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Abubakr NH, Al-Talib T, Bahar N, Badani A, Nelson S, Mago J. Correlation Between Condylar Shape and Malocclusion: CBCT Analysis. Diagnostics (Basel) 2025; 15:768. [PMID: 40150112 PMCID: PMC11941284 DOI: 10.3390/diagnostics15060768] [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: 02/26/2025] [Revised: 03/14/2025] [Accepted: 03/18/2025] [Indexed: 03/29/2025] Open
Abstract
Background/Objectives: This study introduces a novel classification system using cone-beam computed tomography (CBCT) to assess condylar morphology and its correlation with different skeletal classifications. Methods: A retrospective CBCT analysis of 288 subjects evaluated condylar shape, flattening at the medial and lateral poles, and the presence of degenerative changes. Statistical analyses identified significant associations. Results: Class II skeletal malocclusion was the most prevalent (63.5% females and 36.4% males). Females exhibited a significantly higher prevalence of degenerative changes (p < 0.001), with notable lateral pole flattening. The most common condylar morphology was convex (52.43% left and 51% right), followed by angled, round, and flat. Degenerative changes were more frequent on the left side, particularly in Class II Division 1 cases (37%). Conclusions: This classification system enhances temporomandibular joint (TMJ) evaluation in orthodontic diagnosis and treatment planning, allowing for the early detection of morphological changes to optimize patient care.
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Affiliation(s)
- Neamat Hassan Abubakr
- Department of Biomedical Sciences, School of Dental Medicine, University of Nevada, Las Vegas, NV 89106, USA
| | - Tanya Al-Talib
- Department of Clinical Sciences, School of Dental Medicine, University of Nevada, Las Vegas, NV 89106, USA; (T.A.-T.); (S.N.); (J.M.)
| | - Nastaran Bahar
- School of Dental Medicine, University of Nevada, Las Vegas, NV 89106, USA; (N.B.); (A.B.)
| | - Arshia Badani
- School of Dental Medicine, University of Nevada, Las Vegas, NV 89106, USA; (N.B.); (A.B.)
| | - Stanely Nelson
- Department of Clinical Sciences, School of Dental Medicine, University of Nevada, Las Vegas, NV 89106, USA; (T.A.-T.); (S.N.); (J.M.)
| | - Jyoti Mago
- Department of Clinical Sciences, School of Dental Medicine, University of Nevada, Las Vegas, NV 89106, USA; (T.A.-T.); (S.N.); (J.M.)
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Shi Q, Gu Z, Lai D, Dai Q, Yu F. Three-dimensional evaluation of condylar morphology after orthodontic treatment in adult patients with Class II malocclusion by cone-beam computed tomography. BMC Oral Health 2024; 24:48. [PMID: 38191341 PMCID: PMC10775592 DOI: 10.1186/s12903-023-03728-y] [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: 06/17/2023] [Accepted: 12/01/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND The aim of this study was to evaluate the condylar morphological changes after orthodontic treatment in adult patients with Class II malocclusion using a Cone-beam computed tomography (CBCT). METHODS Images of twenty-eight adult patients with Class II malocclusion who have no temporomandibular symptoms were involved in this study. To analyze the post-treatment changes in condylar morphology, mimics 17.0 software was used to measure several values and reconstruct the three-dimensional condyle, including height of the condyle, area and bone mineral density of the maximum axial and sagittal section, volume and bone mineral density of the three-dimensional condyle and condylar head before and after orthodontic treatment. Using SPSS 19.0 software package Paired t-test was applied for comparison of condylar morphology analysis between pre-treatment and post-treatment. RESULTS Height of condylar head increase significant (P < .05). Bone mineral density showed a decrease in the maximum axial and sagittal section, three-dimensional condyle and condylar head (P < .01). Evaluation of volume revealed that volume of both condyle and condylar head decrease considerably (P < .05). No significant difference was detected in other values ((P > .05). CONCLUSION Condylar volume decreased and height of condylar head have changed, so we speculated that adaptive bone remodeling of the condyle occurs.
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Affiliation(s)
- Qiutao Shi
- Department of stomatology, Ningbo No.2 Hospital, Ningbo, 315010, China.
