of patients with a bilateral posterior cross-bite was shown to have higher scores in all dimensions of the CPQ-Esp11-14, as well as a higher total score. Sex only influenced the oral symptom dimension of the CPQ-Esp11-14 questionnaire; in this dimension, the girls described a greater impact. Age did not influence OHRQoL. CONCLUSION The presence of a posterior cross-bite had a negative impact on OHRQoL in the preadolescent population that was studied.
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Affiliation(s)
- Adrián Curto
- Department of Surgery, Faculty of Medicine, University of Salamanca, Alfonso X El Sabio Avenue s/n, 37007 Salamanca, Spain; (A.A.); (A.A.-L.); (Á.Z.-M.)
| | - Alberto Albaladejo
- Department of Surgery, Faculty of Medicine, University of Salamanca, Alfonso X El Sabio Avenue s/n, 37007 Salamanca, Spain; (A.A.); (A.A.-L.); (Á.Z.-M.)
| | - Alfonso Alvarado-Lorenzo
- Department of Surgery, Faculty of Medicine, University of Salamanca, Alfonso X El Sabio Avenue s/n, 37007 Salamanca, Spain; (A.A.); (A.A.-L.); (Á.Z.-M.)
| | - Álvaro Zubizarreta-Macho
- Department of Surgery, Faculty of Medicine, University of Salamanca, Alfonso X El Sabio Avenue s/n, 37007 Salamanca, Spain; (A.A.); (A.A.-L.); (Á.Z.-M.)
| | - Daniel Curto
- Department of Pathology, 12 de Octubre University Hospital, Córdoba Avenue s/n, 28041 Madrid, Spain;
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Guan H, Yonemitsu I, Ikeda Y, Ono T. Reversible Effects of Functional Mandibular Lateral Shift on Masticatory Muscles in Growing Rats. Biomedicines 2023; 11:2126. [PMID: 37626623 PMCID: PMC10452155 DOI: 10.3390/biomedicines11082126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 07/22/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
In this study, we aimed to determine the effects of functional mandibular lateral shift (FMLS) on the muscle mass, fiber size, myosin heavy chain fiber type, and related gene expression in masticatory muscles (masseter and temporalis), as well as whether the baseline levels could be recovered after FMLS correction in growing rats. The FMLS appliance was placed to shift the mandible leftward by approximately 2 mm. After FMLS placement for 2 and 4 weeks, the muscles on the left side had significantly lower wet weight, mean cross-sectional area, and proportion of type IIa fibers than those on the right side or in the control groups (p < 0.05), with downregulation and upregulation of IGF-1 and GDF-8 gene expression, respectively (p < 0.05). Following 2 weeks devoted to recovery from FMLS, the muscle parameters in the recovery group were not significantly different to those of the control group, and IGF-1 expression in the left-side muscles was enhanced and GDF-8 expression was simultaneously suppressed. These findings indicate that the masticatory muscle changes induced via FMLS tend to revert to normal conditions if the intervention is eliminated at an early stage. Therefore, appropriate orthodontic treatment for FMLS during the growth period is advisable to prevent asymmetric alterations in masticatory muscles.
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Affiliation(s)
| | - Ikuo Yonemitsu
- Department of Orthodontic Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo 113-8549, Japan
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Lim YN, Baharin F, Lin GSS, Hassan R, Tsai MH, Wei LC, Yeoh S, Ping MKX. Evaluation of the Changes of the Intercanine and Intermolar Widths Following Palatal Expansion in the Mixed Dentition Patients with Bilateral Posterior Crossbite: A Systematic Review. Dent J (Basel) 2023; 11:dj11020052. [PMID: 36826197 PMCID: PMC9955097 DOI: 10.3390/dj11020052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/17/2023] [Accepted: 02/06/2023] [Indexed: 02/17/2023] Open
Abstract
This systematic review aimed to identify the intercanine and intermolar width changes following palatal expansion in bilateral posterior crossbite (PXB) in mixed dentition. This review was registered in the PROSPERO database (CRD42021275833). All randomized controlled trials (RCT) and non-RCT articles between 1980 and August 2022 on the palatal expansion of bilateral PXB in mixed dentition were searched in seven online databases (Google Scholar, Ovid, Web of Science, Scopus, EBSCOHost, Cochrane Library and PubMed). The risk of bias (RoB) of the articles included was analyzed using the Joanna Briggs Institute (JBI) critical appraisal tool. Three non-RCT studies were included and showed a low risk of bias. Meta-analysis on the changes in intercanine and intermolar widths was not performed due to study design heterogeneity. One study reported an over-correction of the bilateral PXB. There is a need for more RCT studies with standardized landmark measurements, outcome assessment methods and retention periods to investigate the interdental changes following palatal expansion.
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Affiliation(s)
- Yen Nie Lim
- Paediatric Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Malaysia
| | - Fadzlinda Baharin
- Paediatric Dentistry Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Malaysia
- Correspondence: ; Tel.: +60-9-767-5853
| | - Galvin Sim Siang Lin
- Department of Dental Materials, Faculty of Dentistry, Asian Institute of Medicine, Science and Technology (AIMST) University, Bedong 08100, Malaysia
| | - Rozita Hassan
- Orthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Malaysia
| | - Milton Hongli Tsai
- Discipline of Orthodontics, Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur 50300, Malaysia
| | - Lim Chia Wei
- Taman Intan Dental Clinic, Ministry of Health Malaysia, Sungai Petani 08000, Malaysia
| | - Suzanne Yeoh
- Tudan Dental Clinic, Tudan Health Clinic, Ministry of Health Malaysia, Miri 98000, Malaysia
| | - Mark Ko Xiang Ping
- RTC Sibuti Dental Clinic, Bangunan RTC Sibuti, Ministry of Health Malaysia, Bekenu 98150, Malaysia
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Yi F, Liu OS, Lei L, Liu SL, Wang Y, Chu YH, Zhang LL, Li CR, Chen JJ, Lu YQ. Factors related to microimplant-assisted rapid palatal expansion in teenagers and young adults: A cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2022; 163:475-482. [PMID: 36564316 DOI: 10.1016/j.ajodo.2022.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 01/01/2022] [Accepted: 01/01/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION For patients with maxillary transverse deficiency, selecting an appropriate therapeutic method is important for the treatment effect and prognosis. Our study aimed to explore factors related to microimplant-assisted rapid palatal expansion (MARPE) in teenagers and young adults using cone-beam computed tomography. METHODS Twenty-five patients who underwent MARPE were included in this retrospective study from February 2014 to June 2019. Midpalatal suture density (MPSD) ratio, midpalatal suture maturation (MPSM), bone effect, dentoalveolar effect, and dental effect in maxillary first molar were evaluated using cone-beam computed tomography. Spearman correlation analysis was used to analyze the correlation between the MPSD ratio, MPSM, age, and the expansion amount generated by MARPE. RESULTS Twenty-five patients (mean age, 19.84 ± 3.96 years; range, 15-29 years) with maxillary transverse deficiency were analyzed. Age was negatively correlated with bone expansion, alveolar expansion, and alveolar change (all P <0.05). There was a negative correlation between MPSM and nasal cavity variation, bone expansion, and alveolar change (all P <0.05). The bone expansion was negatively correlated with MPSD ratio 3 (r = -0.417; P <0.05) and MPSD ratio 4 (all P <0.05). CONCLUSIONS Age, MPSM, and MPSD ratio were significantly related to the MARPE effect. Age, MPSM, and MPSD ratio should be considered when choosing MARPE.
