Commentaries on scientific papers published in this edition

Abstract

Aim: The aim of this study was to assess the effects of four enamel preparation techniques on shear bond strength (SBS) of brackets bonded with a resin-modified glass ionomer cement (RMGIC). Adhesive Remnant Index (ARI) and enamel surface roughness (Ra) were also investigated after cement removal. Materials and methods: One hundred and forty-four human premolars were divided into four groups (n?=?36 in each group) as follows: Group 1, 37% phosphoric acid (i.e. conventional); Group 2, sandblasting; Group 3, sodium hypochlorite and 37% phosphoric acid; and Group 4, sodium hypochlorite and sandblasting. Twenty-four hours after bonding, the brackets were debonded with an Instron machine using a crosshead speed of 1·0 mm/min; the ARI was evaluated by an image analyser system; the Ra was measured by profilometry; and the morphology of the tooth enamel surface was observed by scanning electron microscope evaluation. Data were submitted to ANOVA and the Kruskal–Wallis test (α?=?0·05). Results: Mean SBS values for Groups 1–4 were 13·86, 9·08, 17 and 9·63 MPa, respectively. Mean ARI for Groups 1–4 were 11·16, 2·06, 20·66 and 3·73%. The SBS and ARI showed statistically significant differences between the four groups (P<0·001). The Ra (μm) showed no significant differences between groups. Conclusions: Bracket bonding using RMGIC showed adequate adhesion for clinical use, and the type of enamel preparation had a significant influence.     

Commentaries on scientific papers published in this edition

Abstract

This occasional section is designed to draw the attention of readers to papers that have been published in non-orthodontic journals, but which may be of interest. The abstracts have been selected and edited by Gavin Power and Professor Nigel Hunt.     

Commentaries on scientific paper published in this edition

Abstract

Accurate easy placement bonded retainers have long been a desired aspect of contemporary orthodontic treatment. This article offers the reader a simple and precise method of placing a fixed bonded retainer. This technique also has the advantage of providing a retainer that can be used as both the positioner and the dual removable retainer.     

Commentaries on scientific papers published in this issue

Abstract

The incidence of a solitary maxillary median central incisor (SMMCI) tooth in the general population is low, in either the primary or secondary dentition. The most common cause of a missing maxillary central incisor is trauma, or more rarely hypodontia. However, SMMCI is also a recognized genetic anomaly and affected individuals can be carriers for a potentially more serious condition affecting midline development of the brain and face, holoprosencephaly (HPE). The presence of an SMMCI of unknown aetiology is therefore considered a risk factor for HPE, even in the absence of any other clinical signs. The orthodontist may be responsible for diagnosing cases of SMMCI with no obvious cause, and in these subjects due consideration should be given to referral for the appropriate genetic testing and counselling.     

Orthodontic treatment and its impact on oral health-related quality of life in Brazilian adolescents

Abstract

Objective: To assess whether Brazilian adolescents who had completed orthodontic treatment had lower levels of impacts on their oral health-related quality of life.

Design: A cross-sectional study.

Setting: The study was conducted in public and private secondary schools in Bauru-SP, Brazil.

Participants: 1675 randomly selected adolescents aged between 15 and 16 years.

Methods: Adolescents were clinically examined using the Index of Orthodontic Treatment Need (IOTN). Two oral health-related quality of life measures, namely the Oral Impacts on Daily Performance (OIDP) and the shortened version of the Oral Health Impacts Profile (OHIP-14) were used to assess adolescents’ oral health-related impacts. Multiple logistic regression was used in the data analysis.

Results: A response rate of 100% was obtained. Adolescents who had completed orthodontic treatment had fewer oral health-related impacts compared to the other two groups. They were 1.85 times (95% CI 1.30 to 2.62) less likely to have an oral health impact on their daily life activities than adolescents currently under treatment or 1.43 (1.01 to 2.02) times than those who never had treatment.