| | - Zhiyuan Gu
- School of stomatology, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Danping Lai
- Department of stomatology, The Second Affiliated Hospital of Zhejiang University, Hangzhou, 310005, China
| | - Qi Dai
- Department of Radiology, Ningbo No.2 Hospital, Ningbo, 315010, China
| | - Fengyang Yu
- Orthodontic Center, Perfect Dental Care, Hangzhou, 310051, China
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Marghalani HYA. Volumetric comparison of mandibular condyles and mandibles in the different skeletal classes in the Saudi population. PeerJ 2024; 12:e16750. [PMID: 38188155 PMCID: PMC10771761 DOI: 10.7717/peerj.16750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 12/13/2023] [Indexed: 01/09/2024] Open
Abstract
Background Assessing the relationship between the condyle and mandible volume and the various skeletal classes is essential in orthodontic diagnosis. The current study evaluated this relationship using volumetric cone-beam computed tomography (CBCT), cephalometric methods, and the correlations between them. Materials and Methods The study examined 37 full-head CBCTs (74 condyles) from adults in the Saudi population. The condyle and mandible were separated from within the CBCT images. The volume of each segment was compared to measurements from multiple cephalometric analyses. Results The combined total condylar volume has a moderate correlation with the maxillomandibular differential in each of the genders and in the total sample. Mandibular volume has a significant correlation with the Wits appraisal (sagittal classification) in males. It was also significantly correlated with the vertical classification using gonial angles in females and in the total sample. Conclusion The relationship between mandible and condyle volume and cephalometric measurements is both dimensional and within the maxillomandibular complex rather than positional or related to the cranial base. Also, the correlation between the condylar and mandibular volumes and the sagittal and vertical dimensions in the orthodontic skeletal classes provides better insight into the mandibular complex.
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Affiliation(s)
- Hussain Y. A. Marghalani
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
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López Ramírez JC, Mariel Cárdenas J, Gutiérrez Cantú FJ, Salas Orozco MF, Medina-Solís CE, Hernández Molinar Y, Trejo Rivero E, Patiño-Marín N. Association Between Gender, Age, and Skeletal Class With Mandibular Condyle Morphology: A Retrospective Study. Cureus 2023; 15:e49043. [PMID: 38116346 PMCID: PMC10729778 DOI: 10.7759/cureus.49043] [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] [Accepted: 11/19/2023] [Indexed: 12/21/2023] Open
Abstract
OBJECTIVES This study aimed to examine the impact of demographic variables on mandibular condyle morphology, a critical factor in orthodontic treatment and maxillofacial surgery. The investigation focuses on the relationship between gender, age, and skeletal class with the morphological dimensions of the condyle, utilizing panoramic radiography as a diagnostic tool. METHODOLOGY A retrospective analysis was conducted on 150 panoramic radiographs from individuals stratified into six groups according to gender and skeletal class. Skeletal classes were determined using Steiner and McNamara cephalometry. The Kodak Carestream software (Rochester, NY: Carestream Health) was employed to measure condylar height, width, and morphology. Statistical evaluations included ANOVA, correlation assessments, and multivariate binary logistic regression to discern the differences and associations among the variables studied. RESULTS The findings revealed notable differences in condylar dimensions between genders across different skeletal classes, with males typically presenting larger condylar dimensions than females. The data also showed a moderate positive correlation between condyle height and width. Round-shaped condyles were the most common form found, with significant gender differences observed in certain skeletal classes. Additionally, logistic regression analysis identified significant associations between gender, age, and condylar width and shape. CONCLUSIONS The study concludes that demographic factors, such as gender and age, significantly affect mandibular condyle morphology. These factors should be carefully considered in clinical evaluations using panoramic radiography to enhance the precision of diagnoses and the effectiveness of subsequent orthodontic and maxillofacial treatments. The results provide valuable insights for healthcare professionals in regions where more advanced imaging techniques may not be readily available.
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Affiliation(s)
| | - Jairo Mariel Cárdenas
- School of Stomatology, Autonomous University of San Luis Potosí, San Luis Potosí, MEX
| | | | | | | | | | - Edith Trejo Rivero
- School of Stomatology, Autonomous University of San Luis Potosí, San Luis Potosí, MEX
| | - Nuria Patiño-Marín
- School of Stomatology, Clinical Research Laboratory, Autonomous University of San Luis Potosí, San Luis Potosí, MEX
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Zhang Y, Keilig L, Dörsam I, Bourauel C. Numerical investigation of the biomechanical effects of orthodontic intermaxillary elastics on the temporomandibular joint. J Mech Behav Biomed Mater 2023; 141:105764. [PMID: 36965216 DOI: 10.1016/j.jmbbm.2023.105764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/03/2023] [Accepted: 03/06/2023] [Indexed: 03/14/2023]
Abstract
Temporomandibular joint disorder (TMD) often coincides with malocclusion, and in some cases TMDs are reported after orthodontic treatment. Intermaxillary elastics (also known as orthodontic elastics, OE) are a common way to apply force during orthodontic treatment, and they might cause mechanical effects on the temporomandibular joint (TMJ), thereby lead to joint remodeling. It is still a controversial topic whether the adapted remodeling of the TMJ or of the alveolar bone is the main cause for the alteration of occlusion after treatment with OEs. It was the aim of this study to analyze whether variations of OEs would develop harmful effects on the healthy TMJ. A TMJ model with a masticatory system based on Hill-type muscle actuators was established. Mouth opening and closure with and without OEs were simulated, and maximum principal stresses in the disc and condylar cartilage as well as the displacement of the mandible were analyzed. We found no considerably difference in the mandibular movement without and with symmetrical OEs during mouth opening and closing. At full mouth opening, stresses in the disc and condylar cartilage of some models with OEs were much smaller than without OEs, but we did not find consistency in the results from the left and right sides of the same model (e.g. the lowest compressive stress on the left side of disc from the model with Class II OEs is much smaller than without OEs, -17.3 MPa compared with -28.2, while on the right side, there was no obvious difference). Hence, we could not conclude that OEs would develop deleterious effects on the healthy TMJ.