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Affiliation(s)
- Fang Yi
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Ou-Sheng Liu
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Lei Lei
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Si-Ling Liu
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Yue Wang
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Yan-Hao Chu
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Ling-Ling Zhang
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Cheng-Ri Li
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Jun-Jie Chen
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China
| | - Yan-Qin Lu
- Hunan Key Laboratory of Oral Health Research and Hunan 3D Printing Engineering Research Center of Oral Care and Hunan Clinical Research Center of Oral Major Diseases and Oral Health and Xiangya Stomatological Hospital, and Xiangya School of Stomatology, Central South University, Changsha, Hunan, China.
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Ashari A, Nik Mustapha NM, Yuen JJX, Saw ZK, Lau MN, Xian L, Syed Mohamed AMF, Megat Abdul Wahab R, Yeoh CK, Deva Tata M, Sinnasamy S. A two-year comparative assessment of retention of arch width increases between modified vacuum-formed and Hawley retainers: a multi-center randomized clinical trial. Prog Orthod 2022; 23:40. [PMID: 36018418 PMCID: PMC9415262 DOI: 10.1186/s40510-022-00424-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/24/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives To compare the clinical effectiveness of Hawley retainers (HRs) and modified vacuum-formed retainers (mVFRs) with palatal coverage in maintaining transverse expansion throughout a 24-month retention period and to assess the subjects’ perception toward the retainers.
Materials and methods The trial accomplished blinding only by the outcome assessor and data analyst. Data were collected from post-orthodontic treatment patients who met the inclusion criteria. Thirty-five subjects were randomly allocated using a centralized randomization technique into either mVFR (n = 18) or HR group (n = 17). Dental casts of subjects were evaluated at debond (T0), 3-month (T1), 6-month (T2), 12-month (T3), and 24-month retention (T4). The intercanine width (ICW), interpremolar width (IPMW), interfirst molar mesiobuccal cusp width (IFMW1), and interfirst molar distobuccal cusp width (IFMW2) were compared between groups over time using Mixed ANOVA. A pilot-tested and validated questionnaire consisting of six items were given at T4. Subjects were instructed to rate their retainer in terms of fitting, speech, appearance, oral hygiene, durability, and comfort on a 100-mm Visual Analogue Scale (VAS).
Results No statistically significant differences in arch width were found between the two groups at ICW (P = .83), IPMW (P = 0.63), IFMW1 (P = .22), and IFMW2 (P = .46) during the 24-month retention period. Also, no statistically significant differences were found between perception of both retainers in terms of fitting, speech, oral hygiene, durability, and comfort (P > .05) after 24-month wear. The appearance of mVFRs was rated significantly higher compared to HRs (P < .05).
Conclusions HR and mVFR have similar clinical effectiveness for retention of transverse expansion cases in a 24-month retention period. Both retainers were perceived to be equal in terms of fitting, speech, oral hygiene, durability, and comfort. Subjects in the mVFRs group found their retainers to be significantly more esthetic than those in HRs group.
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Affiliation(s)
- Asma Ashari
- Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Nik Mukhriz Nik Mustapha
- Centre for Paediatric Dentistry and Orthodontic Studies, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Jonathan Jun Xian Yuen
- Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zhi Kuan Saw
- Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - May Nak Lau
- Department of Paediatric Dentistry and Orthodontics, University of Malaya (UM), Kuala Lumpur, Malaysia.
| | - Lew Xian
- Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | - Rohaya Megat Abdul Wahab
- Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Chiew Kit Yeoh
- Orthodontic Specialist Unit, Klinik Pergigian Sungai Chua, Ministry of Health, Selangor, Malaysia
| | - Malathi Deva Tata
- Orthodontic Speciaist Unit, Klinik Pergigian Bandar Botanik, Ministry of Health, Selangor, Malaysia
| | - Sindhu Sinnasamy
- Orthodontic Speciaist Unit, Klinik Pergigian Bandar Botanik, Ministry of Health, Selangor, Malaysia
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Alsawaf DH, Almaasarani SG, Hajeer MY, Rajeh N. The effectiveness of the early orthodontic correction of functional unilateral posterior crossbite in the mixed dentition period: a systematic review and meta-analysis. Prog Orthod 2022; 23:5. [PMID: 35156156 PMCID: PMC8841381 DOI: 10.1186/s40510-022-00398-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 01/05/2022] [Indexed: 12/15/2022] Open
Abstract
Objective This systematic review and meta-analysis aimed to critically appraise the available evidence of the effectiveness of early intervention of functional unilateral posterior crossbites (FPXB) between the ages of 6 and 12 years. Materials and methods Electronic search in four databases (PubMed, Scopus, Embase, and Google Scholar) for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) was performed between 1st January 1990 and 31st October 2021. Methodological index for non-randomized studies (MINORS) for CCTs and Cochrane's risk of bias tool for RCTs were applied. The certainty of the evidence was evaluated according to the grading of recommendations, assessment, development, and evaluation (GRADE) approach. Results Nine studies (6 RCTs and 3 CCTs) were included in this review, and six of them were appropriate for quantitative synthesis. The meta-analysis revealed that the quad-helix (QH) was more effective than expansion plates (EP) in increasing the intermolar width (WMD = 1.25; 95% CI 0.75, 1.75; P < 0.001), and decreasing treatment time (WMD = − 3.36; 95% CI − 4.97, − 1.75; P < 0.001). The relapse rate at 5.6 years post-treatment was greater in the QH group than in the EP group (RR = 3.00); however, the difference was statistically insignificant. There was no significant difference between the QH and the EP in other outcome measures. When assessing the rapid maxillary expansion (RME), only one RCT compared the RME with an untreated control group and reported a significant increase in the maxillary intermolar and intercanine width (P < 0.001, P = 0.002, respectively) and a significant decrease in lower midline deviation (P < 0.001). Conclusion There is weak to moderate evidence that the treatment of functional posterior crossbite (FPXB) by the QH increased the maxillary intermolar width and the success rate and decreased the treatment duration compared to the EP. The relapse percentage was greater in the QH group. There is very weak evidence that the mandibular midline correction rate did not differ significantly between the QH and the EP modalities. The RME using the Hyrax appliance corrected the FPXB successfully; however, the strength of evidence in this regard is very low. As the quality of evidence ranged from very low to moderate in this review, we confirm the need for more RCTs with different expansion appliances in the early treatment of FPXB. Supplementary Information The online version contains supplementary material available at 10.1186/s40510-022-00398-4.
