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Dora H, Shaikh MA, Gupta S, Maqhbool SB, Shamsuddin S, Kokate SR. En masse retraction of anterior teeth through rapid periodontal distraction by a retraction screw: A randomized control trial. J World Fed Orthod 2024; 13:113-122. [PMID: 38508997 DOI: 10.1016/j.ejwf.2024.01.004] [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: 12/09/2023] [Revised: 01/18/2024] [Accepted: 01/19/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Rapid distraction of the periodontal ligament is an effective method to shorten the orthodontic treatment time. The objectives of the present study were to assess the effects of an HYCON device (Adenta GmbH, Germany) on the rate of en masse retraction of the anterior teeth, duration of retraction, anchorage loss, root resorption, and soft tissue changes. METHODS This study was conducted on 60 female patients aged >18 years, divided randomly into two equal groups: Group 1 comprised 30 patients with HYCON, and group 2 comprised 30 patients with nickel-titanium closed coil springs. Skeletal, dental, and soft tissue changes were evaluated on pre- and post-retraction lateral cephalograms, and the rates of anterior tooth movement and anchorage loss were assessed monthly on the dental casts of the patients. Root resorption was assessed using intraoral periapical radiograph. Student's t test was used for the analysis of parametric data, and the Mann-Whitney U test was used for nonparametric data. RESULTS HYCON significantly shortened the retraction duration by 3 months. The rate of anterior teeth retraction was two times faster in group 1, compared with group 2. There was a significant difference in the anchorage loss between the groups in only first 2 months of treatment. Group 2 showed significantly more root resorption and soft tissue changes than group 1 (P < 0.05). CONCLUSIONS HYCON is an effective device for significantly shortening the duration of retraction with anchorage loss of 2 to 2.5 mm. However, careful monitoring for possible root resorption should be performed.
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Affiliation(s)
- Hibu Dora
- Dr Dora's Dental Clinic and Orthodontic Centre, A-Sector, Naharlagun, Papumpere, Arunachal Pradesh, India
| | | | - Seema Gupta
- Department of Orthodontics, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India.
| | | | - Salim Shamsuddin
- Department of Orthodontics, Oxford Dental College, Bangalore, Karnataka, India
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Mohan K, Sivarajan S, Lau MN, Othman SA, Fayed MMS. Soft tissue changes with skeletal anchorage in comparison to conventional anchorage protocols in the treatment of bimaxillary proclination patients treated with premolar extraction : A systematic review. J Orofac Orthop 2024; 85:146-162. [PMID: 35829730 DOI: 10.1007/s00056-022-00411-9] [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: 09/21/2021] [Accepted: 05/29/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE This review systematically evaluates the evidence related to comparisons between skeletal and conventional anchorage protocols in the treatment of bimaxillary proclination patients who underwent premolars extraction with respect to soft tissue profile changes, treatment duration and three-dimensional (3D) soft tissue changes. METHODS Electronic database search and hand search with no language limitations were conducted in the Cochrane Library, PubMed, Ovid, Web of Science, Scopus and ClinicalTrials.gov. The selection criteria were set to include studies with patients aged 13 years and above requiring extractions of upper and lower first premolars to treat bimaxillary proclination with high anchorage demand. Risk of bias assessment was undertaken with Cochrane's Risk Of Bias tool 2.0 (ROB 2.0) for randomised controlled trials (RCTs) and ROBINS‑I tool for nonrandomised prospective studies. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used for quality assessment. Results were summarised qualitatively; no meta-analysis was conducted. RESULTS Two RCTs and two nonrandomised prospective studies were included. According to the GRADE approach, there is low to very low quality of evidence that treatment using mini-implant anchorage may significantly change nasolabial angle, upper and lower lip procumbence, and facial convexity angle compared to treatment with conventional anchorage. Similarly, very low quality evidence exists showing no differences in treatment duration between treatments with skeletal or conventional anchorage. CONCLUSIONS The overall existing evidence regarding the effect of anchorage protocols on soft tissue changes in patients with bimaxillary protrusion and premolar extraction treatment plans is of low quality. TRIAL REGISTRATION NUMBER PROSPERO CRD42020216684.