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Affiliation(s)
- Yaqiu Zhang
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany.
| | - Ludger Keilig
- Oral Technology, Dental School, University Hospital Bonn, Bonn, Germany; Department of Dental Prosthetics, Propaedeutics and Materials Science, Dental School, University Hospital Bonn, Bonn, Germany
| | - Istabrak Dörsam
- Department of Dental Prosthetics, Propaedeutics and Materials Science, Dental School, University Hospital Bonn, Bonn, Germany
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Uetanabaro LC, Gerber JT, Dos Santos KM, Meger MN, da Costa DJ, Küchler EC, Sebastiani AM, Scariot R. Prevalence and associated factors of myofascial pain in orthognathic patients with skeletal class II malocclusion. Oral Maxillofac Surg 2023; 27:25-31. [PMID: 35262814 DOI: 10.1007/s10006-022-01046-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
UNLABELLED Orthognathic patients with skeletal class II malocclusion frequently suffer from myofascial pain (MP). PURPOSE This study aimed to evaluate the prevalence and associated factors of MP in these patients. METHODS This cross-sectional study was performed in adult patients with skeletal Class II malocclusion requiring orthognathic surgery. They were divided according to the presence or absence of MP. The predictor variables were craniofacial morphology, sex, temporomandibular disorders, chronic pain, depression, and polymorphisms of dopamine receptors DRD2 (rs6275 and rs6276) and ANKK1 (rs1800497) genes. Data were submitted to statistical analyses using the linear regression model and Poisson regression with a significance level of 0.05. RESULTS Sixty-five individuals were selected, of which 50 (76.92%) were females. A total of 21 (32.3%) patients had MP. Individuals with MP showed a decrease in the mandible gonial angle (p = 0.042) and an increased risk of having temporomandibular joint (TMJ) disc displacement (p = 0.003), TMJ pain (p = 0.030), chronic pain (p = 0.001), and severe depression (p = 0.015). Additionally, individuals carrying AA and AG genotypes in rs6275, and CC genotype in rs6276, were more likely to have MP (p < 0.05). CONCLUSION In this study, 32.3% of skeletal class II orthognathic patients had MP, which was associated with a decreased gonial angle, TMJ disc displacement, TMJ pain, chronic pain, depression, and polymorphisms in the DRD2 gene.
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Affiliation(s)
| | | | | | | | - Delson João da Costa
- Department of Stomatology, Federal University of Parana, 632 Prefeito Lothário Meissner Avenue, Curitiba, PR, 80210-170, Brazil
| | - Erika Calvano Küchler
- Department of Pediatric Dentistry, Ribeirão Preto Dental School, University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Aline Monise Sebastiani
- Department of Stomatology, Federal University of Parana, 632 Prefeito Lothário Meissner Avenue, Curitiba, PR, 80210-170, Brazil.
| | - Rafaela Scariot
- Department of Stomatology, Federal University of Parana, 632 Prefeito Lothário Meissner Avenue, Curitiba, PR, 80210-170, Brazil
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Shiryaeva TV, Oborotistov NY, Muraev AA. Digital analysis of stomatognathic system morphofunctional condition in patients with distal occlusion before and after treatment with the Twin Block appliance. Pediatr Dent 2023. [DOI: 10.33925/1683-3031-2022-22-4-261-268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Relevance. For many years studies have evaluated the possibilities of modifying the growth of the maxillofacial complex during orthodontic treatment with functional appliances. Despite the large number of studies devoted to orthodontic treatment of distal occlusion in children and adolescents, there is no consensus among orthodontists on the appropriateness, timing and tactics of such treatment.Material and methods. The article presents the results of the treatment of distal occlusion in children and adolescents aged 7-18 years using the Twin Block appliance. The study included clinical, anthropometric, radiographic and functional research methods.Results. The course of treatment eliminated distal occlusion in all groups; in Group 1, the length of the mandibular body was 64.4 ± 2.8 mm before the treatment and 69.6 ± 2.4 mm after the treatment (p = 0.016); in Group 2, the length of the mandibular body was 69.7 ± 6.6 mm before the treatment and 72.5 ± 6.9 mm after the treatment (p = 0.019); in Group 3, the length of the mandibular body was 69.8 ± 5.6 mm before the treatment and 74.0 ± 4.3 mm after the treatment (p = 0.005). The temporomandibular joints did not show pathological changes; most patients (70%) did not demonstrate anterior position of the condyles after the treatment.Conclusion. Orthodontic treatment of patients aged 7-18 years with distal occlusion using the Twin Block appliance is an effective treatment method. The orthodontic treatment with functional appliances is most reasonable during the period of peak growth when significant skeletal changes are possible to obtain.
