The significance of cephalometrics in treatment planning.

Twenty-four orthodontists were asked to provide a treatment plan for a series of six cases of malocclusion. In certain types of cases there was high or total agreement on treatment planning whether or not a cephalometric radiograph and analysis was available. In view of these findings, it may be appropriate for orthodontists to reassess their routine use of cephalograms.     

Consistency of orthodontic treatment planning decisions

The aim of this project was to analyse the consistency of a group of orthodontists’ treatment decisions and to identify factors that may influence this consistency. Ten orthodontists examined 60 case vignettes and recorded their treatment decisions on two separate occasions. Inter- and intra-examiner agreements were measured using the Kappa statistic. Data analysis revealed that the consistency within each orthodontist was moderate. However, between-orthodontist consistency was poor. It can be concluded that there is marked variation between orthodontists in treatment planning decisions, and this may reflect the lack of evidence for the effectiveness of competing treatments.     

青少年拔牙矫治期间对颅面部硬组织结构影响的研究

目的 研究青少年拔牙矫治时颅面部硬组织的影响。方法 选择50例为青少年恒牙He，安氏Ⅰ类患者，25例需拔除四个第一双尖牙治疗，25例无需拔牙治疗，用标准方丝弓技术矫治，共收集到完整病例43例，拔牙20例，非拔牙23例，利用X线头影测量技术，比较拔牙与非拔牙组治疗前后的变化。结果 拔牙矫治与非拔牙矫治组都存在一定的颅面部骨骼的生长，但两者矫治前后改变无明显差别。拔牙矫治明显改变了前牙位置。结论 青少年拔牙矫治期间对颅面部骨骼的改变无影响。     

Consistency of orthodontic treatment planning decisions.

OBJECTIVE: (i) To analyse the consistency of a group of orthodontists' treatment decisions and (ii) to identify factors that may influence this consistency. DESIGN: Cross-sectional observational study. SUBJECTS: Ten orthodontists. METHODS: The orthodontists examined 60 case vignettes and recorded their treatment decisions on two separate occasions. MAIN MEASURE: Inter- and intra-examiner agreement was evaluated with the Kappa statistic. RESULTS: The consistency within each orthodontist was moderate. However, between-orthodontist consistency was poor. CONCLUSION: It appears that there is marked variation between orthodontists in treatment planning decisions and this may reflect the lack of evidence for the effectiveness of competing treatments.     

The use of the occlusogram in planning orthodontic treatment.

A method of planning orthodontic treatment in the transverse plane has been presented. The occlusogram procedure outlined augments other orthodontic records in order to define more specifically the requirements of successful orthodontic treatment. Anchorage requirements, extractions, if any, and arch widths plus the final occlusal relationships can be determined at the outset of orthodontic treatment.     

The influence of orthodontic treatment on previously traumatized permanent incisors.

The reaction of previously traumatized teeth to orthodontic force application was investigated. Four groups of children were examined: group T comprised 56 children who encountered trauma to their maxillary incisors; group O comprised 29 orthodontic patients with intact incisors; group TO comprised 28 previously traumatized orthodontic patients; and group C served as the control group (n = 26). Orthodontic treatment was restricted to tipping movement executed only by means of removable appliances. Groups T, O, and TO were followed up longitudinally by means of clinical and radiographic examinations. In most of the cases the reported trauma occurred to teeth with completed roots and affected the crown only. Group TO presented the highest, though relatively moderate, prevalence of root resorption (27.8 per cent) and was followed by groups O and T (6.7 and 7.8 per cent, respectively) while in the control group no resorption was observed. Electrical pulp testing revealed the highest prevalence of loss of tooth vitality in group TO (7.3 per cent) in which the highest prevalence of pulp obliteration was also found. It can be concluded that the combination of trauma with orthodontic tipping renders the teeth more susceptible to complications, especially to root resorption and loss of vitality.     

The emerging soft tissue paradigm in orthodontic diagnosis and treatment planning

Until now, orthodontic diagnosis and treatment planning has been based on hard tissue relationships and on the Angle paradigm that considers ideal dental occlusion ‘nature's intended ideal form’. In this view, the clinician and nature are partners in seeking the ideal. In the modem biological model, variation is accepted as the natural form; ideal occlusion is the exception rather than the rule, and the orthodontist and nature are often adversaries. The orthodontist's task is to achieve the occlusal and facial outcomes that would most, benefit that individual patient, whose esthetic concerns are often paramount. Because the soft tissues largely determine the limitations of orthodontic treatment, from the perspectives of function and stability, as well as esthetics, the orthodontist must plan treatment within the patient's limits of soft tissue adaptation and soft tissue contours. This emerging soft tissue paradigm in diagnosis and treatment planning places greater emphasis on clinical examination of soft tissue function and esthetics than has previously been the case, and new information in these areas is required.     

父母对青少年正畸依从性影响的研究

通过对2012~2013年在泸州医学院附属口腔医院正畸科接受固定矫治的青少年患者(共626名,根据家庭情况分为4组)进行12个月的依从性评估调查,研究结果显示:(1)高文化程度家庭患者普遍重视口腔卫生,双亲家庭患者则在复诊方面表现较好(P<0.05)。(2)父母文化程度对复诊及时率,以及家庭完整性对口腔卫生的维护均没有明显的影响。