Conclusions: Adolescents who had completed orthodontic treatment had a better oral health-related quality of life than those currently under treatment or those who never had treatment.     

Unmet orthodontic treatment need in rural Nigerian adolescents

Abstract A survey of orthodontic treatment need was carried out among randomly selected rural Nigerian adolescents using the index of orthodontic treatment need. Altogether, 704 subjects (381 boys and 323 girls) aged 12–18 years (mean 14.8, SD 1.79) were recruited in the study. The results indicated that 12.6% of the population were in objective need of orthodontic treatment. Whilst there was a discrepancy in the proportions of Nigerian adolescents needing orthodontic treatment on aesthetic and dental health grounds, girls were found to have a more attractive dental appearance and less orthodontic treatment need than boys. However, the differences were not statistically significant (P > 0.05). The correlation between the orthodontist's and the subject's rating of dental appearance was found to be low (r=0.35). The study also provided reliable baseline data for planning orthodontic services in Nigeria especially in areas where there are no dental services.     

上海地区青少年正畸治疗需要的调查研究

目的:调查上海地区青少年人群的正畸治疗需要及自身美学评价。方法:随机抽取上海地区11～13岁青少年686例(男355例,女331例),由正畸专科医师采用正畸治疗需要指数(index of orthodontic treatment need,IOTN)评定受试者正畸治疗需要。IOTN包括学(dental health component,DHC)及美学(aesthetic component,AC)2部分。同时采用IOTN的美学部分让受试者对自身美观程度进行评价(self-perceived aesthetic component,SAC)。采用描述性统计及卡方检验对调查结果进行统计分析。结果:DHC评分显示26.0%的受试者明确需要正畸治疗,19.8%的受试者为临界病例;AC评分显示5.5%的受试者明确需要正畸治疗,31.7%为临界病例;SAC评分显示1.7%的受试者明确需要正畸治疗,6.4%为临界病例。在明确需要正畸治疗的受试者中,最常见的特征是严重接触点异常(>4 mm)。DHC与AC在评价治疗需要时77.8%结果一致,AC与SAC在评价治疗需要时65.0%结果一致。结论:将近一半的青少年人群明确需要正畸治疗或为临界病例,受试者在进行自身美观程度评价有从轻的倾向。     

不同类型正畸患者对颜面美感知的差异及相关因素研究

目的：调查不同类型的正畸患者对颜面美的感知差异,为正畸医师进行诊断设计提供美学参考。方法：选取45例初诊患者的面像（正面像、正面微笑像、侧面像、正面咬合像）制作调查问卷。另随机选取213例正畸患者在治疗前对问卷中病例资料的颜面美进行评价,进行统计学分析。结果：①．性别、年龄、文化程度等因素会影响患者对颜面美的感知度,婚姻状况对患者颜面美的感知影响不明显。中青年、女性、文化程度较高者比少年、男性、文化程度较低者对颜面美的感知度相对较高。②．正畸患者对安氏Ⅲ类病例颜面美的评价最低,其次是安氏Ⅱ1类病例,对安氏Ⅱ2类、安氏I类病例的美学评价较高。结论：不同背景患者对颜面美的感知度不同,提示进行正畸治疗前应充分了解患者的美学倾向,制定个性化的矫治方案。     

正畸治疗前后患者颜面美的感知变化及相关因素研究

目的探讨接受正畸治疗的患者对颜面美的感知变化及相关影响因素,用于指导临床治疗提高患者的满意度。方法选取12例矫治完成的病例图像制作调查问卷。随机选择于山东大学口腔医院接受正畸治疗的患者100例,分别在其正畸治疗前(对照组)及治疗一年半后(治疗组),评价问卷中病例颜面美的改变,并进行统计学分析。结果接受正畸治疗的患者对颜面美的感知度显著提高。其中文化水平较高的中年女性患者对颜面美的感知度提高最为显著,而高中以下的少年男性患者对颜面美的感知度提高不明显。拔牙及不拔牙患者对颜面美的感知度均提高,但提高的程度无显著差异。结论患者对颜面美的感知会随着正畸治疗的进行而提高,正畸治疗中要注重患者的审美心理及行为的变化,适时调整矫治方案,加强同患者的沟通,提高患者的满意度。     

A cephalometric evaluation of patients presenting with persistent digit sucking habits.

