Orthodontic planning and biomechanics fortransverse distraction osteogenesis

Orthodontic treatment planning in the transverse dimension has historically been based on the mandible because of the interest in keeping this dental arch width more or less constant for reasons of stability. However, the advent of mandibular (with or without maxillary) transverse distraction osteogenesis (TDO) has allowed the practitioner to achieve results previously thought to be impractical and/or unattainable. There are numerous indications for incorporating TDO into patients' treatment plans because it may lead to enhanced facial esthetics, prevent dental extractions, and improve stability. Planning treatment requires not only an astute diagnosis and the establishment of appropriate goals, but an understanding of the biomechanics. Orthodontic management of the dentition during the predistraction and postdistraction period is discussed. The article also describes the planning, construction, mechanics, rigidity, placement, activation, and stabilization of the expansion appliance. TDO has been shown to be an effective technique for maxillary and mandibular widening in some situations in which other orthodontic and orthognathic procedures have been lacking.     

Orthodontic treatment for adults

The number of adults undergoing orthodontic treatment has increased strongly and the average age that adult patients undergo orthodontic treatment increased steadily although 3/4 is still younger than 27 years. In adults the facial skeletal pattern can only be changed in a very confined way, consequently in case of an abnormal skeletal pattern one has to choose between a combined orthodontic-surgical approach (which is the case in 18% of the patients) and a compromised orthodontic treatment, if necessary combined with other disciplines. It is still controversial whether tooth movement in adults is slower and more difficult than in adolescents. The same holds true for the risk for loss of periodontal support, for root resorption, for gnathologic problems and for relapse. As related to these variables there appears to be a large individual variation. Many adults show one or more problems in their dentition that may influence their orthodontic treatment. About 60% of the adult patients need a multidisciplinary approach. The development of implantology and of bone regeneration and bone grafting has lead to more combined treatments. The risks of such complex treatment plans are generally larger than those for more simple kinds of treatment. A very careful treatment planning and good communication between the different specialists is essential. Moreover the treatment plan with all its (dis)advantages has to be extensively discussed with the patient.     

成年人正畸

近年来 ,随我国改革开放、经济发展 ,公众对形象美的追求日益重视 ,成年人要求矫正牙颌畸形 ,改善自身形象 ,提高生活质量的就诊患者迅速增加。据我们近年正畸门诊统计 ,约占门诊量的 1/ 3左右。造成这一趋势的原因 ,一方面是时代进步和社会开放的要求 ,使这一代成年人在经济条件改善和生活稳定后有可能弥补过去未能治疗的遗憾。另一方面也是由于正畸技术的普及和简化 ,使越来越多的普通口腔医生参与正畸治疗 ,同行业的竞争促使专业正畸医师的治疗范围向成年人治疗和唇腭裂矫治等难度更大、技术要求更高的领域开拓。今天 ,成人正畸已成为每…     

Orthodontic treatment after autotransplantation

Autotransplantation is an alternative method to replace a missing tooth. This study reports a 17-year-old man who had autotransplantation of the left upper third molar with the congenitally missing left lower second premolar. No signs of inflammation, root resorption, ankylosis, mobility, sensitivity, pocket problems, or pulp destructions were found after 2-year follow up. Autotransplantation can lead to shorter treatment time and an improved treatment result in certain cases. It also eliminates the need for implants or prosthetic therapy.     

Orthodontic treatment need in Latvia

Measuring the prevalence of malocclusion and treatment need in a population is useful for the planning of orthodontic services. In addition, knowledge concerning the attitudes of patients to malocclusion is becoming increasingly important in orthodontics. Without a satisfactory estimate of the need and demand for treatment it is difficult to develop and organize a meaningful service. The aims of this investigation were to estimate the need for orthodontic treatment in 12-13-year-old school children in urban and rural schools in Latvia. Five hundred and four school children aged 12-13 years were examined using the Index of Complexity, Outcome and Need (ICON). The children were invited to complete a questionnaire about treatment need and their appearance. The survey was carried out in four urban and five rural school settings. There were no statistically significant differences in treatment need between rural and urban settings or between boys and girls. However, there was a difference in ICON scores between Riga and Daugavpils, with a greater need for treatment in Daugavpils. Individual responses to questionnaires illustrated a correlation between individuals who expressed dissatisfaction with the arrangement of their teeth and treatment need according to the ICON score. The overall prevalence of individuals needing orthodontic treatment in Latvia was 35.3 per cent, but this figure masked considerable variation between schools. For example, a greater need was found in Daugavpils than in Riga. This difference is not fully explained but could be due to genetics, the individuals in Daugavpils being mainly of Russian origin. The individuals' perception of the arrangement of teeth and the need for treatment correlated significantly with the ICON score.     

Orthodontic treatment and root resorption

Root resorption after orthodontic treatment occurs frequently. The biologic process of tooth movement and root resorption is described. Furthermore, attention is given to the frequency and severity of root resorption, diagnostics and aspects of the orthodontic treatment which aggravate root resorption. Displacement of teeth with resorptions that already exist or with deviating rootforms is riskfull.     

Orthodontic treatment in periodontal patients

Orthodontic treatment poses a significant challenge in patients suffering from periodontal disease. Providing orthodontic treatment to periodontal patients should be carefully planned and performed in a tight collaboration between the orthodontist and periodontist. Resolution and stabilization of the periodontal condition is a pre-requisite for orthodontic treatment initiation. Careful oral hygiene performance and highly frequent recall periodontal visits are also crucial. Pre- or post- orthodontic periodontal surgery might help providing better treatment outcomes.