Search Results (511)

(1) Background: The objective of this study was to evaluate the efficacy of the Rapid Maxillary Expander (RME) II System compared to a Herbst appliance and a control group in the treatment of class II skeletal malocclusions in growing patients. (2) Methods: A total of 30 class II patients treated using the RME II System (group R) were compared with 30 patients treated with a Herbst appliance (group H) and 30 untreated class II children (group C). Cephalograms were compared at the start (T0) and after 24 months (T1). Nine cephalometric parameters were analyzed: SN-MP, SN-PO, ANB, AR-GO-ME, AR-GO-N, N-GO-ME, SN-PP, LFH, CO-GN, 1+SN, IMPA, OVERJET, and OVERBITE. Since the variables failed the normality test, a Wilcoxon test was performed for a pairwise comparison of the cephalometric measurements taken at T0 (pre-treatment) and at T1 (post-treatment). ANOVA with Tukey post hoc correction was used to evaluate the differences among the groups. (3) Results: ANOVA showed a statistically significant difference for all analyzed variables except for AR-GO-ME, AR-GO-N, and N-GO-ME. Post hoc Tukey’s HSD test showed the following difference: the SN-PO angle in group H was 3.59° greater than in group R; the LFH in group H was 4.13 mm greater than in group R. The mandibular length (CO-GN) in group H was 3.94 mm greater than in group R; IMPA in group H was 6.4° greater than in group R; and the ANB angle in group H was 1.47° greater than in group R. (4) Conclusions: The RME II System is an effective therapeutic device for class II skeletal malocclusion treatment in growing patients. Full article

Background and Objectives: Orthodontic appliances may cause discomfort for patients. This could influence the person’s psychological well-being. The aim of this study was to examine the psychological health of patients wearing orthodontic appliances. It is important to analyze the well-being of patients during orthodontic treatment because it is started in a young age and it may affect one’s psychological health. Therefore, for doctors and patients, it is important to understand and take every aspect of the treatment into consideration when deciding when to start the treatment and what appliance to choose. Materials and Methods: A total of 339 patients filled out an anonymous questionnaire. They were divided into four groups according to their age and type of appliance. The main reasons to seek treatment were crooked teeth and a bad bite. There was a statistically significant difference between women and men as women sought treatment because of crooked teeth; meanwhile, men indicated bad bite as their main reason for seeking treatment. Results: A total of 48.7% of subjects noted that they were feeling good during treatment; however, 4% of all patients noted that they were feeling bad. A total of 45% of subjects stated that they felt unhappy at least sometimes. A total of 43% of subjects felt stress. Conclusions: Even though patients indicated various negative aspects on their well-being during treatment, for the majority of the subjects, the end results significantly increased their psychological well-being. Full article

(1) Objective: This study aimed to investigate how patients’ perceptions of their dental aesthetics and their sense of self-esteem are related. (2) Methods: This cross-sectional survey recruited 141 new patients seeking orthodontic treatment. Patients completed a self-administered questionnaire consisting of three parts: the Malaysian Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Rosenberg Self-esteem Scale (RSES-M), and Aesthetics Component of the Index of Orthodontics Treatment Need (IOTN-AC). Clinical assessment comprised the Dental Health Component of the Index of Orthodontics Treatment Need (IOTN-DHC). Multiple linear regression was performed, with self-esteem as the dependent variable, while the independent variables comprised the domains of PIDAQ; IOTN-AC; IOTN-DHC; and patients’ demographics, such as age, gender, and their level of education. (3) Results: The response rate was 96.5% (n = 136 respondents). The multiple linear regression found that, when the other predictors in the model are held constant, Social Impact, Aesthetic Concern, and Dental Self-Confidence are the factors that significantly contributed to explaining the variation in self-esteem, accounting for, 3.9%, 2.3%, and 2.0%, respectively. The entire model explained 23% of the variation in self-esteem. (4) Conclusions: Domains of the psychosocial impact of dental aesthetics act as predictors of self-esteem in orthodontic treatment-seeking patients. Full article