Abstract

Persistent digit sucking habits are an important aetiological factor for malocclusion, and patients with persistent habits are frequently referred for orthodontic treatment. The present study investigated the effects of digit sucking habits on vertical and anteroposterior dentofacial characteristics by employing a cephalometric analysis of patients with persistent digit sucking habits compared with patients without such habits. Significant differences were seen in maxillary prognathism, relative prognathism, maxillary incisor angulation, interincisal angle, maxillary length and maxillary plane angulation. No significant differences were observed for mandibular prognathism or length, maxillary mandibular plane angle, cranial base measurements nor any measurement of facial height. The digit sucking group were also found to have a larger variation of lower incisor angulation than the controls, although no significant difference in the mean value for this variable was detected. It is concluded that persistent digit sucking may cause largely dentoalveolar change, together with some minor effects on the skeletal pattern.     

口腔治疗中前牙区美学的考量因素

前牙区是口腔美学治疗的关键,前牙形态和位置的调整是系统性美学治疗的重要部分。临床诊疗中,口腔期望恢复天然牙形态使之与面型协调;关闭前牙间隙、调整中线位置使弓形美观、对称;通过垂直向和水平向控制使牙列与龈、颊组织关系协调,展现美丽微笑。完善的前牙美学治疗需要多学科联合、多种治疗方法介入,同时应考虑患者的文化背景和审美习惯,以实现最佳治疗效果。数字化诊疗技术为治疗前美学分析预测、治疗后美学评估提供了保障。该文结合国内外最新研究成果,从前牙位置、形态以及牙列与龈、颊等软组织关系等方面对口腔治疗中前牙美学考量因素作一综述,为美学区口腔治疗规划提供参考。     

多学科联合治疗重度牙周炎导致的前牙连续缺失（附1例4年随访报告）

 随着生活水平及口腔治疗技术的提高，上前牙美学区种植修复成为越来越多患者的选择。因重度牙周炎伴有错牙合畸形进而导致前牙美学区连续失牙是临床上十分棘手的难题，若同时存在缺牙区软硬组织缺损，采用种植修复将面临巨大挑战，要解决此类问题往往需要多学科联合治疗。文章展示了1例重度牙周炎病例的诊疗全过程，包括病情分析、多学科参与治疗设计、具体实施步骤和修复后效果等，为临床解决因重度牙周炎导致上前牙美学区连续失牙的种植修复问题提供了经验。     

Orthodontic treatment needs in Westmead Hospital Dental Clinical School

One hundred and fifty-four adolescents, 76 female and 78 male consented to take part in this survey. The two authors examined and assessed them for dental aesthetics, malocclusion related features and TMJ related signs. The patients were also questioned about their opinion of dental aesthetics, their interest in having orthodontic treatment and their TMJ symptoms. Only 63 per cent of the adolescents who were considered suitable for orthodontic treatment expressed an interest in wanting treatment. Twenty-seven per cent of patients had signs and/or symptoms of TMJ disturbance. No association was found between individual malocclusion problems and TMJ signs and symptoms. The authors considered 56.5 per cent of the total group for orthodontic treatment, the majority for aesthetic reasons, and placed them into high, medium and low priority groups. Fixed appliance therapy for both arches was the recommended type of treatment for most patients.     