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Affiliation(s)
- T. V. Shiryaeva
- Moscow State University of Medicine and Dentistry named after A. I. Evdokimov
| | - N. Yu. Oborotistov
- Moscow State University of Medicine and Dentistry named after A. I. Evdokimov
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Patel B, Kukreja MK, Gupta A, Rohilla S. Evaluation of Changes in Soft and Hard Tissues of TMJ among Class II Division 2 Patients after Prefunctional Orthodontics and Twin Block Functional Appliance Therapy: A Prospective MRI Study. Int J Clin Pediatr Dent 2022; 15:479-488. [PMID: 36865723 PMCID: PMC9973096 DOI: 10.5005/jp-journals-10005-2439] [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] [Indexed: 02/05/2023] Open
Abstract
Introduction No study has been conducted to explore soft and hard tissue changes brought by functional appliances within the temporomandibular joint (TMJ) after correction of class II division 2 (div 2) malocclusion. Hence, we planned this study to evaluate the mandibular condyle disk-fossa relationship before and after prefunctional and twin block therapy using a magnetic resonance imaging (MRI) scan. Methodology This prospective observational study was conducted among 14 males treated with prefunctional appliances for 3-6 months, followed by 6-9 months of fixed mechanotherapy. MRI scan was evaluated for changes in the TMJ at baseline after completion of prefunctional phase and after completion of functional appliance therapy. Results At pretreatment, there was a flat contour on the posterosuperior surface of the condyles and a notch-like projection on its anterior surface. After functional appliance therapy, slight convexity appeared on the posterosuperior surface of the condyle and the prominence of the notch was reduced. There was a statistically significant anterior shift of condyles both after prefunctional and twin block treatment. The meniscus on both sides had significantly shifted posteriorly over three stages with respect to the posterior condylar (PC) plane and Frankfort horizontal (FH) plane. The superior joint space had significantly increased with significant linear glenoid fossa displacement between pre and posttreatment stages. Conclusion Prefunctional orthodontics induced favorable changes in TMJ soft and hard tissues of patients, but they were not sufficient to place the soft and hard tissues in their normal positions. A functional appliance phase is needed to place the TMJ in their respective normal positions. How to cite this article Patel B, Kukreja MK, Gupta A, et al. Evaluation of Changes in Soft and Hard Tissues of TMJ among Class II Division 2 Patients after Prefunctional Orthodontics and Twin Block Functional Appliance Therapy: A Prospective MRI Study. Int J Clin Pediatr Dent 2022;15(5):479-488.
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Affiliation(s)
- Bhumika Patel
- Department of Orthodontics, Postgraduate Institute of Dental Sciences (Govt. Dental College and Hospital), Rohtak, Haryana, India
| | - Manisha Kamal Kukreja
- Department of Orthodontics and Dentofacial Orthopedics, Postgraduate Institute of Dental Sciences (Govt. Dental College and Hospital), Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Ambika Gupta
- Department of Oral Medicine and Radiology, Postgraduate Institute of Dental Sciences (Govt. Dental College and Hospital), Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
| | - Seema Rohilla
- Department of Radiology, Pandit Bhagwat Dayal Sharma University of Health Sciences, Rohtak, Haryana, India
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Three-Dimensional Evaluation of Condyle-Glenoid Fossa Complex Following Treatment with Herbst Appliance. J Clin Med 2021; 10:jcm10204730. [PMID: 34682852 PMCID: PMC8538158 DOI: 10.3390/jcm10204730] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 11/17/2022] Open
Abstract
The purpose of the present retrospective observational study was to compare the effects of treatment with Herbst appliance and fixed therapy with elastics on the condyle and glenoid fossa complex. Thirty patients aged between twelve and sixteen years with skeletal Class II malocclusion who met the inclusion criteria were included in the study: fifteen patients treated with Herbst appliance (Group 1), and fifteen patients treated with orthodontic camouflage using MBT prescription (MBTTM Versatile+ Appliance System) (Group 2). For Group 2, patients had CBCT scans taken before treatment either after Herbst appliance removal or at the end of treatment. CBCT scans were evaluated for changes in condyle-glenoid fossa complex using the In Vivo Dental 5.1 software. Statistical significance was set at p ≤ 0.05. On inter-group comparison, the Herbst group showed statistically significant increases in the condylar height of 1.35 mm (p ≤ 0.001) on the right and 1.21 mm (p ≤ 0.01) on the left side, and a condylar volume of 111.03 mm3 (p ≤ 0.01) on the right and 127.80 mm3 (p ≤ 0.001) on the left side. The Herbst group showed anterior remodelling on the postero-superior aspect of glenoid fossa. Herbst appliance treatment induced growth at the condylar head and anterior remodelling of glenoid fossa, thereby improving the maxilla-mandibular relationship in growing skeletal Class II patients.