(1) Background and aim: The effects of functional therapies on dentoalveolar and skeletal structures have been investigated in orthodontics for many years. The aim of this retrospective study was to evaluate the changes caused by fixed and removable functional therapy in the mandibular anterior trabecular structures using fractal dimension (FD) analysis. (2) Methods: A total of 60 patients with skeletal and dental class II malocclusion were included in the study and three groups were formed: the untreated control group (CG), the Forsus fatigue-resistant device group (FFRDG), and the Monoblock group (MBG). Bone areas of interest determined in the buccoapical of the mandibular incisors and the symphysis in the lateral cephalometric radiographs taken before (T0) and after (T1) functional therapy were evaluated using FD analysis. The relationship between the FD and IMPA (Incisor Mandibular Plane Angle) angles was evaluated. Parametric and nonparametric tests were used in statistical analysis according to normality distribution. The statistical significance level was determined as p < 0.05. (3) Results: There was no statistically significant difference between the FD values of all groups at T0 (p > 0.05). At T1, buccoapical FD values were significantly lower in FFRDG and MBG compared to the control group (p < 0.05), while symphyseal FD values were not found to be significant (p > 0.05). The IMPA angle was significantly lower in the FFRDG and MBG than in the control group at T0, while it was higher at T1 (p < 0.05). While a significant negative correlation was observed between the IMPA angle and buccoapical FD values in both FFRDG and MBG (p < 0.05), it was not observed with the symphysis FD values (p > 0.05). (4) Conclusions: Trabecular changes caused by functional therapy in the mandibular anterior bone can be evaluated on lateral cephalometric radiographs with FD analysis. It was concluded that orthodontists should ensure controlled changes in the IMPA angle during functional therapy, especially for the decreases in FDs seen in the buccoapical alveolar region due to the forward movement of the mandibular incisors. Full article

The study of dentition anomalies and pathologies in wildlife contributes, together with other indicators, to understanding the relevance of some factors on the health status of populations. This has not been properly evaluated in invasive mammals. To test the feasibility of eradication, the government of Tierra del Fuego performed the eradication of beavers (Castor canadensis) from 2016 to 2018: 1121 animals were removed and 970 examined. These beavers were examined to analyze the incidence of dentition anomalies and other dentition and cranial conditions. The beavers presented two dentition anomalies: hypodontia and hyperdontia (0.41% in both cases), and for the first time, a dentition anomaly in the upper quadrants was reported. Beavers also presented artifactual tooth loss (0.30%) and acquired tooth loss (0.61%) but with low incidence. The presence of fractured teeth (0.41%) and caries (0.31%) occurred in all age classes, also with low incidence. The third molar tooth was the most affected, showing a female bias. The 0.93% of skulls had a cranial abnormality represented as a buccal curvature. Malocclusion cases also were recorded (0.51%). The low prevalence of dentition anomalies, fractured teeth, caries, and cranial abnormalities would not compromise the lifespan of beavers. These results leave a precedent of dentition anomalies and dentition and cranial conditions in an invasive mammal. Full article

Background: Bimaxillary surgeries (BiMax) are an essential part of the craniomaxillofacial specialty. The osteotomies and subsequent spatial rearrangement of the maxilla and the mandible enable the correction of facial deformities, asymmetry, and malocclusion. Moreover, the movements performed during the procedure affect the morphology of surrounding soft tissues, including the upper airway (UA). Objectives: The objective of this study was to radiologically assess the potential volumetric alterations of the UA in the supine position at various intervals following BiMax advancement surgeries. Methods: A group of 31 patients who underwent BiMax advancement surgery were included in the study. Medical computed tomography (CT) of the head and neck region was performed 2 weeks preoperatively, 1 day postoperatively, and 6 months postoperatively. The UA volumes were calculated and analyzed based on the acquired Digital Imaging and Communications in Medicine (DICOM) files using different software applications. The sella-nasion-A point (SNA) and sella-nasion-B point (SNB) angles were evaluated to measure the achieved maxillomandibular advancement. Results: When comparing the volume of the UA before surgery, post-surgery, and 6 months post-surgery, the p-value was <0.001, indicating statistically significant differences in UA volume between the successive examinations. A statistically significant difference was found between UA volume before surgery and 6 months post-surgery and between UA volume after surgery and 6 months post-surgery, with the obtained p-values being <0.001 and 0.001, respectively. A significantly larger UA volume was observed 6 months post-surgery (mean ± SD: 27.3 ± 7.3) compared to the volume before surgery (mean ± SD: 22.2 ± 6.4), as well as 6 months post-surgery compared to the volume assessed shortly after surgery (mean ± SD: 24.2 ± 7.3). Conclusions: BiMax advancement surgeries result in the significant enlargement of the UA. The volume of the UA does not diminish immediately following the procedure and is not constant; it increases significantly during the postoperative observation period. Full article