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Ugolini A, Agostino P, Silvestrini-Biavati A, Harrison JE, Batista KB. Orthodontic treatment for posterior crossbites. Cochrane Database Syst Rev 2021; 12:CD000979. [PMID: 34951927 PMCID: PMC8709729 DOI: 10.1002/14651858.cd000979.pub3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND A posterior crossbite occurs when the top back teeth bite inside the bottom back teeth. The prevalence of posterior crossbite is around 4% and 17% of children and adolescents in Europe and America, respectively. Several treatments have been recommended to correct this problem, which is related to such dental issues as tooth attrition, abnormal development of the jaws, joint problems, and imbalanced facial appearance. Treatments involve expanding the upper jaw with an orthodontic appliance, which can be fixed (e.g. quad-helix) or removable (e.g. expansion plate). This is the third update of a Cochrane review first published in 2001. OBJECTIVES To assess the effects of different orthodontic treatments for posterior crossbites. SEARCH METHODS Cochrane Oral Health's Information Specialist searched four bibliographic databases up to 8 April 2021 and used additional search methods to identify published, unpublished and ongoing studies. SELECTION CRITERIA Randomised controlled trials (RCTs) of orthodontic treatment for posterior crossbites in children and adults. DATA COLLECTION AND ANALYSIS Two review authors, independently and in duplicate, screened the results of the electronic searches, extracted data, and assessed the risk of bias of the included studies. A third review author participated to resolve disagreements. We used risk ratios (RR) and 95% confidence intervals (CIs) to summarise dichotomous data (event), unless there were zero values in trial arms, in which case we used odds ratios (ORs). We used mean differences (MD) with 95% CIs to summarise continuous data. We performed meta-analyses using fixed-effect models. We used the GRADE approach to assess the certainty of the evidence for the main outcomes. MAIN RESULTS We included 31 studies that randomised approximately 1410 participants. Eight studies were at low risk of bias, 15 were at high risk of bias, and eight were unclear. Intervention versus observation For children (age 7 to 11 years), quad-helix was beneficial for posterior crossbite correction compared to observation (OR 50.59, 95% CI 26.77 to 95.60; 3 studies, 149 participants; high-certainty evidence) and resulted in higher final inter-molar distances (MD 4.71 mm, 95% CI 4.31 to 5.10; 3 studies, 146 participants; moderate-certainty evidence). For children, expansion plates were also beneficial for posterior crossbite correction compared to observation (OR 25.26, 95% CI 13.08 to 48.77; 3 studies, 148 participants; high-certainty evidence) and resulted in higher final inter-molar distances (MD 3.30 mm, 95% CI 2.88 to 3.73; 3 studies, 145 participants, 3 studies; moderate-certainty evidence). In addition, expansion plates resulted in higher inter-canine distances (MD 2.59 mm, 95% CI 2.18 to 3.01; 3 studies, 145 participants; moderate-certainty evidence). The use of Hyrax is probably effective for correcting posterior crossbite compared to observation (OR 48.02, 95% CI 21.58 to 106.87; 93 participants, 3 studies; moderate-certainty evidence). Two of the studies focused on adolescents (age 12 to 16 years) and found that Hyrax increased the inter-molar distance compared with observation (MD 5.80, 95% CI 5.15 to 6.45; 2 studies, 72 participants; moderate-certainty evidence). Intervention A versus intervention B When comparing quad-helix with expansion plates in children, quad-helix was more effective for posterior crossbite correction (RR 1.29, 95% CI 1.13 to 1.46; 3 studies, 151 participants; moderate-certainty evidence), final inter-molar distance (MD 1.48 mm, 95% CI 0.91 mm to 2.04 mm; 3 studies, 151 participants; high-certainty evidence), inter-canine distance (0.59 mm higher (95% CI 0.09 mm to 1.08 mm; 3 studies, 151 participants; low-certainty evidence) and length of treatment (MD -3.15 months, 95% CI -4.04 to -2.25; 3 studies, 148 participants; moderate-certainty evidence). There was no evidence of a difference between Hyrax and Haas for posterior crossbite correction (RR 1.05, 95% CI 0.94 to 1.18; 3 studies, 83 participants; moderate-certainty evidence) or inter-molar distance (MD -0.15 mm, 95% CI -0.86 mm to 0.56 mm; 2 studies of adolescents, 46 participants; moderate-certainty evidence). There was no evidence of a difference between Hyrax and tooth-bone-borne expansion for crossbite correction (RR 1.02, 95% CI 0.92 to 1.12; I² = 0%; 3 studies, 120 participants; low-certainty evidence) or inter-molar distance (MD -0.66 mm, 95% CI -1.36 mm to 0.04 mm; I² = 0%; 2 studies, 65 participants; low-certainty evidence). There was no evidence of a difference between Hyrax with bone-borne expansion for posterior crossbite correction (RR 1.00, 95% CI 0.94 to 1.07; I² = 0%; 2 studies of adolescents, 81 participants; low-certainty evidence) or inter-molar distance (MD -0.14 mm, 95% CI -0.85 mm to 0.57 mm; I² = 0%; 2 studies, 81 participants; low-certainty evidence). AUTHORS' CONCLUSIONS: For children in the early mixed dentition stage (age 7 to 11 years old), quad-helix and expansion plates are more beneficial than no treatment for correcting posterior crossbites. Expansion plates also increase the inter-canine distance. Quad-helix is more effective than expansion plates for correcting posterior crossbite and increasing inter-molar distance. Treatment duration is shorter with quad-helix than expansion plates. For adolescents in permanent dentition (age 12 to 16 years old), Hyrax and Haas are similar for posterior crossbite correction and increasing the inter-molar distance. The remaining evidence was insufficient to draw any robust conclusions for the efficacy of posterior crossbite correction.
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Affiliation(s)
- Alessandro Ugolini
- Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
| | - Paola Agostino
- Department of Surgical and Diagnostic Sciences, University of Genoa, Genoa, Italy
| | | | - Jayne E Harrison
- Orthodontic Department, Liverpool University Dental Hospital, Liverpool, UK
| | - Klaus Bsl Batista
- Department of Preventive and Public Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil
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Van de Velde AS, De Boodt L, Cadenas de Llano-Pérula M, Laenen A, Willems G. Short term effects of interceptive expansion treatment: a prospective study. Eur J Orthod 2021; 43:324-331. [PMID: 33830217 DOI: 10.1093/ejo/cjab006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES This prospective cohort study investigated the short term effects of interceptive orthodontic treatment with a removable expansion plate, evaluating the changes in occlusion in all its dimensions: transversal, sagittal and vertical. SUBJECTS AND METHODS A total of 226 patients treated with a removable expansion plate (slow maxillary expansion, SME) by orthodontic residents at the Department of Orthodontics, University Hospitals Leuven, Belgium were included. The patients had a mean age of 8.5 years at the start of the treatment. The mean treatment time was 6.9 months. Transversal measurements (intercanine and intermolar width) and occlusal characteristics (molar occlusion, overjet, overbite and functional shift) were collected before (T0) and after active treatment (T1). Statistical analysis was performed using the Wilcoxon signed rank test, Sign test and McNemar test for assessing changes between T0 and T1. Linear models were used to assess the associations between patient factors and the amount of expansion. RESULTS A significant increase in transversal width at different occlusal landmarks was found. Correction of unilateral, bilateral and frontal crossbites was successful in 99.0%, 95.2% and 93.6% of the cases respectively. Changes in sagittal molar occlusion were significant: 64.9% (right side) and 62.6% (left side) remained stable, 28.4% (right) and 29.3% (left) improved and 6.7% (right) and 8.1% (left) deteriorated. Overbite changes were found to be statistically significant, though clinically irrelevant. Overjet changes were non-significant. CONCLUSIONS A removable expansion plate is successful in improving the transversal dental dimensions of the maxilla. Statistically significant sagittal effects on molar occlusion were found. Long-term follow-up is needed to evaluate the long-term stability of this treatment.