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He Y, Zhang M, Song J, Warman ML. Cell depleted areas do not repopulate after diphtheria toxin-induced killing of mandibular cartilage chondrocytes. Osteoarthritis Cartilage 2021; 29:1474-1484. [PMID: 34166809 DOI: 10.1016/j.joca.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Revised: 06/04/2021] [Accepted: 06/13/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Growth of mandibular condylar cartilage (MCC) is associated with cell proliferation within the polymorphic cell layer and subsequent differentiation into chondrocytes that reside along the condylar surface and along the cartilage/subchondral bone interface. We examined whether cells in the polymorphic layer would proliferate and repopulate toxin-induced cell-depleted areas in MCCs of adult mice. METHOD We induced diphtheria toxin (DTA) expression (ROSA26l-s-lDTA) to cell-autonomously kill large fractions of MCC chondrocytes throughout the cartilage or along the articular cartilage surface with Aggrecan-CreERt2 (AcanCreERt2) or Lubricin-CreERt2 (Prg4CreERt2) Cre-recombinase-inducible mice, respectively. We examined MCCs from these mice shortly after cell killing or several months later with histology and confocal microscopy for evidence of chondrocyte proliferation and repopulation. RESULTS AcanCreERt2-induced DTA expression killed an average of 53% MCC chondrocytes in adult mice after 1 week (39-66%, 95% confidence interval (CI)). Twelve weeks later, surviving chondrocytes had proliferated but not migrated to cell depleted areas. Prg4CreERt2-induced DTA expression killed an average of 24% surface chondrocytes in mice after 5 weeks (14-34% CI). After thirteen weeks there was 34% fewer surface chondrocytes (4-63% CI) in Prg4CreERt2 DTA-induced mice compared to controls. CONCLUSION In adult mice, after diphtheria toxin-mediated chondrocyte killing, cell depleted areas within MCC cartilage are not repopulated by new cells.
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Affiliation(s)
- Y He
- Department of Orthodontics, Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Stomatological Hospital of Chongqing Medical University, Chongqing, China.
| | - M Zhang
- Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, Boston Children's Hospital and Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - J Song
- Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - M L Warman
- Orthopaedic Research Laboratories, Department of Orthopaedic Surgery, Boston Children's Hospital and Department of Genetics, Harvard Medical School, Boston, MA, USA.
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Effects of fixed functional appliances with temporary anchorage devices on Class II malocclusion: A systematic review and meta‑analysis. J World Fed Orthod 2021; 10:59-69. [PMID: 33785320 DOI: 10.1016/j.ejwf.2021.02.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/20/2021] [Accepted: 02/22/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND The use of fixed functional appliances (FFAs) in conjunction with temporary anchorage devices (TADs) has been proposed to enhance skeletal changes and reduce proclination of the lower incisors. OBJECTIVES To systematically investigate the skeletal and dentoalveolar effects of FFAs with TADs on Class II malocclusion in adolescents. METHODS Electronic searches of databases and manual searches of references were performed up to August 30, 2020. Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) focusing on adolescent patients treated with FFAs combining TADs were included. The modified Cochrane risk-of-bias tool (R.O.B 2.0) and ROBINS-I (Risk of Bias in Non-randomized Studies-of Interventions) Tool were used to assess the risk of bias in RCTs and CCTs, respectively. Meta-analyses of SNA, SNB, ANB, Co-Gn, SN-MP, the lower and upper incisor inclination changes were performed. Subgroup analyses and sensitivity analyses were conducted based on TAD types, FFA types, record types and types of study designs. RESULTS Ten studies were included with a sample size of 281. Meta-analyses revealed significant differences in the changes in SNB (mean difference [MD] 0.67; 95% confidence interval [CI] 0.04-1.29), ANB (MD -1.22, 95% CI -2.04 to -0.39), Co-Gn (MD 1.57; 95% CI 0.22-2.92), inclination of the lower incisors (MD -5.64, 95% CI -7.78 to -3.50)] and inclination of the upper incisors (MD -1.91; 95% CI -3.69 to -0.13). TAD types and FFA types seem to affect the treatment outcome. CONCLUSIONS Compared with FFAs alone, FFAs with TADs exhibit superior skeletal effects and reduce the inclination of the lower incisors in the short term; however, the evidence showed moderate to high risk of bias. Registration number CRD42020177611.
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Onimaru M, Takahashi M, Shimazaki A, Kimura H, Inou N, Maki K. Verification of mechanical load generated by functional orthodontic appliances. J Biomech 2020; 113:110079. [PMID: 33254058 DOI: 10.1016/j.jbiomech.2020.110079] [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: 01/27/2020] [Revised: 10/04/2020] [Accepted: 10/16/2020] [Indexed: 11/17/2022]
Abstract
Functional appliances are widely used for promoting mandibular growth by utilizing a construction bite position. We aimed to measure the mechanical load generated by movement of functional appliances and determine the factors influencing this load. Thirteen patients aged 8-12 years were selected for the study, and the load was measured using a previously developed measurement device. To investigate the factors affecting the load, the temporomandibular joint morphology and muscles related to the mandible were examined using cone-beam computed tomography. The standard regression coefficients of the factors affecting the load per millimeter of movement distance were 0.64 and 0.66 for (a) the inclination of the articular eminence and (b) the angle between occlusal plane and posterior temporalis, respectively. Measurement of the occlusal plane to the posterior temporalis and the inclination of the articular eminence were significantly different (p < 0.05). The angle of inclination of the articular eminence emerged as a strong influencing factor. Similarly, the influence of measurements from the occlusal plane to the posterior temporalis was considerable since the posterior temporalis muscle is the most active when the mandible is extended forward. We also found a possible relationship between the occlusal force and load at the construction bite position. To our knowledge, this is the first study to determine the actual load associated with the angle of the temporalis muscle to the occlusal plane, inclination angle of the articular eminence, angle between the occlusal plane and the Frankfort plane, and the angle between the geniohyoid muscle and the occlusal plane. Therefore, mechanical considerations need to be more accurate to facilitate safe orthodontic treatment.