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Affiliation(s)
- Kumeran Mohan
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, 50603, Lembah Pantai, Kuala Lumpur, Malaysia
- Department of Orthodontics, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan, Malaysia
| | - Saritha Sivarajan
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, 50603, Lembah Pantai, Kuala Lumpur, Malaysia.
| | - May Nak Lau
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, 50603, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Siti Adibah Othman
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, 50603, Lembah Pantai, Kuala Lumpur, Malaysia
| | - Mona M Salah Fayed
- Department of Orthodontics, Faculty of Dentistry, Cairo University, Cairo, Egypt
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Hsin-Chung Cheng J, De-Shing Chen D, Tan Y, Hu HT. Factors associated with usage frequency and pricing of temporary anchorage devices among orthodontists. J Dent Sci 2024; 19:404-410. [PMID: 38303874 PMCID: PMC10829646 DOI: 10.1016/j.jds.2023.07.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/28/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose Temporary anchorage devices (TADs) are widely used in contemporary orthodontic treatments for anchorage purposes. This research aimed to investigate orthodontists' attitude toward temporary anchorage devices (TADs) by surveying their TAD usage frequency and pricing and to identify factors influencing TAD usage frequency and pricing. Materials and methods A structured, self-administered questionnaire with a total of 26 questions was randomly distributed to members of the Taiwanese Association of Orthodontics at the annual orthodontic meeting. The questionnaire comprised 6 questions on demographics, 10 questions on work patterns and patient type, and 10 questions on orthodontic technique. Responses were analyzed using a Pearson chi-Square test to identify factors of interest. Results Factors associated with TAD usage frequency included degree of income satisfaction, number of working hours per week, and proportion of extraction-based treatments in treatment plans. Factors associated with TAD pricing included orthodontist age, geographic region of practice, and adult treatment fee. Conclusion More Taiwanese orthodontists use TADs compared with orthodontists in other countries. TADs have become universally accepted, but practitioners use them selectively. The main factor influencing TAD usage frequency was the proportion of extraction-based treatments in treatment plans, and those influencing TAD were orthodontist age, geographic region of practice, and adult treatment fee. These findings may be applicable to other parts of the world and should be investigated at an international level.
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Affiliation(s)
- Johnson Hsin-Chung Cheng
- Orthodontic Division, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Daniel De-Shing Chen
- Orthodontic Division, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
| | - Yawen Tan
- Orthodontic Division, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hao-Ting Hu
- Orthodontic Division, Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
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Sinha SP, Bajracharya M, Huang CS, Ko EWC. Does the floor of the maxillary sinus affect tooth movement for premolar extraction space closure? Clin Oral Investig 2023; 27:299-304. [PMID: 36104604 DOI: 10.1007/s00784-022-04723-3] [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: 02/14/2022] [Accepted: 09/06/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE The study investigated orthodontic tooth movement by comparing various horizontal and angular measures of the teeth having different sinus-root relationship (SRR) of patients undergoing first premolar extraction treatment protocols. MATERIALS AND METHODS This retrospective cross-sectional study included 45 Taiwanese adult patients, classified as the control group (n = 15) and the sinus group (n = 30) according to SRR. The control group had type I SRR (sinus floor above the level connecting the buccal and palatal root apices), whereas the sinus group included patients with type V SRR (the buccal and palatal root displayed apical protrusion into the sinus floor). Morphology was identified using pretreatment orthopantomograms. Lateral cephalometric measurements were conducted before treatment (T1) and at debonding (T2). RESULTS Post debonding, there were no statistically significant difference in the two groups. However, the incisors in the control group became marginally more upright than those of the sinus group, and the molars demonstrated tipping movement with minimal anchorage loss in the sinus group than in the control group. The total treatment time was not significantly different between the 2 groups. CONCLUSION The study revealed that the sinus-root relationship does not affect the orthodontic tooth movement. However, a more extensive 3-D study with larger sample size is strongly recommended before coming to any conclusion. CLINICAL RELEVANCE The lining of the floor of the maxillary sinus does not affect the orthodontic tooth movement.
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Affiliation(s)
- Suraj Prasad Sinha
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Manish Bajracharya
- Dental Department, Orthodontic Unit, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal
| | - Chiung-Shing Huang
- Graduate Institute of Craniofacial and Dental Science, Chang Gung University, Taoyuan, Taiwan.,Department of Craniofacial Orthodontic, Chang Gung Memorial Hospital, 6F, 199, Tung Hwa North Road, Taipei, 105, Taiwan
| | - Ellen Wen-Ching Ko
- Graduate Institute of Craniofacial and Dental Science, Chang Gung University, Taoyuan, Taiwan. .,Department of Craniofacial Orthodontic, Chang Gung Memorial Hospital, 6F, 199, Tung Hwa North Road, Taipei, 105, Taiwan. .,Department of Dentistry, Chang Gung Memorial Hospital, Linkous, Taiwan.