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Affiliation(s)
- A-S Van de Velde
- Department of Oral Health Sciences-Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - L De Boodt
- Department of Oral Health Sciences-Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - M Cadenas de Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - A Laenen
- Interuniversity Institute for Biostatistics and Statistical Bioinformatics, KU Leuven and University Hasselt, Belgium
| | - G Willems
- Department of Oral Health Sciences-Orthodontics, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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13
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The rationale for orthodontic retention: piecing together the jigsaw. Br Dent J 2021; 230:739-749. [PMID: 34117429 DOI: 10.1038/s41415-021-3012-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 03/08/2021] [Indexed: 12/12/2022]
Abstract
Retaining teeth in their corrected positions following orthodontic treatment is one of the most challenging aspects of orthodontic practice. Despite much research, the rationale for retention is not entirely clear. Teeth tend to revert to their pre-treatment positions due to periodontal and gingival, soft tissue, occlusal and growth factors. Changes may also follow normal dentofacial ageing and are unpredictable with great variability. In this overview, each of these factors are discussed with their implications for retention, along with adjunctive procedures to minimise relapse. The state of current knowledge, methods used to assess relapse, factors regarded as predictive of or associated with stability as well as overcorrection are outlined. Potential areas requiring further investigation are suggested. The way in which the clinician may manage current retention practice, with a need for individualised retention plans and selective retainer wear, is also considered.
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14
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Caroccia F, Moscagiuri F, Falconio L, Festa F, D’Attilio M. Early Orthodontic Treatments of Unilateral Posterior Crossbite: A Systematic Review. J Clin Med 2020; 10:E33. [PMID: 33374420 PMCID: PMC7795353 DOI: 10.3390/jcm10010033] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/10/2020] [Accepted: 12/22/2020] [Indexed: 12/11/2022] Open
Abstract
We aimed to report an update of the systematic review by Petrén et al. (2003). The objective was to evaluate how orthodontic treatments can affect unilateral posterior crossbite (UPXB) in primary and early mixed dentition. Several databases were consulted, and articles published between January 2002 and March 2020 were selected. This review examines the following studies: randomized clinical trials, prospective and retrospective studies with concurrent untreated or normal control groups, and clinical trials comparing at least two treatment strategies. Among the 1581 articles retrieved from the searches, 11 studies were included. Quad-helix (QH) and expansion plate (EP) appliances were compared in three studies. One study compared rapid maxillary expansion (RME) treatment anchored on primary dentition otherwise on permanent molars. One study compared RME and a modified RME with arms extended until deciduous canine and EP. Four studies evaluated the effects of expansion appliances compared with a control group. Compared with the previous review, the quality of the included studies is higher. However, heterogeneity of treatments, different strategies in measurements, lack of a similar follow-up length, and absence of a cost-effectiveness analysis preclude the possibility of providing reliable scientific evidence on the most effective UPXB treatment in primary and early mixed dentition.
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Affiliation(s)
| | | | | | | | - Michele D’Attilio
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy; (F.C.); (F.M.); (L.F.); (F.F.)
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15
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Muradova N, Özçırpıcı AA. Modified Haas Expander for the Treatment of Anterior Openbite and Posterior Crossbite Associated with Thumb Sucking-A Case Report: 3-Years Follow-Up. Turk J Orthod 2020; 32:247-252. [PMID: 32110471 DOI: 10.5152/turkjorthod.2019.19070] [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: 06/15/2019] [Accepted: 08/25/2019] [Indexed: 11/22/2022]
Abstract
Thumb sucking is an abnormal habit that occurs in childhood and can cause several malocclusions if it persists for a long time. Malocclusions caused by oral habits require proper treatment timing to maintain a normal growth and should be treated at an early age. This case report shows the management of thumb sucking and early correction of anterior open bite and posterior crossbite by a modified Haas expander. Three-year follow-up results showed the effectiveness of this special designed appliance.
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Affiliation(s)
- Nargiz Muradova
- Department of Orthodontics, Başkent University School of Dentistry, Ankara, Turkey
| | - Ayça Arman Özçırpıcı
- Department of Orthodontics, Başkent University School of Dentistry, Ankara, Turkey
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16
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Le MHT, Noor Hayaty AK, Zaini ZM, Dom SM, Ibrahim N, Radzi ZB. Alveolar restoration following rapid maxillary expansion with and without corticotomy: A microcomputed tomography study in sheep. Korean J Orthod 2019; 49:235-245. [PMID: 31367578 PMCID: PMC6658903 DOI: 10.4041/kjod.2019.49.4.235] [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: 08/28/2018] [Revised: 03/12/2019] [Accepted: 03/25/2019] [Indexed: 12/01/2022] Open
Abstract
Objective This study examined bone microstructure restoration after rapid maxillary expansion (RME) with and without corticotomy over multiple retention periods. Methods Eighteen male Dorper sheep were randomly distributed into three groups (n = 6 each group): group 1, RME with corticotomy on the buccal and palatal sides; group 2, conventional RME treatment; and group 3, no treatment. Post-RME, trabecular bone microstructure and new bone formation were evaluated by using microcomputed tomography (microCT) and histomorphometry after a 4- or 12-week retention period. Intergroup differences in bone quality and bone remodeling were analyzed by using two-way analysis of variance with Bonferroni post-hoc test. Results The bone volume fraction (bone volume [BV]/total volume [TV]) values relative to the control in groups 1 and 2 were 54.40% to 69.88% after the 4-week retention period and returned to approximately 80% after the 12-week retention period. The pooled BV/TV values of the banded teeth in groups 1 and 2 were significantly lower than those of the control after the 4-week retention period (p < 0.05). However, after the 12-week retention period, the pooled BV/TV values in group 2 were significantly lower than those in groups 1 and 3 (p < 0.05). Histomorphological analysis showed that the new bone formation area in group 1 was approximately two to three times of those in group 2 and control. Conclusions Corticotomy significantly enhanced the restoration of bone quality after the retention periods for banded teeth. This benefit might result from the increased new bone formation after corticotomy.
