Patients' perceptions of recovery after surgical exposure of impacted maxillary teeth treated with an open-eruption surgical-orthodontic technique

Patient-reported outcome measures comparing static computer-aided implant surgery and conventional implant surgery for single-tooth replacement: A randomized controlled trial

OBJECTIVE

To compare static computer-aided implant surgery (s-CAIS) and conventional implant surgery (CIS) for single-tooth replacement in posterior sites in terms of patient-reported outcome measures (PROMs).

METHODS

Forty patients were divided into two groups for treatment with s-CAIS (Test) and CIS (Control). Patients' anxiety level was measured using the modified dental anxiety score before implant surgery. After surgery, patients completed two questionnaires for 7 days. The first questionnaire assessed pain level using a visual analog scale (VAS) and the incident rate of pain using a 5-point Likert scale; analgesic intake was also recorded. The second questionnaire investigated patients' oral health-related quality of life (OHRQoL) including postoperative symptoms, oral function, and daily activity. The difference between data was compared at significance level (α = 0.05).

RESULTS

There was no statistically significant difference in pretreatment dental anxiety level, postoperative pain scores, and OHRQoL between treatment groups. Overall, mild or moderate dental anxiety was reported by 70% and 20% of patients, respectively. Pain score was significantly reduced by postoperative Day 3 in the test group and Day 4 in the control group, compared with baseline. Both groups significant reduced analgesic intake by postoperative Day 5. Most OHRQoL-related complaints subsided approximately 3 days after surgery.

CONCLUSIONS

Overall, PROMs between s-CAIS and CIS were not significantly different for the single-tooth implant surgery in the posterior area. Postoperative symptoms after implant surgery still inevitably occurred, reflecting the normal process of oral wound healing.

Comparison of Short-Term Oral Impacts Experienced by Patients Treated with Invisalign or Conventional Fixed Orthodontic Appliances

OBJECTIVES

Our objective was to test the hypothesis that thermoplastic clear aligners (Invisalign®; Align Technology, Santa Clara, CA, USA) are more pleasant for patients than conventional fixed orthodontic appliances.

SUBJECTS AND METHODS

This was an observational retrospective study in which subjects were matched for age, treatment modality, and the treating orthodontist. A total of 60 adult patients (30 in the Invisalign group and 30 in the conventional buccal fixed appliance group) who met the inclusion criteria completed a validated self-reporting questionnaire, rating their experience after appliance activation in regard to oral impact experience and satisfaction of both treatment modalities. Categorical variables were compared using the χ2 test, Fisher's exact test, and the Z test. Continuous variables such as pain level and age were analyzed using the 2-sample t test.

RESULTS

Patients on clear aligner therapy reported significantly more difficulty in speech (p = 0.035) necessitating change in speech delivery (p = 0.003). In addition, they reported better chewing ability (p < 0.001), no restrictions on amounts or types of food (p = 0.02), and less mucosal ulcerations (p = 0.01). Effects on daily routine, use of analgesics, and overall treatment satisfaction were not significantly different between the 2 groups.

CONCLUSION

Clear aligner therapy is not necessarily more pleasant, but it is more tolerable as it satisfies patient needs over food consumption and absence of mucosal ulcerations. However, clear aligners affect pronunciation and speech delivery in the short term.

The impact of personality on adult patients' adjustability to orthodontic appliances

OBJECTIVE

To evaluate the impact of psychological traits on patients' choice of orthodontic appliances and their adjustability to orthodontic treatment.

MATERIALS AND METHODS

The sample consisted of 68 adult patients divided into three groups (28 buccal, 19 lingual, and 21 clear aligners). Prior to treatment participants filled out the Brief Symptom Inventory to assess symptoms of mental distress and the Narcissistic Vulnerability Scale to assess narcissistic personality traits. During the first week after appliance delivery and on day 14, patients completed a Health-Related Quality of Life questionnaire to assess their perception of pain and four areas of dysfunction. The correlation between personality traits and patients' reaction to treatment was evaluated.

RESULTS

Somatization was the only trait that affected the choice of lingual and clear aligner appliance. Reduced self-esteem regulation was associated with increased pain in all patients, while exploitation was associated with pain in lingual patients. Narcissistic vulnerability slightly influenced patients' adaptability to orthodontic appliances. Although adjustability to lingual appliances was the most difficult, only two parameters were affected by personality features. In the buccal group, adjustability was affected by numerous parameters. Adaptation to the clear aligner appliance was relatively uneventful and least affected by psychological features.

CONCLUSION

Anxious individuals tend to prefer lingual and clear aligner appliances. The selection of lingual and clear aligner appliances governs the patient's response and recovery process, leaving little room for the effect of psychological features. On the other hand, the buccal appliance allows for greater impact of personality traits on adjustability.