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3D Finite Element Study of the Physiological Anchorage Control Concept on Anchorage Molars in Lingual Orthodontics. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:1421586. [DOI: 10.1155/2022/1421586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 10/18/2022] [Accepted: 10/26/2022] [Indexed: 11/23/2022]
Abstract
Objective. To study the effect of the physiological anchorage control concept on anchorage molars in lingual and labial orthodontic techniques. Methods. Three-dimensional finite element models, including the right maxillary first molar, periodontal ligament, alveolar bone, and buccal tube, were established. The models were divided into the McLaughlin–Bennett–Trevisi (MBT™) straight-wire model with 0-degree maxillary first molar axial inclination and the physiologic anchorage Speewire system (PASS) model with −7-degree maxillary first molar axial inclination. Simulated sliding retraction forces (1 N, 1.5 N, and 2 N) were loaded on the buccal side and lingual side, and retraction forces (0.5 N, 0.75 N, and 1 N) were loaded on the buccal and lingual sides simultaneously. The displacements, principal stresses, and von Mises stresses of the periodontal ligament under different conditions were derived. Results. The anchorage molars showed different degrees of rotation, tipping, intrusion, and extrusion. As the force increased, these displacement trends also increased. The mesial displacement of the buccal + lingual force loading was less than that of the other two groups. Under the same force load method, the mesial displacement of the PASS group was less than that of the MBT group. Tilt movement increases the tensile stress of the distal cervical margin and root mesial apical third and the compressive stress of the mesial cervical margin and root distal apical third. The maximum stress of the periodontal ligament was less than that of the other two groups when the lingual force was loaded. Conclusion. The physiological anchorage control concept in lingual orthodontics provides better sagittal anchorage control than in labial orthodontics, but there is no significant difference numerically. Attention should be given to the control of torsion, torque, and arch width. Tilt movement increases the PDL stress of the cervical margin and root apical third. The sliding retraction force should be loaded lingually to maintain the force value of 1∼1.5 N.
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Gupta P, Bhagyalakshmi A, Avinash BS, Prashant A, Raghunath N. Evaluation of injectable platelet-rich fibrin effect on the rate of canine retraction and alkaline phosphatase levels: An in-vivo study. Am J Orthod Dentofacial Orthop 2022; 162:735-743. [PMID: 36008239 DOI: 10.1016/j.ajodo.2021.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 07/01/2021] [Accepted: 07/01/2021] [Indexed: 11/17/2022]
Abstract
INTRODUCTION With time, the treatment protocol has changed, and currently, there is a new school of treatment called accelerated orthodontics, wherein the goal is to shorten the time. In this study, a liquid formulation of platelet-rich fibrin such as injectable platelet-rich fibrin (i-PRF), was used, and its effect on the rate of canine retraction and the crevicular alkaline phosphatase (ALP) levels were studied. METHODS Thirteen patients were recruited for this study with a mean age of 20.6 ± 3.2 years. A split-mouth type of study design was used in which the maxillary arch of each subject was divided into an experimental and control group. I-PRF was injected in the labial and lingual attached gingiva of the canine in the experimental group. The gingival crevicular fluid collection was done from the distal aspect of the canine before canine retraction, 24 hours after retraction, and 28 days after retraction from both sites (ie, control and experimental sites). ALP activity was analyzed using a semiautomated analyzer, and the rate of canine retraction was measured on stone casts with the help of a digital vernier caliper. RESULTS The individual canine retraction was 1.8-fold faster in the i-PRF group than in the control group. The ALP activity was significantly greater at 24 hrs and 28 days after retraction in the experimental group. CONCLUSIONS These results suggest that i-PRF is an innovative, noninvasive approach to accelerating tooth movement. ALP activity in gingival crevicular fluid reflects the biological changes in the periodontium, and the steep increase in the activity indicates increased bone remodeling within the experimental group.
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Affiliation(s)
- Paridhi Gupta
- Department of Orthodontics and Dentofacial Orthopaedics, JSS Dental College and Hospital, Mysore, Karnataka, India.