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Affiliation(s)
- My Huy Thuc Le
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Abu Kasim Noor Hayaty
- Department of Restorative Dentistry, Wellness Research Cluster, University of Malaya, Kuala Lumpur, Malaysia
| | - Zuraiza Mohamad Zaini
- Department of Oro-maxillofacial Surgical and Medical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Sulaiman Md Dom
- Department of Medical Imaging, Faculty of Health Sciences, Universiti Teknologi MARA (UiTM), Selangor, Malaysia
| | - Norliza Ibrahim
- Department of Oro-maxillofacial Surgical and Medical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Zamri Bin Radzi
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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17
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Masucci C, Cipriani L, Defraia E, Franchi L. Transverse relationship of permanent molars after crossbite correction in deciduous dentition. Eur J Orthod 2018; 39:560-566. [PMID: 28057700 DOI: 10.1093/ejo/cjw080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective To evaluate the transverse relationships of the first permanent molars after the correction of posterior crossbite performed during the deciduous dentition with two different treatment protocols. Materials/methods Ninety patients (40 males and 50 females) with posterior crossbite were treated during the deciduous dentition with either a removable expansion plate (RP group, 60 patients) or rapid maxillary expander (RME group, 30 patients). The dental casts before treatment (T0, mean age 5.1 ± 0.7 years) and after treatment, when the first permanent molars were fully erupted, (T1, mean age 7.7 ± 1.0 years) were analysed. The prevalence rates for posterior crossbite on the first permanent molars in the two groups were compared by means of chi-squared test with Yates correction. A logistic regression was performed to evaluate the factors that could influence the presence/absence of posterior crossbite on the first permanent molars. Results Prevalence rate of posterior crossbite on the first permanent molars at T1 was 34.4 per cent in the total sample, 28.3 per cent for the RP group and 46.6 per cent for the RME group. No significant predictors for the 'presence/absence of posterior crossbite on the first permanent molars' at T1 were found. Limitations Retrospective study. Conclusions After treatment of posterior crossbite during the deciduous dentition phase, the first permanent molars erupted in crossbite in the 34.4 per cent of the cases. The type of treatment is not a significant predictor for the presence of posterior crossbite on the first permanent molars.
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Affiliation(s)
- Caterina Masucci
- Department of Surgery and Translational Medicine, School of Dentistry, Unit of Orthodontics, University of Florence, Florence, Italy
| | - Linda Cipriani
- Department of Surgery and Translational Medicine, School of Dentistry, Unit of Orthodontics, University of Florence, Florence, Italy
| | - Efisio Defraia
- Department of Surgery and Translational Medicine, School of Dentistry, Unit of Orthodontics, University of Florence, Florence, Italy
| | - Lorenzo Franchi
- Department of Surgery and Translational Medicine, School of Dentistry, Unit of Orthodontics, University of Florence, Florence, Italy
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Costa JG, Galindo TM, Mattos CT, Cury-Saramago ADA. Retention period after treatment of posterior crossbite with maxillary expansion: a systematic review. Dental Press J Orthod 2018; 22:35-44. [PMID: 28658354 PMCID: PMC5484268 DOI: 10.1590/2177-6709.22.2.035-044.oar] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 09/12/2016] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVE: The aim of this systematic review was to evaluate the duration of the retention period in growing patients undergoing maxillary expansion and its relation with posterior crossbite stability. METHODS: Search strategies were executed for electronic databases Cochrane Library, Web of Science, PubMed and Scopus, which were completed on January 15, 2016. The inclusion criteria included randomized, prospective or retrospective controlled trials in growing subjects with posterior crossbite; treated with maxillary expanders; retention phase after expansion; post-retention phase of at least 6 months. The exclusion criteria were anterior crossbite, craniofacial anomalies, surgery or another orthodontic intervention; case reports; author’s opinions articles, thesis, literature reviews and systematic reviews. The risk of bias of selected articles was assessed with Cochrane risk of bias tool for RCTs and Downs and Black checklist for non-RCTs. RESULTS: A total of 156 titles/abstracts was retrieved, 44 full-texts were examined, and 6 articles were selected and assessed for their methodological quality. The retention period after maxillary expansion ranged between 4 weeks and 16 months. Fixed (acrylic plate, Haas, Hyrax and quad-helix) or removable (Hawley and Hawley expander) appliances were used for retention. CONCLUSIONS: Six months of retention with either fixed or removable appliances seem to be enough to avoid relapse or to guarantee minimal changes in a short-term follow-up.
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Affiliation(s)
- Julia Garcia Costa
- Orthodontics department, Universidade Federal Fluminense, Niterói, Brazil
| | | | - Claudia Trindade Mattos
- Professor of Orthodontics, Dental Clinic department, Universidade Federal Fluminense, Niterói, Brazil
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Miamoto CB, Marques LS, Abreu LG, Paiva SM. Comparison of two early treatment protocols for anterior dental crossbite in the mixed dentition: A randomized trial. Angle Orthod 2017; 88:144-150. [PMID: 29106299 DOI: 10.2319/052117-344.1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To evaluate and compare two treatment protocols to correct anterior dental crossbite in the mixed dentition. MATERIALS AND METHODS Thirty children, 8-10 years of age, participated. Individuals were divided into two groups. Group 1 consisted of 15 children treated with an upper removable appliance with finger springs; group 2, 15 children treated by bonding resin-reinforced glass ionomer cement bite pads on the lower first molars. The 30 participants were evaluated before treatment (T1) and 12 months after treatment began (T2). The variables evaluated included overjet, perimeter of the maxillary arch, intercanine distances in the maxilla and mandible, SNA, SNB, ANB, and U1.NA. Data analysis included descriptive statistics, paired t-test and Student's t-test. Effect sizes and confidence intervals were also calculated. RESULTS Group 1 showed a significant increase in overjet ( P < .001), intercanine distance in the maxilla ( P = .006), intercanine distance in the mandible ( P = .031), and U1.NA ( P = .002). Group 2 showed a significant increase in overjet ( P = .008), intercanine distance in the mandible ( P = .005), and U1.NA ( P < .001). For all the evaluated variables, no statistically significant differences were observed between the two groups. CONCLUSIONS No significant differences were observed between the two protocols: use of a removable maxillary biteplate with finger springs and bonding of resin-reinforced glass ionomer cement bite pads on the lower first molars, for the correction of anterior crossbite in the mixed dentition.
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20
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McNamara JA, Amat P. [Not Available]. Orthod Fr 2017; 88:117-129. [PMID: 28597833 DOI: 10.1051/orthodfr/2017007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
James A. McNamara, diplômé de l’Université de Californie de Berkeley, a suivi ses études de dentisterie et d’orthodontie au sein de l’Université de Californie de San Francisco, et a obtenu un doctorat en anatomie à l’Université du Michigan. Il est titulaire actif de la chaire de professeur émérite Thomas M. and Doris Graber dans le département d’orthodontie et d’odontologie pédiatrique. Il est également professeur émérite de biologie cellulaire et du développement à la faculté de médecine de l’Université du Michigan, et professeur émérite chargé de recherche au Centre de la croissance et du développement humains. Il est l’auteur (avec l’artiste William L. Brudon) de Orthodontics and Dentofacial Orthopedics, manuel très largement utilisé.