Adult patients' adjustability to orthodontic appliances. Part I: a comparison between Labial, Lingual, and Invisalign™

This prospective study examined the adult patient's perception of recovery after insertion of three types of orthodontic appliances: Buccal, Lingual and Invisalign. The sample consisted of sixty-eight adult patients (45 females and 23 males) who comprised three groups: 28 Buccal, 19 Lingual, and 21 Invisalign patients. After appliance insertion, patients completed a Health-Related Quality of Life questionnaire daily for the first week and again on day 14, in order to assess patients' perception of pain and analgesic consumption. In addition, four areas of dysfunction were assessed: oral dysfunction, eating disturbances, general activity parameters, and oral symptoms. Lingual appliance was associated with more severe pain and analgesic consumption, the greatest oral and general dysfunction, and the most difficult and longest recovery. The Invisalign patients complained of relatively high levels of pain in the first days after insertion; however this group was characterized by the lowest level of oral symptoms and by a similar level of general activity disturbances and oral dysfunction compared to the Buccal appliance. Many Lingual and some Buccal patients did not reach a full recovery from their eating difficulties by the end of the study period. The present study provides information to adult patients and clinicians assisting them in choosing the most appropriate treatment modality in relation to Health-Related Quality of Life parameters.

Comparative analysis of traditional radiographs and cone-beam computed tomography volumetric images in the diagnosis and treatment planning of maxillary impacted canines

INTRODUCTION

In this prospective study, we compared differences in the diagnosis and treatment planning of impacted maxillary canines between 2 imaging modalities.

METHODS

Twenty-five consecutive impacted maxillary canines were identified from the pool of patients seeking orthodontic treatment. The first set of radiographs consisted of traditional 2-dimensional (2D) images including panoramic, occlusal, and 2 periapical radiographs. The second set comprised prints of 3-dimensional (3D) volumetric dentition images obtained from a cone-beam computed tomography (CBCT) scan. Seven faculty member completed a questionnaire for every impacted canine and diagnostic radiographic modality (2D and 3D).

RESULTS

The data show that the judges produced different decisions regarding localization depending on the x-ray method. There were 21% disagreement (or discordance) in the perceived mesiodistal cusp tip position and 16% difference in the perceived labiopalatal position. In the perception of root resorption of adjacent teeth, there was 36% lack of congruence. Twenty-seven percent of the teeth that were planned to be left, recovered, or extracted with the 2D radiographs had different treatment plans when the judges viewed the 3D CBCT images (McNemar test, chi-square, 4.45; P = 0.035). The clinicians' confidence of the accuracy of diagnosis and treatment plan was statistically higher for CBCT images (P <0.001).

CONCLUSIONS

These results showed that 2D and 3D images of impacted maxillary canines can produce different diagnoses and treatment plans.

Surgical-orthodontic management of dental impaction

The aim of this study was to assess the management of impacted teeth using surgical-orthodontic techniques at a dental treatment centre in Casablanca and to suggest strategies designed to enhance treatment of dental impaction.

MATERIALS AND METHODS

The sample comprised 30 patients represented by their clinical files (mean age: 17 years; standard deviation: 8.141).

RESULTS

Impaction most often involved a single tooth (56.7%), generally the upper canine (66%). The location was buccal in 43.3% of cases and generally high (63.3%). Presurgical orthodontic treatment was required in 80 of these cases. A closed eruption technique is reported in 93.1% of cases. Mean treatment duration was 11.4 months. The success rate of the surgical technical technique was 70%.

DISCUSSION

A similarity exists between most of the variables studied and findings of other studies published on the same topic.

Short- and long-term periodontal evaluation of impacted canines treated with a closed surgical?orthodontic approach

AIM

The aims were to evaluate and compare the periodontal status of unilateral impacted maxillary canines treated by a combined surgical-orthodontic technique with that of normally erupted controlateral canines.

MATERIAL AND METHODS

One hundred and twenty-five patients, consecutively enrolled, aged between 12.8 and 52.0 years, 31 males and 94 females, presented one impacted maxillary canine (test group) and the controlateral canine normally erupted (control group). All cases were treated by a surgical flap and orthodontic traction directed to the centre of the crest and evaluated periodontally at the end of treatment. Fifty-eight patients were followed up for a mean of 3.4 +/- 0.5 years. Pocket depth (PD), keratinized tissue width (KT) and gingival recession were recorded. Multilevel models were created.

RESULTS

At the end of the orthodontic treatment, PD and KT of the 125 impacted canines were slightly, but statistically significantly higher than controls. Only one treated canine showed a recession (1 mm). At follow-up (58 patients), this difference decreased and the two groups were not significantly different.

CONCLUSIONS

The combined technique permitted the traction of the impacted canines to the centre of the crest, thus simulating a physiological eruption pattern. Correct alignment and good periodontal status were obtained.