| | - A Bhagyalakshmi
- Department of Orthodontics and Dentofacial Orthopaedics, JSS Dental College and Hospital, Mysore, Karnataka, India
| | - B S Avinash
- Department of Periodontology, JSS Dental College and Hospital, Mysore, Karnataka, India
| | - Akila Prashant
- Department of Biochemistry, JSS Medical College and Hospital, Mysore, Karnataka, India
| | - N Raghunath
- Department of Orthodontics and Dentofacial Orthopaedics, JSS Dental College and Hospital, Mysore, Karnataka, India
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Su H, Xu K, Han B, Chen G, Xu T. A retrospective study of factors contributing to anchorage loss in upper premolar extraction cases. Niger J Clin Pract 2022; 25:664-669. [PMID: 35593610 DOI: 10.4103/njcp.njcp_1791_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Anchorage control is one of the components in the treatment of extraction cases. However, what determines more or less anchorage loss is still an unanswered question. Aim: The purpose of this study was to investigate the most important factors contributing to the anchorage loss of maxillary first molars in premolar extraction cases. Materials and Methods The study included 726 upper premolar extraction cases, including 214 male patients and 512 female patients, and the mean age was 14.4 ± 4.5 years old (range: 9-45). Factors including physiological characteristics, treatment mechanics, and cephalometric variables were collected and their influences on the angulation changes of maxillary first molars were analyzed. Results The mean angulation change of maxillary first molar after treatment was 2.81°(mesial tipping). The change of UM/PP showed a statistically significant difference in different sex (male 3.84° ± 5.26° vs female 2.38° ± 5.10°), age (adult -0.05° ± 4.73° vs teenager 3.46° ± 5.07°), and molar relationship (Class II 3.28° ± 5.15° vs Class I 2.36° ± 5.19°). There are six variables accounted in the regression analysis (R = 0.608, R2 = 37.0%). Among them, the pre-treatment molar tipping (Standardized Coefficients: -0.65) and the pre-treatment incisor/molar height ratio (Standardized Coefficients: -0.27) were the most important factors influencing anchorage loss during treatment. Conclusion Compared with treatment-related factors, the patient's physiological characteristics play a more important role in anchorage loss. The pre-treatment angulation of the maxillary first molar is the most influential factor in changes to maxillary molar angulation, which are often predisposing anchorage loss.
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Affiliation(s)
- H Su
- First Clinical Division, Peking University School and Hospital of Stomatology, Beijing 100034; National Center of Stomatology and National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing, China
| | - K Xu
- Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, USA
| | - B Han
- Department of Orthodontics, Peking University School and Hospital of Stomatology; National Center of Stomatology and National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing, China
| | - G Chen
- Department of Orthodontics, Peking University School and Hospital of Stomatology; National Center of Stomatology and National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing, China
| | - T Xu
- Department of Orthodontics, Peking University School and Hospital of Stomatology; National Center of Stomatology and National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing, China
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Yassir YA, Nabbat SA, McIntyre GT, Bearn DR. Which anchorage device is the best during retraction of anterior teeth? An overview of systematic reviews. Korean J Orthod 2022; 52:220-235. [PMID: 35418518 PMCID: PMC9117787 DOI: 10.4041/kjod21.153] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 10/07/2021] [Accepted: 11/17/2021] [Indexed: 12/04/2022] Open
Abstract
Objective To evaluate the available evidence regarding the clinical effectiveness of different types of anchorage devices. Methods A comprehensive literature search of different electronic databases was conducted for systematic reviews investigating different anchorage methods published up to April 15, 2021. Any ongoing systematic reviews were searched using PROSPERO, and a grey literature search was undertaken using Google Scholar and OpenGrey. No language restriction was applied. Screening, quality assessment, and data extraction were performed independently by two authors. Information was categorized and narratively synthesized for the key findings from moderate- and high-quality reviews. Results Fourteen systematic reviews were included (11 were of moderate/high quality). Skeletal anchorage with miniscrews was associated with less anchorage loss (and sometimes with anchorage gain). Similarly, skeletal anchorage was more effective in retracting anterior teeth and intruding incisors and molars, resulting in minor vertical skeletal changes and improvements in the soft tissue profile. However, insufficient evidence was obtained for the preference of any anchorage method in terms of the duration of treatment, number of appointments, quality of treatment, patient perception, or adverse effects. The effectiveness of skeletal anchorage can be enhanced when directly loaded, used in the mandible rather than the maxilla, used buccally rather than palatally, using dual rather than single miniscrews, used for en-masse retraction, and in adults. Conclusions The level of evidence regarding anchorage effectiveness is moderate. Nevertheless, compared to conventional anchorage, skeletal anchorage can be used with more anchorage preservation. Further high-quality randomized clinical trials are required to confirm these findings.