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Alves ACDM, Maranhão OBV, Janson G, Garib DG. Mandibular dental arch short and long-term spontaneous dentoalveolar changes after slow or rapid maxillary expansion: a systematic review. Dental Press J Orthod 2017; 22:55-63. [PMID: 28746488 PMCID: PMC5525446 DOI: 10.1590/2177-6709.22.3.055-063.oar] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 12/12/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: The aim of this systematic review was to analyze the short and long-term spontaneous dentoalveolar changes of the mandibular dental arch after slow (SME) or rapid (RME) maxillary expansion in the mixed and early permanent dentitions. METHODS: An electronic search was performed in the following databases: PubMed/Medline, Cochrane Library, Scopus, Embase and Web of Science. Eligibility criteria for article selection included randomized controlled trials and prospective studies written in English, with no restriction of year of publication, involving patients who underwent SME or RME during the mixed or early permanent dentitions. A double-blind search of articles was performed by two reviewers. Initially, the title and the abstract of the studies were read, and their references were also hand-searched for possible missing studies. A methodological quality scoring scale was used to analyze the selected articles. RESULTS: The search retrieved 373 articles, but only 6 were selected for review after application of the eligibility and exclusion criteria. Non-clinically significant spontaneous dentoalveolar changes of approximately 1mm were found in the mandibular dental arch in the short and long-term, after slow or rapid maxillary expansions. Furthermore, no significant differences were found between treated and control groups. CONCLUSIONS: There is enough evidence to conclude that negligible short and long-term spontaneous dentoalveolar changes tend to occur in the mandibular dental arch after SME or RME in the mixed and early permanent dentitions. More randomized studies with appropriate control group are required to better evaluate this issue.
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Affiliation(s)
| | | | - Guilherme Janson
- Universidade de São Paulo, Department of Orthodontics, Bauru, São Paulo, Brazil
| | - Daniela Gamba Garib
- Universidade de São Paulo, Department of Orthodontics, Bauru, São Paulo, Brazil
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Mohan CN, Araujo EA, Oliver DR, Kim KB. Long-term stability of rapid palatal expansion in the mixed dentition vs the permanent dentition. Am J Orthod Dentofacial Orthop 2017; 149:856-62. [PMID: 27241996 DOI: 10.1016/j.ajodo.2015.11.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 11/01/2015] [Accepted: 11/01/2015] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Palatal expansion has been a popular and proven technique for transverse discrepancies used in orthodontics for decades. The short-term effectiveness of the technique is understood, yet questions remain regarding the long-term stability, with much debate surrounding the optimum treatment timing to initiate expansion for the most beneficial and stable results, especially with regard to mixed dentition treatment. The purpose of this study was to determine the long-term stability of palatal expansion performed in the mixed dentition vs the permanent dentition. METHODS Fifty-four subjects were grouped as follows: 24 in the mixed dentition and 30 in the permanent dentition at the start of treatment. All patients had been treated with the Haas type of palatal expansion appliance followed by nonextraction fixed edgewise mechanics. Digitized dental casts were evaluated at 3 times: before treatment (T1), after treatment (T2), and at the long-term retention (T3). Intermolar widths were computed by subtracting measurements between time points, and comparisons between the groups were made to determine expansion and stability differences. RESULTS Significant intermolar width increases were observed from T1 to T2 with significant relapses from T2 to T3, and an overall net gain remained at T3 in each group. No significant differences were found for relapse between the mixed and permanent dentitions. CONCLUSIONS There are no differences for the long-term intermolar width stability in patients treated with palatal expansion in the mixed dentition vs the permanent dentition.
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Affiliation(s)
| | - Eustaquio A Araujo
- Professor, Department of Orthodontics, Saint Louis University, St Louis, Mo
| | - Donald R Oliver
- Associate clinical professor, Department of Orthodontics, Saint Louis University, St Louis, Mo
| | - Ki Beom Kim
- Associate professor, Department of Orthodontics, Saint Louis University, St Louis, Mo.
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Chiodelli L, Pacheco ADB, Missau TS, Silva AMTD, Corrêa ECR. Influence of generalized joint hypermobility on temporomandibular joint and dental occlusion: a cross-sectional study. Codas 2017; 28:551-557. [PMID: 27849244 DOI: 10.1590/2317-1782/20162014082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 12/01/2014] [Indexed: 01/22/2024] Open
Abstract
Purpose To evaluate the dental occlusion and temporomandibular joint in women with and without generalized joint hypermobility. Methods Generalized joint hypermobility was assessed by the Beighton score. Individuals were divided into two groups: with and without hypermobility. The Research Diagnostic Criteria for Temporomandibular Disorders was used to evaluate the temporomandibular joint. Dental occlusion was assessed according to Angle classification, overjet and overbite measures, presence of open bite or crossbite, pattern of disocclusion, and occlusal interference. Results Forty-three women participated voluntarily in the study: 17 in the group with hypermobility and 26 in the group without hypermobility. The frequencies of joint noise and deviation during mouth opening were greater in the hypermobility group (52.9% vs. 38.5% and 76.5% vs. 50%, respectively), but without statistical significance. None of the volunteers presented ideal occlusion and no significant difference was found in Angle Class between the groups. The hypermobility group presented a higher percentage of changes in occlusion (29.4% of overbite, 47.1% of overjet, and 17.6% of crossbite), with crossbite showing statistical difference between the groups. Conclusion Hypermobility does not influence occlusion and range of mandibular motion in the women assessed. Nevertheless, the higher percentage of articular noise and uncorrected deviation during mouth opening shown by the group with hypermobility, even without statistical difference, may constitute evidence of correlation between hypermobility and temporomandibular disorder.
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Affiliation(s)
- Lais Chiodelli
- Universidade Federal de Santa Maria - UFMS - Santa Maria (RS), Brasil
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Vasilakou N, Araujo EA, Kim KB, Oliver DR. Quantitative assessment of the effectiveness of phase 1 orthodontic treatment using the American Board of Orthodontics Discrepancy Index. Am J Orthod Dentofacial Orthop 2016; 150:997-1004. [DOI: 10.1016/j.ajodo.2016.05.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 05/01/2016] [Accepted: 05/01/2016] [Indexed: 11/15/2022]
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Germa A, Clément C, Weissenbach M, Heude B, Forhan A, Martin-Marchand L, Bonet M, Vital S, Kaminski M, Nabet C. Early risk factors for posterior crossbite and anterior open bite in the primary dentition. Angle Orthod 2016; 86:832-838. [PMID: 26998889 PMCID: PMC8600852 DOI: 10.2319/102715-723.1] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 01/01/2016] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE To investigate risk factors specific to posterior crossbite and anterior open bite at the age of 3 years. MATERIALS AND METHODS The study included 422 children of the French EDEN mother-child cohort. The main outcomes were the presence of posterior crossbite and anterior open bite assessed by dentists at 3 years. Social characteristics (collected during pregnancy), neonatal characteristics (collected at birth), duration of breast-feeding (collected prospectively), sucking habits at 3 years, and open lips (as a proxy for mouth breathing) were studied and two logistic regressions conducted. RESULTS Preterm birth appears to be a risk factor specific for posterior crossbite (OR: 3.13; 95% CI: 1.13-8.68), whereas small for gestational age seems to be associated with a lower risk of posterior crossbite (OR: 0.32; 95% CI: 0.12-0.87). Ongoing pacifier or thumb sucking at 3 years is a risk factor for both posterior crossbite and anterior open bite. CONCLUSIONS Children born preterm seem to be more at risk for posterior crossbite than those born at term. Different mechanisms may be involved in posterior crossbite and anterior open bite.