The aim was to objectively assess compliance in patients prescribed headgear and evaluate the impact of monitoring awareness, treatment duration, gender, and age on compliance levels. A total of 22 patients with Class II malocclusion wore the headgear integrated with the force and temperature sensitive Smartgear monitoring system (Smartgear, Swissorthodontics AG, Cham, Switzerland). Patients were instructed to wear the headgear for 13 h daily over a 3-month period. Randomly, 11 patients were informed that they monitored and 11 were not informed. Data were organized using Microsoft Excel and analyzed using R for statistical estimates, graphs, and hypothesis testing. Smartgear recorded an average daily compliance of 6.7 h. No statistically significant differences were found in cooperation between study group and control group over the 3 months of treatment, regardless of gender and age. However, there was slight greater cooperation in the first month than in the other months, and patients ≤10 years of age had almost 2 h more cooperation than their older counterparts. Moreover, the informed group exhibited an average of 1.1 more hours of cooperation per day than the uninformed group, which may carry clinical significance. This cooperation primarily occurred at night and was found to be statistically significant. Compliance among young patients typically remained lower than the prescribed level, regardless of their gender and psychological maturity. Although an awareness of monitoring does not seem to improve compliance, implementing such systems could still offer dentists a valuable means of obtaining objective information about their patients’ adherence. Full article

Elastodontics is an interceptive orthodontic therapy that uses light and biological elastic forces through preformed or custom-made removable orthodontic appliances. This study aims to evaluate the effects of elastodontic devices on correcting sagittal discrepancies in growing subjects with mixed dentition. Electronic research was conducted on four databases: PubMed, Scopus, EMBASE, and Web of Science. Data were extracted based on the first author, year of publication, setting and country, study design, sample characteristics, sample size calculation, type of malocclusion, intervention, control group type, compliance, follow-up, and cephalometric measurements. Sixteen studies were included in the final review. Most studies observed a statistically significant reduction (p < 0.05) in SNB and ANB angles. Ten studies reported a reduction in overjet, while eight studies found no change in facial divergence. Comparisons with conventional functional devices revealed no consensus on the skeletal and dentoalveolar effects. Elastodontic appliances significantly improve cephalometric and dentoalveolar parameters, potentially correcting skeletal and dental relationships. However, result variability and unclear advantages over traditional appliances highlight the need for further research. Full article

Aims: This review aims to analyze the multiple factors affecting the staging of the orthodontic tooth movement during clear aligner treatment and to provide an efficient work methodology in this regard during digital treatment planning. Materials and Methods: A literature search was conducted on electronic databases (Pubmed, Scopus, Google Scholar and CNKI). The results of the present study have been divided into several sections: (1) definition and concept of staging, (2) basic principles of clear aligners, (3) macro-staging, (4) micro-staging, and (5) limitations. Results: The terminology of macro-staging and micro-staging proposed in this paper aims to be a first step towards a more detailed analysis of staging. The macro-staging constitutes the general biomechanics of movements that need to be prioritized to meet the objectives of the treatment plan. It provides a comprehensive view of the movements occurring in each dental arch. The micro-staging constitutes the biomechanics of movements for each individual tooth. This involves studying the movements in the different planes of space in which each tooth is programmed, deciding if they are compatible, and having strategies to create space to avoid lack of expression. Conclusions: Further studies should focus on exploring different staging approaches to address similar malocclusions to determine which are the most effective and applicable to clinical practice. Full article