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Affiliation(s)
- Yassir A Yassir
- Orthodontic Department, College of Dentistry, University of Baghdad, Baghdad, Iraq.,School of Dentistry, University of Dundee, Dundee, UK
| | | | | | - David R Bearn
- School of Dentistry, University of Dundee, Dundee, UK
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Harikrishnan S, Ramasamy N. Effect of local administration of bisphosphonate on orthodontic anchorage – A systematic review of animal studies. J Orthod Sci 2022; 11:31. [PMID: 36188196 PMCID: PMC9515565 DOI: 10.4103/jos.jos_189_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 06/03/2022] [Accepted: 06/06/2022] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND: Pharmacological means of anchorage control can improve patient compliance. Bisphosphonates could be helpful in orthodontic anchorage control if their actions could be localized to limit (or control) unwanted tooth movement while not interfering with the desired tooth movement. OBJECTIVE: This systematic review aimed to examine and evaluate the quality of all animal studies that reported the effect of locally administered bisphosphonate on limiting orthodontic tooth movement. DATA SOURCES: An electronic search was conducted in the PubMed-Medline, Scopus, Google Scholar, and Cochrane databases till May 2022, using the keywords anchorage, anchorage loss, molar movement, posterior tooth movement, incisor movement, incisor retraction, anterior retraction, unwanted tooth movement, tooth displacement, tooth movement forward, bisphosphonate, local bisphosphonate administration, bisphosphonate injection, and bbisphosphonate vestibular induction. Only studies involving localized bisphosphonate administration for anchorage purposes were taken into account. DATA SELECTION: Animal studies that simulated orthodontic tooth movement after localized injection of bisphosphonate and evaluated the rate of tooth movement were included in the review. DATA EXTRACTION AND ANALYSIS: The quality of the studies was assessed by using ARRIVE guidelines (Animal Research: Reporting of In Vivo Experiments). Bias in the studies was analyzed by SYRCLE's tool (Systematic Review Centre for Laboratory Animal Experimentation) for risk of bias. RESULTS: The search strategy yielded 925 titles. After screening, 908 articles were discarded because they did not fulfill the inclusion/exclusion criteria based on the title and abstract. The remaining 16 articles were read entirely, of which nine were excluded as they involved systemic administration of bisphosphonates. Finally, after careful consideration, seven papers that met our inclusion criteria were included in the qualitative analysis. The majority of studies were assessed to have an uncertain risk of bias, with just one deemed low risk of bias. CONCLUSION: This systematic review found that bisphosphonates limit orthodontic tooth movement around the application site without affecting adjacent sites. More potent bisphosphonates in smaller doses or less potent bisphosphonates in higher frequencies have been proposed to improve outcomes. However, the data quality is insufficient to recommend a protocol for bisphosphonate administration for anchoring control. Long-term studies evaluating various types, frequencies, and dosages of bisphosphonates are required to clarify the effects on orthodontic tooth movement. REGISTRATION NUMBER FOR PROSPERO: CRD42021224033
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Bano N, M SK, Shivamurthy PG, Sabrish S, Mathew S. Comparison of the effectiveness of butterfly arch versus transpalatal arch in anchorage reinforcement: A linear 3D finite element study. J Dent Res Dent Clin Dent Prospects 2022; 16:101-106. [PMID: 36561379 PMCID: PMC9763661 DOI: 10.34172/joddd.2022.017] [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: 10/21/2021] [Accepted: 02/12/2022] [Indexed: 11/08/2022] Open
Abstract
Background. Although there are various intraoral and extraoral appliances for anchorage management in orthodontics, most fail to preserve the anchorage efficiently. Thus, there is a need for an appliance that can preserve anchorage in the sagittal, vertical, and transverse directions with good patience compliance and cost-effectiveness. This study compared the efficacy of butterfly arch and transpalatal arch (TPA) as an anchorage reinforcing unit during orthodontic space closure using a linear finite element model. Methods. A 3D model of the maxilla and associated structures was developed from CT images of an individual's skull at a slice thickness of 1 mm. The magnitude of movements of anchor teeth in vertical, horizontal, and transverse directions was calculated in first premolar extraction cases during anterior retraction using a linear finite element model analysis and compared in two situations-butterfly arch and TPA attached to maxillary first molar for anchorage. Results. The anterior teeth had similar movements in the case of TPA and butterfly arch. There was more mesial and lingual movement in the first molars with TPA than in the butterfly arch, which had buccal but no mesial movement. The anterior teeth showed extrusion and the second premolars showed intrusion with TPA. Also, the von Mises stress and maximum principal stress were maximum with TPA at the cervical region of anterior and posterior teeth compared to the butterfly arch, where both stresses were uniformly distributed all over the teeth. Conclusion. A butterfly arch with its unique design, configuration, and biomechanical properties can be used as a device that can maintain the posterior anchorage efficiently.