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Affiliation(s)
- Minako Onimaru
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan.
| | - Masahiro Takahashi
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Aya Shimazaki
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Hitoshi Kimura
- Department of Engineering Design, Tamagawa University, Tokyo, Japan
| | - Norio Inou
- Organization for Fundamental Research Institute of Innovative Research, Tokyo Institute of Technology, Tokyo, Japan
| | - Koutaro Maki
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
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Vásquez-Cárdenas J, Zapata-Noreña Ó, Carvajal-Flórez Á, Barbosa-Liz DM, Giannakopoulos NN, Faggion CM. Systematic reviews in orthodontics: Impact of the PRISMA for Abstracts checklist on completeness of reporting. Am J Orthod Dentofacial Orthop 2019; 156:442-452.e12. [PMID: 31582116 DOI: 10.1016/j.ajodo.2019.05.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 05/01/2019] [Accepted: 05/01/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION This study evaluated and compared the completeness of reporting of abstracts of orthodontics systematic reviews before and after the publication of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for Abstracts Checklist (PRISMA-A). METHODS Abstracts of systematic reviews and meta-analyses in orthodontics published in PubMed, Latin American and Caribbean Health Sciences Literature, and the Cochrane Database of Systematic Reviews databases before March 23, 2018, that met the predefined inclusion and exclusion criteria, were evaluated using the 12 items of PRISMA-A, scoring each item from 0 to 2. Abstracts were classified into 2 groups: before and after publication of the PRISMA-A checklist. Three calibrated evaluators (intraclass correlation coefficient and kappa > 0.8) assessed the scores for compliance with the checklist. The number of authors, country of affiliation of the first author, performance of meta-analysis, and topic of the article were recorded. A regression analysis was performed to assess the associations between abstract characteristics and the PRISMA-A scores. RESULTS Of 1034 abstracts evaluated, 389 were included in the analysis. The mean PRISMA-A score was 53.39 (95% CI, 51.83-54.96). The overall score for studies published after the publication of the checklist was significantly higher than for studies published before (P ≤ 0.0001). The components returning significantly higher scores after publication of PRISMA-A were title (P = 0.024), information from databases (P = 0.026), risk of bias (P ≤ 0.0001), included studies (P ≤ 0.0001), synthesis of results (P ≤ 0.0001), interpretation of results (P = 0.035), financing and conflict of interest (P ≤ 0.0001), and registration (P ≤ 0.0001). These results showed the positive effect of PRISMA-A had on the quality of reporting of orthodontics systematic reviews. Nevertheless, the poor adherence revealed that there is still need for improvement in the quality of abstract reporting. CONCLUSIONS The quality of reporting of abstracts of orthodontic systematic reviews and meta-analyses increased after the introduction of PRISMA-A.
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Affiliation(s)
- Jenny Vásquez-Cárdenas
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Óscar Zapata-Noreña
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Álvaro Carvajal-Flórez
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia
| | - Diana María Barbosa-Liz
- Orthodontic Postgraduate Program, Gionorto Research Group, Faculty of Dentistry, University of Antioquia, Medellín, Colombia.