This case report presents a virtual treatment simulation of the orthodontic treatment and surgery-first orthognathic surgery employed to treat a patient with a repaired unilateral cleft lip and alveolus with Class III malocclusion and lower third facial asymmetry. The patient exhibited a negative overjet of 9 mm, a missing lower right second premolar, and a 5 mm gap between the upper right central and lateral incisors with midline discrepancy. The three-dimensional virtual planning began with virtual pre-surgical orthodontics, followed by the positioning of the facial bones and teeth in their ideal aesthetic and functional positions. The sequence of steps needed to achieve this outcome was then reverse-engineered and recorded using multiplatform Nemostudio software (Nemotec, Madrid, Spain), which facilitated both surgical and orthodontic planning. The treatment included a two-piece segmental maxillary osteotomy for dental space closure, a LeFort I maxillary advancement, and a mandibular setback with bilateral sagittal split osteotomy to correct the skeletal underbite and asymmetry. A novel approach was employed by pre-treating the patient for orthognathic surgeries at age 11, seven years prior to the surgery. This early phase of orthodontic treatment aligned the patient’s teeth and established the dental arch form. The positions of the teeth were maintained with retainers, eliminating the need for pre-surgical orthodontics later. This early phase of treatment significantly reduced the treatment time. The use of software to predict all the necessary steps for surgery and post-surgical orthodontic tooth movements made this approach possible. Multi-step virtual planning can be a powerful tool for analyzing complex craniofacial problems that require multidisciplinary care, such as cleft lip and/or palate. Full article

Background: (1) Periodontal disease (PD) is a globally prevalent chronic inflammatory condition, exacerbated by the dysbiosis of the oral microbiota. This study aims to evaluate the bacterial load of specific periodontopathogenic bacteria in patients with malocclusions (MAL) compared to those without. (2) Methods: Conducted at the “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania, this pilot study involved two groups: patients with MAL and PD, and patients with PD but without MAL. We included 20 patients: 10 with MAL (9 with crowding and 1 with an open bite) and 10 without MAL. Gingival crevicular fluid was collected for bacterial DNA extraction and quantified bacterial load using real-time PCR, focusing on 12 periodontopathogenic bacteria across different complexity classes. (3) Results: The study identified significantly higher concentrations of Treponema denticola (p = 0.023, median = 4.32, IQR = 2.76–5.53 vs. median = 1.93, IQR = 0–3.19), Tannerella forsythia (p = 0.020, mean = 6.04 ± 0.72 vs. mean = 4.4 ± 1.89) and Porphyromonas gingivalis (p = 0.002, median = 5.64, IQR = 4.94–5.98 vs. median = 2.48, IQR = 0–4.05) in patients with MAL compared to those without. This suggests that MAL contributes to an environment conducive to the proliferation of specific pathogens, potentially accelerating PD progression. Additionally, Eikenella corrodens (p = 0.040, mean = 4.55 ± 1.02 vs. mean = 3.23 ± 1.56), Campylobacter rectus (p < 0.001, mean = 4.2 ± 0.56 vs. mean = 1.8 ± 1.51), Prevotella intermedia (p = 0.043, median = 5.04, IQR = 0–5.49 vs. median = 0, IQR = 0–3.39), Capnocytophaga sputigena (p = 0.011, median = 5.91, IQR = 5.47–6.17 vs. median = 4.63, IQR = 3.83–5.64), and Capnocytophaga gingivalis (p = 0.007, median = 5.87, IQR = 5.34–6.03 vs. median = 4.4, IQR = 3.5–5.71) also showed elevated concentrations, indicating the broad impacts of MAL on oral microbial profiles. (4) Conclusions: The findings demonstrate a significant relationship between MAL and increased bacterial loads, underscoring the need for its integration in managing PD. Future research should expand demographic diversity and employ longitudinal designs to better understand the causative mechanisms at play. Full article