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Effects of Palatal Expansion with Torque Activation using a Transpalatal Arch: A Preliminary Single-Blind Randomized Clinical Trial. Int J Dent 2021; 2021:8883254. [PMID: 34122551 PMCID: PMC8189803 DOI: 10.1155/2021/8883254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 05/19/2021] [Accepted: 05/28/2021] [Indexed: 11/18/2022] Open
Abstract
Purpose The literature regarding the treatment of posterior crossbites using a transpalatal arch (TPA) is scarce. Moreover, there is only one clinical study on the correction of unilateral crossbites using torque activation. This is an important clinical issue; therefore, this study was conducted to show the effects of an active Goshgarian TPA in correcting nonfunctional single-tooth unilateral crossbite. Methods The present single-blind, randomized clinical trial examined 60 observations on 30 individuals with nonfunctional single-tooth unilateral crossbites in the first permanent molar area. Patients were randomly divided into two groups of "symmetric expansion" [control] and "expansion + torque activation" using Goshgarian TPAs [experimental]. The palatal arch was expanded at a rate of 2 mm/month, for 2-8 months. The average treatment durations were 157.9 and 117.1 days, respectively, for the control and experimental groups. Dentoskeletal alterations were assessed on dental records, posteroanterior frontal cephalographs, and occlusal radiographs taken before and after treatment. Changes induced by treatments in each group and differences between changes in both groups were analyzed statistically (α = 0.05). Results The treatment duration was significantly shorter in the experimental group (P < 0.05). The extent of dental displacement on the crossbite side was significant no matter what treatment was applied (P < 0.001); no between-group difference was detected (P > 0.05). Both treatments tilted the teeth in crossbite (P < 0.001) without any between-group difference (P > 0.05). The noncrossbite molar was displaced in the control group, whereas this did not occur in the experimental group (between-group P < 0.001). Conclusions The Goshgarian TPA can be used with torque activation in order to deliver a more effective and faster correction of nonfunctional single-tooth unilateral crossbites with more favorable clinical results.
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Biomechanical analysis for total mesialization of the maxillary dentition: A finite element study. Am J Orthod Dentofacial Orthop 2021; 159:790-798. [DOI: 10.1016/j.ajodo.2020.02.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 01/01/2020] [Accepted: 02/01/2020] [Indexed: 12/26/2022]
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Bowman SJ. Reprint of: Uno, dos, tres: One concept for three angle classes. Semin Orthod 2021. [DOI: 10.1053/j.sodo.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Abbassy MA, Mitwally RA. Atypical extraction in Class I malocclusion: A case report. J Orthod Sci 2020; 9:9. [PMID: 33110768 PMCID: PMC7585465 DOI: 10.4103/jos.jos_1_20] [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: 01/01/2020] [Revised: 05/12/2020] [Accepted: 05/16/2020] [Indexed: 11/30/2022] Open
Abstract
The treatment of Angle Class I malocclusion by atypical extraction is rather challenging. The extraction of four first premolars often manages it. However, in cases of compromised and non-restorable teeth, the extraction decision may be altered, making the anchorage and the treatment mechanics more challenging. This article reports the clinical case of a 16-year-old patient from Sudan who presented with a chief complaint “My teeth are crooked and sticking out.” He had Angle Class I malocclusion with a bimaxillary dentoalveolar protrusion. He had severe crowding in both arches and localized marginal gingivitis related to an ectopically erupted upper right canine (UR3) and lower right first premolar (LR4). The patient had a provisional restoration in the lower right first molar (LR6). Extraction of three first premolars and one first molar was the alternative of choice for this treatment, which restored function, providing improved periodontal health, achieved the desired facial esthetics, and allowed finishing with a stable and balanced occlusion. Management of angle class I malocclusion with atypical extraction patterns should be performed with careful mechanics and anchorage planning to obtain good results.
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Affiliation(s)
- Mona A Abbassy
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Alexandria University, Alexandria, Egypt
| | - Rania A Mitwally
- Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Orthodontic, North Dental Specialty Center, Ministry of Health, Jeddah, Saudi Arabia
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15
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Tian H, Xie C, Lin M, Yang H, Ren A. Effectiveness of orthodontic temporary anchorage devices in canine retraction and anchorage preservation during the two-step technique: a systematic review and meta-analysis. BMC Oral Health 2020; 20:278. [PMID: 33036593 PMCID: PMC7547464 DOI: 10.1186/s12903-020-01271-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 10/01/2020] [Indexed: 12/04/2022] Open
Abstract
Background Temporary anchorage devices have been used for decades in orthodontic practice for many applications. The aim of this systematic review was to assess the effectiveness of orthodontic temporary anchorage devices in canine retraction during the two-step technique. Methods A search was systematically performed for articles published prior to June 30, 2019 in five electronic databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus). The risk of bias was assessed using the Cochrane risk of bias tool for randomized controlled trials (RCTs) and the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool for controlled clinical trials (CCTs). The Grading of Recommendation, Assessment, Development and Evaluation (GRADE) approach was used for the quality assessment. Data concerning the mean difference in mesial molar movement and extent of canine retraction were extracted for statistical analysis. The mean differences and 95% confidence intervals were analyzed for continuous data. A meta-analysis with a random-effects model for comparable outcomes was carried out. Results Three RCTs and five CCTs were finally included. Meta-analysis showed a significant increase not only in anchorage preservation in the implant anchorage group in both the maxilla (1.56 mm, 95% CI: 1.14 to 1.98, P < 0.00001) and the mandible (1.62 mm, 95% CI: 1.24 to 2.01, P < 0.00001) but also in canine retraction in the implant anchorage group in both the maxilla (0.43 mm, 95% CI: 0.16 to 0.69, P = 0.001) and the mandible (0.26 mm, 95% CI: 0.02 to 0.49, P = 0.03). Conclusions There is very low-quality evidence showing that implant anchorage is more efficient than conventional anchorage during canine retraction. Additional high-quality studies are needed.