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Affiliation(s)
- Alice Germa
- Associate Professor, Paris Descartes University, Faculty of Odontology, Montrouge, France; INSERM, UMR 1153, Obstetrical, Perinatal, and Pediatric Epidemiology (EPOPE) Team, Epidemiology and Biostatistics, Sorbonne Paris Cité Research Center, Paris, France; Hôpital Charles Foix, Ivry-sur-Seine, France
| | - Céline Clément
- Associate Professor, Department of Dental Public Health, Faculty of Dental Surgery, Université de Lorraine, Nancy, France
| | - Michel Weissenbach
- Professor Emeritus, Department of Dental Public Health, Faculty of Dental Surgery, Université de Lorraine, Nancy, France
| | - Barbara Heude
- Senior Researcher, INSERM, UMR 1153, Early Origin of the Child’s Health and Development Team (ORCHAD) team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, Villejuif, France
| | - Anne Forhan
- Research Engineer, INSERM, UMR 1153, Early Origin of the Child’s Health and Development Team (ORCHAD) team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, Villejuif, France
| | - Laetitia Martin-Marchand
- Research Engineer, INSERM, UMR 1153, Obstetrical, Perinatal, and Pediatric Epidemiology (EPOPE) Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, Paris, France
| | - Mercedes Bonet
- Researcher, INSERM, UMR 1153, Obstetrical, Perinatal, and Pediatric Epidemiology (EPOPE) Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, Paris, France
| | - Sibylle Vital
- Professor, Pediatric Dentistry, Faculty of Odontology, Paris Descartes University, Montrouge, France
| | - Monique Kaminski
- Senior Researcher, INSERM, UMR 1153, Obstetrical, Perinatal, and Pediatric Epidemiology (EPOPE) Team, Epidemiology and Biostatistics Sorbonne Paris Cité Research Center, Paris, France
| | - Cathy Nabet
- Professor, Department of Dentistry, Toulouse University Hospital, Toulouse, France
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Solano-Mendoza B, Sonnemberg B, Solano-Reina E, Iglesias-Linares A. How effective is the Invisalign® system in expansion movement with Ex30' aligners? Clin Oral Investig 2016; 21:1475-1484. [PMID: 27435982 DOI: 10.1007/s00784-016-1908-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Accepted: 07/07/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aims of this study are to validate a new method for quantifying the predictability of expansion movement with the Invisalign® system and to determine whether there are statistically significant differences between planned expansion with ClinCheck® and actual clinical quantification using upper post-treatment model comparisons. MATERIALS AND METHODS A sample of 116 patients subjected to expansion with Invisalign® was studied. The following variables were measured at T1 and T2 on 3D models and ClinCheck®: canine gingival width, first premolar gingival width, second premolar gingival width, first molar gingival width, canine cuspid width, first premolar cuspid width, second premolar cuspid width, first molar cuspid width, canine depth, arch depth, first molar rotation, first right and left molar rotation, and first molar inclination. RESULTS Measurement error was tested, showing good precision for all variables. The paired test showed non-significant differences between the 3D model and ClinCheck® at T1 for all variables except first molar cuspid width and arch depth. Statistically significant differences were found for canine gingival width, first premolar gingival width, second premolar gingival width, first molar gingival width, canine cuspid width, first premolar cuspid width, second premolar cuspid width, first molar cuspid width, and canine depth when the 3D model and ClinCheck® were compared at T2. CONCLUSIONS Differences between the 3D model and ClinCheck® at T2 showed that planned expansion at the end of treatment is not predictable. CLINICAL RELEVANCE This is the first in vivo human study to quantify the predictability of expansion in patients with Invisalign® Ex30 material.
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Affiliation(s)
- B Solano-Mendoza
- School of Dentistry, University of Seville, C/ avicena sn, Seville, Spain
| | | | - E Solano-Reina
- School of Dentistry, University of Seville, C/ avicena sn, Seville, Spain
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Treatment of unilateral posterior crossbite with facial asymmetry in a female patient with transverse discrepancy. Am J Orthod Dentofacial Orthop 2015; 148:154-64. [DOI: 10.1016/j.ajodo.2014.09.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2014] [Revised: 09/01/2014] [Accepted: 09/01/2014] [Indexed: 11/24/2022]
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Sollenius O, Petrén S, Björnsson L, Norlund A, Bondemark L. Health economic evaluations in orthodontics: a systematic review. Eur J Orthod 2015; 38:259-65. [PMID: 26070925 DOI: 10.1093/ejo/cjv040] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Accepted: 05/11/2015] [Indexed: 11/13/2022]
Abstract
BACKGROUND Economic evaluation is assuming increasing importance as an integral component of health services research. AIM To conduct a systematic review of the literature and assess the evidence from studies presenting orthodontic treatment outcomes and the related costs. MATERIALS/METHODS The literature review was conducted in four steps, according to Goodman's model, in order to identify all studies evaluating economic aspects of orthodontic interventions. The search covered the databases Medline, Cinahl, Cochrane, Embase, Google Scholar, National Health Service Economic Evaluation Database, and SCOPUS, for the period from 1966 to September 2014. The inclusion criteria were as follows: randomized controlled trials or controlled clinical trials comparing at least two different orthodontic interventions, evaluation of both economic and orthodontic outcomes, and study populations of all ages. The quality of each included study was assessed as limited, moderate, or high. The overall evidence was assessed according to the GRADE system (The Grading of Recommendations Assessment, Development and Evaluation). RESULTS The applied terms for searches yielded 1838 studies, of which 989 were excluded as duplicates. Application of the inclusion and exclusion criteria identified 26 eligible studies for which the full-text versions were retrieved and scrutinized. At the final analysis, eight studies remained. Three studies were based on cost-effectiveness analyses and the other five on cost-minimization analysis. Two of the cost-minimization studies included a societal perspective, i.e. the sum of direct and indirect costs. The aims of most of the studies varied widely and of studies comparing equivalent treatment methods, few were of sufficiently high study quality. Thus, the literature to date provides an inadequate evidence base for economic aspects of orthodontic treatment. CONCLUSION This systematic review disclosed that few orthodontic studies have presented both economic and clinical outcomes. There is currently insufficient evidence available about the health economics of orthodontic interventions. Further investigation is warranted.