Background/Objectives: Osteogenesis imperfecta (OI) is a rare genetic disease that is responsible for bone fragility, but also for dental malocclusions and dentinogenesis imperfecta (DI). The aim of this study was to assess whether the severity of dental malocclusion influenced the oral health-related quality of life (OHRQoL) and exposure to bullying in a paediatric OI population compared with a control group. Methods: Dental and occlusal characteristics were noted during oral and radiographic examination. The severity of malocclusion was assessed using the PAR index. P-CPQ, COHIP(34), and BCS-A questionnaires were used to evaluate, respectively, externally and self-perceived OHRQoL and bullying. Results: We included 39 patients with a mean age of 11.3 (±4.8 SD) in the OI group, and 45 patients with a mean age of 12.3 (±3.2 SD) in the control group. There were no significant differences between the two groups in terms of occlusal vertical and transverse dimensions. Patients with severe OI, presenting with bone fractures, bones deformities, and short stature, had significantly more anterior (p < 0.05) and posterior openbites (p < 0.05) and more DI (p < 0.05) compared to patients who had moderate or mild OI. Self-perceived OHRQoL was negatively impacted by the disease (p = 0.01), particularly in the domains of oral health (p < 0.05) and self-image (p < 0.001), but not by its severity. Exposure to bullying did not differ significantly between the two groups, although more patients with OI reported being teased (21.4% face to face and 7.1% online vs. 14.6% and 2.4% in the control group). Conclusion: Interventions for dental malocclusion and oral health in OI patients would help to improve their quality of life and self-image. Full article

We present a case report of a 26-year-old female suffering from Coffin–Siris Syndrome, who underwent orthodontic treatment and surgery to solve her malocclusion and to improve her aesthetics and functional occlusion. Methods: The presurgical phase involved multibracket self-ligating attachments, namely a Damon prescription. The patient underwent maxillofacial surgery to correct the severe skeletal malocclusion and to relocate the bone bases to the right position. Post-surgical orthodontic treatment was performed to complete the alignment. Results: The patient’s aesthetics and functional abilities improved. Conclusions: Syndromic patients can undergo orthodontic treatment if comorbidities and collaboration allow it. The support and collaboration of families and psychotherapists must be considered, but clinical cases of syndromic patients can be faced and solved. Obviously, each syndromic patient is considered unique, and the risk–benefit ratio must be correctly assessed for each one. Full article

This report describes multidisciplinary care combining orthodontics and restorative dentistry for a patient with Class II occlusion and stained mandibular and maxillary resin composite veneers. The orthodontic treatment improved severe overjet and malocclusion prior to restorative care. Occlusal assessment was provided with a novel digital device (PlaneSystem, Zirkonzahn) that is integrated with digital workflows for the evaluation of the occlusal plane and condylar path inclination. Diagnostic digital impressions and digital wax-up for intraoral mock-ups led to the patient’s treatment acceptance. Minimally invasive tooth preparation, final digital impressions, and bonding under dental dam isolation fulfilled the patient’s esthetic and functional demands with all-ceramic restorations. Full article

Nowadays, aligners represent a possible therapeutical approach that combines both esthetic and function in order to address dental malocclusion. However, they require a significant level of compliance from the patient. According to the manufacturer, at least 22 h of wearing a day is demanded to reach the optimal therapeutical level; hence, aligners can only be removed during meals. Patients’ compliance might increase and the duration of the treatment might decrease if they were allowed to eat with aligners on. The idea of patients keeping the aligners on during meals has been contemplated, not only to favor patients’ compliance but also treatment effectiveness. This study aims to assess the degree of chewing difficulty that aligners cause when eating certain kinds of food and the quantity of residue left. Material and Methods: A questionnaire titled “Questionnaire for the Assessment of Masticatory Function with Aligners” was administered using Google Forms to 240 patients in treatment with clear aligners. The survey was validated through the reliability test using the test–retest method. This method had a higher correlation coefficient of 0.9 across all items (with a cutoff of 0.8) with statistical significance, and an excellent internal correlation coefficient (α > 0.9). The statistical analysis performed consisted of descriptive analysis, frequencies, percentages, Pearson’s correlation test and Friedman’s test. Results: Pearson’s test showed a statistically significant correlation between all items except between meat or clams and yogurt or ice cream and with mozzarella or soft cheese regarding food chewing difficulties. Pearson’s test showed a statistically significant correlation between all items regarding food residues. A total of 69.2% of the cohort reported some movements of aligners during mastication. In total, 88.3% of them affirmed not to have perceived deformations or breakage of aligners during chewing. Furthermore, 79.2% of them declared that they would continue to eat if eating with aligners was proven to speed up treatment. Conclusions: Wearing clear aligners while chewing foods such as yogurt, ice cream, soft cheese, bread, rice, etc., can be possible and can help shorten the duration of orthodontic treatment, benefiting both the patient and the orthodontist. However, further research using qualitative methods is needed to understand the barriers and facilitators to chewing food with aligners. Full article