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Affiliation(s)
- Haonan Tian
- College of Stomatology, Chongqing Medical University, No.426 Songshibeilu Road, Yubei District, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Congman Xie
- College of Stomatology, Chongqing Medical University, No.426 Songshibeilu Road, Yubei District, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Min Lin
- College of Stomatology, Chongqing Medical University, No.426 Songshibeilu Road, Yubei District, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Hongmei Yang
- College of Stomatology, Chongqing Medical University, No.426 Songshibeilu Road, Yubei District, Chongqing, China.,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China
| | - Aishu Ren
- College of Stomatology, Chongqing Medical University, No.426 Songshibeilu Road, Yubei District, Chongqing, China. .,Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences, Chongqing, China. .,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China.
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Murugesan A, Sivakumar A. Comparison of bone thickness in infrazygomatic crest area at various miniscrew insertion angles in Dravidian population - A cone beam computed tomography study. Int Orthod 2020; 18:105-114. [PMID: 31926867 DOI: 10.1016/j.ortho.2019.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 11/30/2019] [Accepted: 12/02/2019] [Indexed: 10/25/2022]
Abstract
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.
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Affiliation(s)
- Arathi Murugesan
- Saveetha Institute of Medical and Technical Sciences, Saveetha University, Saveetha Dental College and Hospitals, Department of Orthodontics, Chennai 600077, India.
| | - Arvind Sivakumar
- Saveetha Institute of Medical and Technical Sciences, Saveetha University, Saveetha Dental College and Hospitals, Department of Orthodontics, Chennai 600077, India
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Baxter SJ, Sydorak I, Ma PX, Hatch NE. Impact of pharmacologic inhibition of tooth movement on periodontal and tooth root tissues during orthodontic force application. Orthod Craniofac Res 2019; 23:35-43. [PMID: 31593373 DOI: 10.1111/ocr.12350] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/17/2019] [Accepted: 10/03/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The goal of this study was to investigate potential negative sequelae of orthodontic force application ±delivery of an osteoclast inhibitor, recombinant osteoprotegerin protein (OPG-Fc), on periodontal tissues. SETTING AND SAMPLE POPULATION Sprague Dawley rats from a commercial supplier were investigated in a laboratory setting. MATERIALS AND METHODS Rats were randomly divided into four groups (n = 7 each): one group with no orthodontic appliances and injected once prior to the experimental period with empty polymer microspheres, one group with orthodontic appliances and injected once with empty microspheres, one group with orthodontic appliances and injected once with polymer microspheres containing 1 mg/kg of OPG-Fc, and one group with orthodontic appliances and injected with non-encapsulated 5 mg/kg of OPG-Fc every 3 days during the experimental period. The animals were euthanized after 28 days of tooth movement for histomorphometric analyses. RESULTS Root resorption, PDL area and widths were similar in animals without appliances and animals with appliances plus high-dose OPG-Fc. PDL blood vessels were compressed and decreased in number in all animals that received orthodontic appliances, regardless of OPG-Fc. Hyalinization was significantly increased only in animals with orthodontic appliances plus multiple injections of 5 mg/kg non-encapsulated OPG-Fc when compared to animals without appliances. CONCLUSIONS Results of this study indicate that while pharmacological modulation of tooth movement through osteoclast inhibition is feasible when delivered in a locally controlled low-dose manner, high-dose levels that completely prevent tooth movement through bone may decrease local blood flow and increase the incidence of hyalinization.