多学科联合治疗重度牙周炎导致的前牙连续缺失（附1例4年随访报告）

随着生活水平及口腔治疗技术的提高,上前牙美学区种植修复成为越来越多患者的选择。因重度牙周炎伴有错牙合畸形进而导致前牙美学区连续失牙是临床上十分棘手的难题,若同时存在缺牙区软硬组织缺损,采用种植修复将面临巨大挑战,要解决此类问题往往需要多学科联合治疗。文章展示了1例重度牙周炎病例的诊疗全过程,包括病情分析、多学科参与治疗设计、具体实施步骤和修复后效果等,为临床解决因重度牙周炎导致上前牙美学区连续失牙的种植修复问题提供了经验。     

Dental aesthetics assessed against orthodontic treatment complexity and need in Nigerian patients with sickle-cell anemia

This study investigates the relationship between dental aesthetics and orthodontic treatment complexity and need in a group of patients with sickle-cell anemia (SCA) in Nigeria. The study sample consisted of 176 individuals — 77 (43.8%) male and 99 (56.3%) female subjects with SCA (aged 10 to 35 years) who were coming for routine medical care to two outpatient clinics. Dental aesthetics were assessed using the Standardized Continuum of Aesthetic Need component of the Index of Orthodontic Treatment Need. Treatment complexity and need were assessed according to the Index of Complexity, Outcome and Need and Dental Aesthetic Index. Both parametric and nonparametric statistics were employed in the data analysis. Significant positive relationships were found between dental aesthetics and orthodontic treatment complexity as well as treatment need according to both indices ( p = .000). The correlations of the scores for dental aesthetics and the objectively derived treatment complexity and need were significant ( p = .01). About 50% of the subjects had poor dental aesthetics and this correlated with their high orthodontic treatment complexity and need.     

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正畸治疗要为患者塑造美丽的笑容,对于微笑的评估和设计是很重要的,但是在临床检查中正畸医生经常忽略了微笑分析。本文综述了影响微笑美的主要因素,探讨了其在正畸诊断、矫治设计及治疗中的重要性。     

The use of acupuncture in dentistry: a review of the scientific validity of published papers

OBJECTIVE: To review the scientific validity of published papers on the efficacy of acupuncture in dentistry based on predefined methodological criteria. MATERIALS: A literature search performed by the Royal Society of Medicine and the University Library, Copenhagen, Denmark was able to identify 74 papers written in English, German, Danish, Swedish, Norwegian, Italian, French and Russian published between 1966 and 1996. The search words were: acupuncture and electro-acupuncture, randomised controlled trials (RCT), dental pain, postoperative dental pain, painrelieving in dentistry, and dental analgesia. Among the 74 listed papers, 48 papers were reviewed in the following languages: English, Danish, Swedish, Norwegian and German. Fifteen papers were excluded because they were written in French, Italian or Russian; 11 papers were excluded because the abstract clearly indicated the paper was not a RCT or the paper was of a general nature without relevance to acupuncture.
METHODS: To assess the methodological quality of the included papers, all papers were scored on the basis of predefined criteria. A total of 92 points could be achieved and on the basis of this scale papers were rated as: Excellent (85–100%), Good (70–84%), Fair (60–69%) and Bad (<60%).
MAIN OUTCOME: Fifteen out of 48 papers met the inclusion criteria.
RESULTS: Only one study met the criteria with more than 85%. Five studies met the criteria with 70–84%. Three studies met the criteria with 60–69%. Six studies did not meet the criteria. Acupuncture in 11 out of 15 studies proved effective in the treatment of tempero-mandibular dysfunction (TMD) and as analgesia. Four studies showed no effect of acupuncture.
CONCLUSION: The value of acupuncture as an analgesic must be questioned. The effect of acupunctutre in treating TMD and facial pain seems real and acupuncture could be a valuable alternative to orthodox treatment.     

正畸拔除第二前磨牙后第三磨牙倾斜度的变化

近年来,正畸的研究在口腔医学界日益受到重视,该文总结了拔牙矫治和非拔牙矫治,拔除前磨牙正畸治疗能够改善第三磨牙倾斜度,期望对相关临床和科研人员有所帮助.