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Affiliation(s)
- Ola Sollenius
- *Department of Orthodontics, County Council, Halland, Halmstad,
| | - Sofia Petrén
- **Department of Orthodontics, Faculty of Odontology, Malmö University
| | | | - Anders Norlund
- ***Section of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Lars Bondemark
- **Department of Orthodontics, Faculty of Odontology, Malmö University
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Is orthodontics prior to 11 years of age evidence-based? A systematic review and meta-analysis. J Dent 2015; 43:477-86. [DOI: 10.1016/j.jdent.2015.02.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 02/03/2015] [Accepted: 02/04/2015] [Indexed: 11/19/2022] Open
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Wiedel AP, Bondemark L. Stability of anterior crossbite correction: a randomized controlled trial with a 2-year follow-up. Angle Orthod 2015; 85:189-195. [PMID: 25004240 PMCID: PMC8631885 DOI: 10.2319/041114-266.1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 05/01/2014] [Indexed: 08/29/2023] Open
Abstract
OBJECTIVE To compare and evaluate the stability of correction of anterior crossbite in the mixed dentition by fixed or removable appliance therapy. MATERIAL AND METHODS The subjects were 64 consecutive patients who met the following inclusion criteria: early to late mixed dentition, anterior crossbite affecting one or more incisors, no inherent skeletal Class III discrepancy, moderate space deficiency, a nonextraction treatment plan, and no previous orthodontic treatment. The study was designed as a randomized controlled trial with two parallel arms. The patients were randomized for treatment with a removable appliance with protruding springs or with a fixed appliance with multibrackets. The outcome measures were success rates for crossbite correction, overjet, overbite, and arch length. Measurements were made on study casts before treatment (T0), at the end of the retention period (T1), and 2 years after retention (T2). RESULTS At T1 the anterior crossbite had been corrected in all patients in the fixed appliance group and all except one in the removable appliance group. At T2, almost all treatment results remained stable and equal in both groups. From T0 to T1, minor differences were observed between the fixed and removable appliance groups with respect to changes in overjet, overbite, and arch length measurements. These changes had no clinical implications and remained unaltered at T2. CONCLUSIONS In the mixed dentition, anterior crossbite affecting one or more incisors can be successfully corrected by either fixed or removable appliances with similar long-term stability; thus, either type of appliance can be recommended.
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Affiliation(s)
- Anna-Paulina Wiedel
- Research Fellow, Department of Oral and Maxillofacial Surgery, Skane University Hospital, Malmö, Sweden
| | - Lars Bondemark
- Professor and Head, Department of Orthodontics, School of Dentistry, University of Malmö, Sweden
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Agostino P, Ugolini A, Signori A, Silvestrini-Biavati A, Harrison JE, Riley P. Orthodontic treatment for posterior crossbites. Cochrane Database Syst Rev 2014:CD000979. [PMID: 25104166 DOI: 10.1002/14651858.cd000979.pub2] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND A posterior crossbite occurs when the top back teeth bite inside the bottom back teeth. When it affects one side of the mouth, the lower jaw may have to move to one side to allow the back teeth to meet together. Several treatments have been recommended to correct this problem. Some treatments widen the upper teeth while others are directed at treating the cause of the posterior crossbite (e.g. breathing problems or sucking habits). Most treatments have been used at each stage of dental development. This is an update of a Cochrane review first published in 2001. OBJECTIVES To assess the effects of orthodontic treatment for posterior crossbites. SEARCH METHODS We searched the following electronic databases: the Cochrane Oral Health Group's Trials Register (to 21 January 2014), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 1), MEDLINE via OVID (1946 to 21 January 2014), and EMBASE via OVID (1980 to 21 January 2014). We searched the US National Institutes of Health Trials Register and the World Health Organization (WHO) Clinical Trials Registry Platform for ongoing trials. We placed no restrictions on the language or date of publication when searching the electronic databases. SELECTION CRITERIA Randomised controlled trials (RCTs) of orthodontic treatment for posterior crossbites in children and adults. DATA COLLECTION AND ANALYSIS Two review authors, independently and in duplicate, screened the results of the electronic searches, and extracted data and assessed the risk of bias of the included studies. We attempted to contact the first named authors of the included studies for missing data and for clarification. We used risk ratios (RR) and 95% confidence intervals (CIs) to summarise dichotomous (event) data, and mean differences (MD) with 95% CIs to summarise continuous data. We performed meta-analyses using fixed-effect models (we would have used random-effects models if we had included four or more studies in a meta-analysis) when comparisons and outcomes were sufficiently similar. MAIN RESULTS We included 15 studies, of which two were at low risk of bias, seven were at high risk of bias and six were unclear. Fixed appliances with mid-palatal expansionNine studies tested fixed appliances with mid-palatal expansion against each other. No study reported a difference between any type of appliance. Fixed versus removable appliancesFixed quad-helix appliances may be 20% more likely to correct crossbites than removable expansion plates (RR 1.20; 95% CI 1.04 to 1.37; two studies; 96 participants; low-quality evidence).Quad-helix appliances may achieve 1.15 mm more molar expansion than expansion plates (MD 1.15 mm; 95% CI 0.40 to 1.90; two studies; 96 participants; moderate-quality evidence).There was insufficient evidence of a difference in canine expansion or the stability of crossbite correction.Very limited evidence showed that both fixed quad-helix appliances and removable expansion plates were superior to composite onlays in terms of crossbite correction, molar and canine expansion. Other comparisonsVery limited evidence showed that treatments were superior to no treatment, but there was insufficient evidence of a difference between any active treatments. AUTHORS' CONCLUSIONS There is a very small body of low- to moderate-quality evidence to suggest that the quad-helix appliance may be more successful than removable expansion plates at correcting posterior crossbites and expanding the inter-molar width for children in the early mixed dentition (aged eight to 10 years). The remaining evidence we found was of very low quality and was insufficient to allow the conclusion that any one intervention is better than another for any of the outcomes in this review.
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Affiliation(s)
- Paola Agostino
- Private practice, Via Sant?Andrea di Rovereto 59A, Chiavari, Genoa, Italy, 16043
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Bell RA, Kiebach TJ. Posterior crossbites in children: Developmental-based diagnosis and implications to normative growth patterns. Semin Orthod 2014. [DOI: 10.1053/j.sodo.2014.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Zhou Y, Long H, Ye N, Xue J, Yang X, Liao L, Lai W. The effectiveness of non-surgical maxillary expansion: a meta-analysis. Eur J Orthod 2013; 36:233-42. [DOI: 10.1093/ejo/cjt044] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Borrie FR, Bearn DR. Interceptive orthodontics – current evidence-based best practice. ACTA ACUST UNITED AC 2013; 40:442-4, 446-8, 450. [DOI: 10.12968/denu.2013.40.6.442] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Felicity R Borrie
- Clinical Lecturer in Orthodontics, Dundee Dental Hospital and School, Park Place, Dundee, UK
| | - David R Bearn
- Professor of Orthodontics, Dundee Dental Hospital and School, Park Place, Dundee, UK
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Zuccati G, Casci S, Doldo T, Clauser C. Expansion of maxillary arches with crossbite: a systematic review of RCTs in the last 12 years. Eur J Orthod 2011; 35:29-37. [DOI: 10.1093/ejo/cjr140] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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