Effectiveness of the passive lingual arch for E space maintenance in subjects with anterior or posterior rotation of the mandible: a retrospective study

Effect of Lingual Arch Space Maintainer on the Position of Mandibular Molars and Incisors in the Vertical Direction during the Resolution of Mandibular Incisors Crowding: A Systematic Review of Clinical Trials in Humans

Introduction

This systematic review was designed to define and measure the changes in the position of mandibular molars and incisors in the vertical direction while using a lingual arch appliance as a space maintainer.

Materials and methods

The source of data collection used was PubMed, Medline, Cochrane Central, and Cochrane Database of Systematic Reviews for articles published until March 2021.

Inclusion criteria

Studies on human subjects in the English language using either prospective or retrospective methods considering the effect of the lingual arch used as a space maintainer in the mandibular arch.

Results

Four out of 465 studies acknowledged in the literature search met the final inclusion criteria.

Conclusion

A lingual arch is an effective appliance for controlling the position of mandibular molars and incisors in the vertical direction.

How to cite this article

Ahuja V, Thosar NR, Shrivastav S, et al. Effect of Lingual Arch Space Maintainer on the Position of Mandibular Molars and Incisors in the Vertical Direction during the Resolution of Mandibular Incisors Crowding: A Systematic Review of Clinical Trials in Humans. Int J Clin Pediatr Dent 2021;14(S-1):S76–S81.

Clinical effectiveness of space maintainers and space regainers in the mixed dentition: A systematic review

Background

The aim of this systematic review was to address the clinical effectiveness of space maintainers and space regainers in the prevention and correction of dental arch decreases in mixed dentition.

Methods

An electronic search was conducted using five databases: the Cochrane Database for Systematic Reviews, EBSCO Host, ScienceDirect, PubMed, and Scopus (until February 2021) and 6 relevant journals. Inclusion criteria were: Randomized Controlled Clinical Trials (RCTs), Controlled Clinical Trials (CCTs), cohort studies and case-control studies of children in the mixed dentition requiring a space maintainer or a space regainer, children with mild to moderate crowding, and with Class I and mild Class II or Class III skeletal pattern. All articles included in this review were examined independently by three teams of investigators to assess the level of bias using the Cochrane risk of bias tools RoB 2.0 (for RCTs) and ROBINS-I (for non-RCTs).

Results

Following the three phases of a systematic search, 11 studies were included for the final analysis, of which nine used space maintainers (a lower lingual arch) and two used space regainers (one lip bumper and one transpalatal arch) with contradicting results. Four of the former and one of the latter devices showed a significant increase in arch length. Out of the 11 articles, one was found to be of critical risk, two of serious risk and eight of moderate risk of bias.

Conclusions

There is very low evidence to suggest that space maintainers and regainers are effective in preserving arch length and preventing mild to moderate crowding in children during the mixed dentition stage at the expense of lower incisor proclination. However, considering the low evidence provided by this systematic review, high-quality studies are needed.

Comparison of bone thickness in infrazygomatic crest area at various miniscrew insertion angles in Dravidian population - A cone beam computed tomography study

INTRODUCTION

Infrazygomatic crest miniscrews are an important advancement in the field of orthodontics for anchorage reinforcement. The size of the miniscrews and the site of placement depend on the bone thickness in the infazygomatic crest area. The bone morphology and the thickness vary among different ethnicities of population.

OBJECTIVES

To assess the bone thickness in the infrazygomatic crest area around the distobuccal root of the maxillary first molar using cone beam computed tomography and determine the best possible site and angulation for the placement of the miniscrew. Therefore, to determine the size of the implant that will suit the Dravidian population.

METHODS

The infrazygomatic crest bone thickness was evaluated on 10 patients using cone beam computed tomography. The measurements were made along the distobuccal root of maxillary first molar at different angulations ranging from 75° to 40° to the occlusal surface of the molar.

RESULTS

The infrazygomatic crest bone thickness was of 4.5mm to 9mm for the Dravidian population, when measured at an angle of 40° to 75° to the maxillary first molar occlusal plane and of 11 to 17mm above the occlusal plane. Student t-test (confidence interval 95%) was done to determine gender variation and compare the bone thickness of right and left side. ANOVA and post-hoc test were done to find the statistical difference between the bone thickness measured at different insertion angles.

CONCLUSIONS

The best possible site for miniscrew insertion is 12 to 17mm above the occlusal plane at an angle of 65° to 70°, with no injury to the adjacent anatomical structures, no mucosal irritation and adequate stability for the miniscrew. The ideal infrazygomatic crest screw length for Dravidian population is 9 to 11mm.

Evaluation of Skeletal and Dental Effects of Lower Lingual Arches

OBJECTIVE

A lower lingual arch is usually recommended as a holding device to maintain arch length and to prevent mesial migration of the mandibular first molars. Despite its widespread use, comparatively little is known about the effects of a lower lingual holding arch on preservation of lower arch dimensions and tooth position and the impact of the device on mandibular growth. The aim of this study is to evaluate the skeletal and dental effects of the lower lingual holding arch with regard to arch dimension, positions of mandibular molars and incisors, and usual mandibular growth.

STUDY DESIGN

Thirty-four children (18 males and 16 females) who needed space maintainers were included in the present study. The patients were divided into two groups according to whether they were missing second primary molars on one or both sides. Group I comprised 16 children (8 males and 8 females, average age 8.8 ± 0.9 years) with a missing second primary molar on one side; Group II comprised 18 children (10 males and 8 females, average age 8 ± 0.7 years) with extractions on both sides. Lateral cephalograms, dental pantomograms, and study casts of the patients were taken at the beginning and the end of the study period. Average treatment time was 20.4 ± 4 months.

RESULTS

Lower incisors moved forward and Incisor Mandibular Plane Angle (IMPA°) increased in both treatment groups. Statistically significant differences between the groups were found when comparing pre-treatment and post-treatment arch dimension and position of mandibular molars. Results were better for lingual arches with extraction on one side than with extraction on both sides Conclusions: A lingual arch seems to be an effective tool for maintaining arch length, and was not found to impair mandibular growth.