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Affiliation(s)
- Sarah J Baxter
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Inna Sydorak
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Peter X Ma
- Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - Nan E Hatch
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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A simple approach to correct ectopic eruption of maxillary canines. Am J Orthod Dentofacial Orthop 2019; 155:871-880. [PMID: 31153508 DOI: 10.1016/j.ajodo.2017.11.046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 11/01/2017] [Accepted: 11/01/2017] [Indexed: 11/21/2022]
Abstract
This case report describes the orthodontic treatment of a patient with severe crowding; the maxillary right canines were ectopic, positioned far to the buccal side, and superimposed on the lateral incisors in near-transposition. Treatment included extraction of the 4 first premolars. A transpalatal bar was used as an anchorage device, and beta-titanium T-loop springs (0.019 × 0.025″) were used to better control the ideal force applied to retract the maxillary canines. A segmental T-loop spring was used as if it were a modified system of the segmental archwire technique. After the canines were retracted and space created for the anterior teeth, the latter were included in the treatment and the treatment was finished in the usual manner. Excellent results were achieved, both esthetic and functional. The treatment choices and their straightforward approach were appropriate, yielding predictable and stable results in the long term.
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Anchorage reinforcement with miniscrews and molar blocks in adolescents: A randomized controlled trial. Am J Orthod Dentofacial Orthop 2018; 154:758-767. [DOI: 10.1016/j.ajodo.2018.07.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 07/01/2018] [Accepted: 07/01/2018] [Indexed: 12/11/2022]
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Mohammed H, Wafaie K, Rizk MZ, Almuzian M, Sosly R, Bearn DR. Role of anatomical sites and correlated risk factors on the survival of orthodontic miniscrew implants: a systematic review and meta-analysis. Prog Orthod 2018; 19:36. [PMID: 30246217 PMCID: PMC6151309 DOI: 10.1186/s40510-018-0225-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 06/21/2018] [Indexed: 12/25/2022] Open
Abstract
Objectives The aim of this review was to systematically evaluate the failure rates of miniscrews related to their specific insertion site and explore the insertion site dependent risk factors contributing to their failure. Search methods An electronic search was conducted in the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Knowledge, Scopus, MEDLINE and PubMed up to October 2017. A comprehensive manual search was also performed. Eligibility criteria Randomised clinical trials and prospective non-randomised studies, reporting a minimum of 20 inserted miniscrews in a specific insertion site and reporting the miniscrews’ failure rate in that insertion site, were included. Data collection and analysis Study selection, data extraction and quality assessment were performed independently by two reviewers. Studies were sub-grouped according to the insertion site, and the failure rates for every individual insertion site were analysed using a random-effects model with corresponding 95% confidence interval. Sensitivity analyses were performed in order to test the robustness of the reported results. Results Overall, 61 studies were included in the quantitative synthesis. Palatal sites had failure rates of 1.3% (95% CI 0.3–6), 4.8% (95% CI 1.6–13.4) and 5.5% (95% CI 2.8–10.7) for the midpalatal, paramedian and parapalatal insertion sites, respectively. The failure rates for the maxillary buccal sites were 9.2% (95% CI 7.4–11.4), 9.7% (95% CI 5.1–17.6) and 16.4% (95% CI 4.9–42.5) for the interradicular miniscrews inserted between maxillary first molars and second premolars and between maxillary canines and lateral incisors, and those inserted in the zygomatic buttress respectively. The failure rates for the mandibular buccal insertion sites were 13.5% (95% CI 7.3–23.6) and 9.9% (95% CI 4.9–19.1) for the interradicular miniscrews inserted between mandibular first molars and second premolars and between mandibular canines and first premolars, respectively. The risk of failure increased when the miniscrews contacted the roots, with a risk ratio of 8.7 (95% CI 5.1–14.7). Conclusions Orthodontic miniscrew implants provide acceptable success rates that vary among the explored insertion sites. Very low to low quality of evidence suggests that miniscrews inserted in midpalatal locations have a failure rate of 1.3% and those inserted in the zygomatic buttress have a failure rate of 16.4%. Moderate quality of evidence indicates that root contact significantly contributes to the failure of interradicular miniscrews placed between the first molars and second premolars. Results should be interpreted with caution due to methodological drawbacks in some of the included studies. Electronic supplementary material The online version of this article (10.1186/s40510-018-0225-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | - Khaled Wafaie
- School of Dentistry, University of Dundee, Dundee, UK
| | - Mumen Z Rizk
- School of Dentistry, University of Dundee, Dundee, UK
| | - Mohammed Almuzian
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney, Australia
| | - Rami Sosly
- School of Dentistry, University of Dundee, Dundee, UK
| | - David R Bearn
- School of Dentistry, University of Dundee, Dundee, UK
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