| | | | - Clovis Mariano Faggion
- Department of Periodontology and Operative Dentistry, Faculty of Dentistry, University of Münster, Münster, Germany
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Cheib Vilefort PL, Farah LO, Gontijo HP, Moro A, Ruellas ACDO, Cevidanes LHS, Nguyen T, Franchi L, McNamara JA, Souki BQ. Condyle-glenoid fossa relationship after Herbst appliance treatment during two stages of craniofacial skeletal maturation: A retrospective study. Orthod Craniofac Res 2019; 22:345-353. [PMID: 31419375 DOI: 10.1111/ocr.12338] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 08/08/2019] [Accepted: 08/10/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To perform a three-dimensional evaluation of the position of the condyles in patients treated with Herbst appliance (HA) in two stages of cervical vertebral maturation. SETTING AND SAMPLE POPULATION Retrospective case-control study. Pubertal Herbst group (PHG; n = 24, mean age 14.5 years, CS 3 and CS 4) and pre-pubertal Herbst group (PPHG; n = 17, mean age 9.9 years, CS 1 and CS 2) were contrasted with comparison groups of non-orthopaedically treated Class II patients in pubertal (PCG; n = 17, mean age 13.9 years) and pre-pubertal maturational stages (PPCG; n = 18, mean age 10.6 years). MATERIALS AND METHODS Cone-beam computer tomography scans were taken before treatment (T0) and at T1 after 8 to 12 months. Point-to-point measurements of the displacement of the condyles between T0 and T1, relative to the glenoid fossae, were performed in the X, Y, Z and 3D perspectives. Qualitative assessments using semi-transparent overlays and colour mapping also were produced. RESULTS The displacement of the condyles within the glenoid fossae in the treated groups was small (<0.75 mm; P > .05). Relative to the glenoid fossa, condylar position at T1 was similar to T0 in pre-pubertal and pubertal groups (P > .05). Similar condylar rotations from T0 to T1 were observed in Herbst and comparison groups, and no significant difference was found between pre-pubertal and pubertal patients. CONCLUSIONS Regardless the stage of skeletal maturation, HA treatment did not change the condyle-glenoid fossa relationship.
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Affiliation(s)
| | | | - Henrique Pársia Gontijo
- Graduate Program in Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - Alexandre Moro
- Graduate Program in Dentistry, University Positivo, Curitiba, Brazil
| | | | | | - Tung Nguyen
- Department of Orthodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC, USA
| | - Lorenzo Franchi
- School of Dentistry, University of Florence, Florence, Italy
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Bernardo Quiroga Souki
- Graduate Program in Dentistry, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
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Kyburz KS, Eliades T, Papageorgiou SN. What effect does functional appliance treatment have on the temporomandibular joint? A systematic review with meta-analysis. Prog Orthod 2019; 20:32. [PMID: 31402395 PMCID: PMC6689567 DOI: 10.1186/s40510-019-0286-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 07/24/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The aim of the current systematic review was to compare the radiologic effects of functional appliance Class II treatment compared to no treatment on the temporomandibular joint and its components. METHODS Nine databases were searched up to June 2019 for randomized or prospective non-randomized clinical trials comparing Class II patients treated with functional appliances to untreated patients. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane tool and the ROBINS-I tool, random effects meta-analyses of mean differences (MDs) and their 95% confidence intervals (CIs) were performed, followed by the assessment of the quality of evidence with GRADE. RESULTS A total of 11 papers on 8 unique trials with 377 patients (39.8% male; average age 10.3 years) were finally included. Limited evidence indicated that compared to untreated growing patients functional appliance treatment was associated with increased condylar width (2 studies; MD 1.1 mm; 95% CI 0.1 to 2.2 mm; very low evidence quality), decreased anterior joint space (2 studies; MD - 0.7 mm; 95% CI - 0.5 to - 0.9 mm; very low evidence quality), increased superior joint space (2 studies; MD 0.7 mm; 95% CI 0.5 to 1.0 mm; very low evidence quality), increased posterior joint space (2 studies; MD 1.0 mm; 95% CI 0.9 to 1.2 mm; very low evidence quality), and vertical displacement of the glenoid fossa (2 studies; MD 0.4 mm; 95% CI 0.1 to 0.7 mm; very low evidence quality). The main limitations affecting the validity of the present findings were the inclusion of non-randomized studies with methodological issues, imprecision due to limited samples of the included studies, and inconsistencies among studies. CONCLUSIONS Currently existing evidence from controlled clinical studies on humans indicates that functional appliance treatment is associated with positional and skeletal alterations of the temporomandibular joint in the short term compared to untreated controls. However, the clinical relevance of these changes remains unclear, while the quality of existing evidence is low due to methodological issues of existing studies. REVIEW REGISTRATION PROSPERO, CRD42018109271.
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Affiliation(s)
- Karma Shiba Kyburz
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, Switzerland
| | - Theodore Eliades
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, Switzerland
| | - Spyridon N. Papageorgiou
- Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, Zurich, Switzerland
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The Effect Evaluation of Functional Appliance Used for Class II Patients With Temporomandibular Joint Anterior Disc Displacement. J Craniofac Surg 2019; 30:e15-e17. [DOI: 10.1097/scs.0000000000004903] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Three-dimensional skeletal, dentoalveolar and temporomandibular joint changes produced by Twin Block functional appliance. J Orofac Orthop 2018; 79:245-258. [DOI: 10.1007/s00056-018-0137-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 02/26/2018] [Indexed: 12/20/2022]
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Souki BQ, Vilefort PLC, Oliveira DD, Andrade I, Ruellas AC, Yatabe MS, Nguyen T, Franchi L, McNamara JA, Cevidanes LHS. Three-dimensional skeletal mandibular changes associated with Herbst appliance treatment. Orthod Craniofac Res 2018; 20:111-118. [PMID: 28414870 DOI: 10.1111/ocr.12154] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Three-dimensional evaluation of skeletal mandibular changes following Herbst appliance treatment. SETTING AND SAMPLE POPULATION Retrospective case-control study, based on a sample size calculation. Twenty-five pubertal patients treated with Herbst appliance (HAG), and 25 matched Class II patients who received other non-orthopaedic dental treatments (CG). MATERIAL AND METHODS Three-dimensional models were generated from pre-treatment (T0) and post-treatment (T1) cone beam computed tomograms. Volumetric registration on the cranial base was used to assess mandibular displacement; volumetric regional registration was performed to evaluate mandibular growth. Quantitative measurements of X, Y, Z and 3D Euclidian changes, and also qualitative visualization by colour-mapping and semi-transparent overlays were obtained. RESULTS Downward displacement of the mandible was observed in both HAG and CG (2.4 mm and 1.5 mm, respectively). Significant forward displacement of the mandible was observed in the HAG (1.7 mm). HAG showed greater 3D superior and posterior condylar growth than the CG (3.5 mm and 2.0 mm, respectively). Greater posterior growth of the ramus was noted in the HAG than in CG. CONCLUSIONS Immediately after Herbst therapy, a significant mandibular forward displacement was achieved, due to increased bone remodelling of the condyles and rami compared to a comparison group. Three-dimensional changes in the direction and magnitude of condylar growth were observed in Herbst patients.
