Two-phase orthodontic treatment of a complex malocclusion: giving up efficiency in favor of effectiveness, quality of life, and functional rehabilitation?

Orthodontic and Orthognathic Surgical Treatment in a Patient with a Large Lymphatic Malformation of the Face: A Case Report

Lymphatic malformations (LMs) are congenital abnormalities in the development of the lymphatic system. They can damage other structures including the airway, blood vessels, nerves, or bones. LMs of the face can result in malocclusion, and many patients with LMs of the face require orthognathic surgery to correct the malocclusion. Surgery-first is a treatment modality which should be considered for individuals with LMs and is a protocol in which orthognathic surgery is performed prior to orthodontic treatment. This case report describes surgery-first and subsequent orthodontic treatment in a patient with a class III malocclusion due to a large facial LM.

Comparison Between Removable and Fixed Devices for Nonskeletal Anterior Crossbite Correction in Children and Adolescents: A Systematic Review

OBJECTIVE

To compare removable and fixed orthodontic devices in the correction of non-skeletal anterior crossbite in children and adolescents in the mixed dentition.

MATERIALS AND METHODS

Electronic searches were conducted in the following databases: PubMed, Web of Science, Scopus, Medline Ovid, Lilacs, US Clinical Trials, and Proquest. A hand search of the reference lists of the included articles and a Google Scholar search were also conducted. References were evaluated by 2 review authors. Articles that met the eligibility criteria were included. Data extraction, methodological quality assessment (Cochrane tool), and strength of the evidence evaluation (GRADE) were also carried out.

RESULTS

Seven articles were included. The results showed that removable and fixed devices were equally efficacious for overjet correction. Removable and fixed devices can also present inconveniences regarding pain and discomfort levels, the accomplishment of everyday activities (leisure and school), and the performance of functions, such as chewing and speech. However, treatment time and costs were significantly lower in orthodontic therapy with fixed appliances. Sequence generation, allocation concealment, and complete outcome data were not a concern. Blinding of participants or personnel was not reported in any article, and blinding of the assessor was a concern in 2 articles. Selective reporting was a concern in 2 articles. The certainty of the evidence for overjet correction was very low.

CONCLUSION

Removable and fixed orthodontic devices are efficacious for overjet correction in non-skeletal anterior crossbite. However, treatment time and costs are lower for cases treated with fixed devices.

Impact of two early treatment protocols for anterior dental crossbite on children's quality of life

Objective:

To assess the impact of two early treatment protocols for anterior dental crossbite on children’s quality of life.

Methods:

Thirty children, 8 to 10 years of age, with anterior dental crossbite, participated in this study. Individuals were divided into two groups: Group 1 - 15 children undergoing treatment with an upper removable appliance with digital springs; Group 2 - 15 children undergoing treatment with resin-reinforced glass ionomer cement bite pads on the lower first molars. Quality of life was evaluated using the Brazilian version of the Child Perceptions Questionnaire (CPQ_8-10), which contains four subscales: oral symptoms (OS), functional limitations (FL), emotional well-being (EW), and social well-being (SW). A higher score denotes a greater negative impact on children’s quality of life. Children answered the questionnaire before treatment (T₁) and twelve months after orthodontic treatment onset (T₂). Descriptive statistics, the Wilcoxon test and analysis of covariance (ANCOVA) were performed.

Results:

Children’s mean age was 9.07 ± 0.79 years in Group 1 and 9.00 ± 0.84 years in Group 2. For Group 1, the FL and EW subscale scores and the overall CPQ_8-10 were significantly higher in T₁ as compared to T₂ (p= 0.004, p= 0.012 and p= 0.015, respectively). For Group 2, there were no statistically significant differences. The ANCOVA showed no significant difference regarding quality of life at T₂ between groups, after controlling for quality of life measures at T₁.

Conclusions:

The difference regarding the impact on quality of life between groups is not related to the protocol used.

An evaluation of oral health-related quality of life in orthodontic patients treated with fixed and twin blocks appliances

OBJECTIVE

To study the impact of orthodontic treatment on the quality of life in two patient groups, one treated with the twin block appliance and the other with fixed appliances.

MATERIALS AND METHODS

Ninety-eight patients, aged between 10 and 16 years, were recruited in the fixed (20 males and 29 females) or functional (29 males and 20 females) treatment groups. The oral health-related quality of life (OHRQoL) was measured before treatment and followed up at the end of the treatment. The instrument used to measure OHRQoL was a modified self-administered short version of the English Oral Health Impact profile (OHIP-16[E]) questionnaire.

RESULTS

OHRQoL worsened at the initial stages of the treatment. The overall score of OHRQoL reduced significantly at the end of the treatment in both groups. Both groups showed comparable improvements in OHRQoL as the treatment progressed (analysis of variance test P = 0.05).

CONCLUSIONS

The OHRQoL patterns, during the treatment with fixed and twin block appliances, were very similar. This suggests that the functional appliance's impact on the QoL may be overestimates by clinicians. OHRQoL improved significantly with both fixed and functional appliances by the end of the treatment. The OHRQoL trends observed during the study can be communicated to patients and used to increase patients' compliance since they are made aware of the whole treatment process.

Short-term and long-term treatment outcomes with Class III activator

OBJECTIVE

The purpose of this retrospective study was to investigate short-term and long-term skeletodental outcomes of Class III activator treatment.

METHODS

A Class III activator treatment group (AG) comprised of 22 patients (9 boys, 13 girls) was compared with a Class III control group (CG) comprised of 17 patients (6 boys, 11 girls). The total treatment period was divided into three stages; the initial stage (T1), the post-activator treatment or post-mandibular growth peak stage (T2), and the long-term follow-up stage (T3). Cephalometric changes were evaluated statistically via the Mann-Whitney U-test and the Friedman test.

RESULTS

The AG exhibited significant increases in the SNA angle, ANB angle, Wits appraisal, A point-N perpendicular, Convexity of A point, and proclination of the maxillary incisors, from T1 to T2. In the long-term follow-up (T1-T3), the AG exhibited significantly greater increases in the ANB angle, Wits appraisal, and Convexity of A point than the CG.

CONCLUSIONS

Favorable skeletal outcomes induced during the Class III activator treatment period were generally maintained until the long-term follow-up period of the post-mandibular growth peak stage.