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Affiliation(s)
- B Q Souki
- Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - P L C Vilefort
- Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - D D Oliveira
- Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - I Andrade
- Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil
| | - A C Ruellas
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - T Nguyen
- University of North Carolina, Chapel Hill, NC, USA
| | - L Franchi
- University of Florence, Florence, Italy
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Comparison of Morphologic Parameters of Temporomandibular Joint for Asymptomatic Subjects Using the Two-Dimensional and Three-Dimensional Measuring Methods. JOURNAL OF HEALTHCARE ENGINEERING 2017; 2017:5680708. [PMID: 29065621 PMCID: PMC5434231 DOI: 10.1155/2017/5680708] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 04/04/2017] [Indexed: 11/18/2022]
Abstract
The differences of temporomandibular joint (TMJ) morphologic parameters by using two-dimensional (2D) and three-dimensional (3D) measuring methods were compared. Ten asymptomatic subjects (26.75 ± 4.89 years) were randomly recruited. The 3D models of the maxilla, mandible, and teeth were reconstructed according to cone-beam computed tomography (CBCT) image data. The morphologic parameters of TMJs were measured by the 2D CBCT measuring method (group A) and the 3D reconstruction model measuring method (group B), respectively. The morphologic parameters in each group were assessed by paired samples t-test, and the statistical significance was achieved when p < 0.05. The horizontal condylar angle (HCA), sagittal ramus angle (SRA), medial joint space (MJS), lateral joint space (LJS), superior joint space (SJS), and anterior joint space (AJS) in group A were significantly smaller than those in group B (p < 0.05). The HCA on the left side was significantly smaller than that on the right side in group A (p < 0.05). However, all the morphologic parameters in group B were not significantly different between left and right sides. In conclusion, there were significant differences for the morphologic parameters of TMJ measured on 2D CBCT and 3D models. 3D measuring method should be used for the detection of TMJ morphology in clinical practice.
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Donovan TE, Marzola R, Murphy KR, Cagna DR, Eichmiller F, McKee JR, Metz JE, Albouy JP. Annual review of selected scientific literature: Report of the committee on scientific investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2016; 116:663-740. [PMID: 28236412 DOI: 10.1016/j.prosdent.2016.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 09/08/2016] [Accepted: 09/08/2016] [Indexed: 02/07/2023]
Abstract
STATEMENT OF PROBLEM It is clear the contemporary dentist is confronted with a blizzard of information regarding materials and techniques from journal articles, advertisements, newsletters, the internet, and continuing education events. While some of that information is sound and helpful, much of it is misleading at best. PURPOSE This review identifies and discusses the most important scientific findings regarding outcomes of dental treatment to assist the practitioner in making evidence-based choices. This review was conducted to assist the busy dentist in keeping abreast of the latest scientific information regarding the clinical practice of dentistry. MATERIAL AND METHODS Each of the authors, who are considered experts in their disciplines, was asked to peruse the scientific literature published in 2015 in their discipline and review the articles for important information that may have an impact on treatment decisions. Comments on experimental methodology, statistical evaluation, and overall validity of the conclusions are included in many of the reviews. RESULTS The reviews are not meant to stand alone but are intended to inform the interested reader about what has been discovered in the past year. The readers are then invited to go to the source if they wish more detail. CONCLUSIONS Analysis of the scientific literature published in 2015 is divided into 7 sections, dental materials, periodontics, prosthodontics, occlusion and temporomandibular disorders, sleep-disordered breathing, cariology, and implant dentistry.
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Affiliation(s)
- Terence E Donovan
- Professor, Biomaterials, University of North Carolina School of Dentistry, Chapel Hill, N.C.
| | | | | | - David R Cagna
- Professor, Advanced Prosthodontics University of Tennessee Health Sciences Center, Memphis, Tenn
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