Prevalence of TMD among Children Provided with Fixed Orthodontic Treatment

BackgroundAccording to available scientific references and textbooks, there are contradictory views concerning the etiology of signs and symptoms of TMD.ObjectivesThe aim of this study was to determine a correlation between the incidence of signs and symptoms of TMD in children aged 12-18 who do not wear a fixed orthodontic appliance and the incidence of signs and symptoms of TMD in children who wear a fixed orthodontic appliance.Material and MethodsThe total number of 120 subjects were included in this survey and divided into two groups. There were 60 respondents in the experimental group that consisted of 30 boys and 30 girls with different types of malocclusion, who were treated with a fixed orthodontic straight wire technique. The remaining 60 respondents, which was a group that also consisted of 30 boys and 30 girls, were patients with neutroclusion.ResultsThe results of the study have shown that the TMJ clicking sound symptom, the most common symptom of TMD, occurs with almost equal prevalence in both groups of respondents; specifically, 56.4% in orthodontic patients, and 46.6% in the control group respondents. A statistically significantly higher percentage of female respondents in both groups have experienced headache problems (p <0.03).ConclusionOn the basis of the statistics obtained as a result of this research, we can come to the conclusion that there is no correlation between the fixed orthodontic treatment and the development of signs and symptoms of TMD.     

固定矫正与牙龈炎的关系探讨

目的 探讨正畸治疗患者牙龈炎发生的原因。方法 选取114例病例,分为成人组和青少年组。成人和青少年组又各自分实验组和对照组。在初戴固定矫正器2个月后检查牙龈,进行牙龈指数（GI）测定,从而比较成人与青少年患牙龈炎的比率。结果 成人组牙龈炎患病率低于青少年组,两者有显著性差异,P＜0．01。青少年对照组与相比,实验组患病率高,两者有显著性差异,P＜0．05。成人对照组与实验组相比,两者无显著性差异,P＞0．05。结论 口腔卫生的保健好坏,对正畸治疗患者牙龈炎的发生有着重要作用。进行正畸治疗的患儿家长,应配合督促儿童保持口腔卫生。     

A Comparison Between Written,Verbal, and Videotape Oral Hygiene Instruction for Patients with Fixed Appliances

Abstract

The objective of the study was to compare the effectiveness of written, videotape, and one-to-one instruction upon the knowledge, oral hygiene standard, and gingival health of subjects undergoing orthodontic treatment with a lower fixed appliance.

Subjects for whom fixed appliances had been fitted recently were divided randomly into three groups of 21, 22, and 22, respectively. Group 1 received written oral hygiene instruction, group 2 a specially made videotape, and group 3 saw a hygienist for one-to-one instruction. Results were assessed in terms of improvement in knowledge concerning oral hygiene procedures, and of plaque and gingival index scores.

Analysis of variance revealed no significant main effects or interactions at P = 0?05, although the difference in the plaque index scores before and after instruction was close to significance.     

成人和青少年正畸患者对治疗相关认识的对比性研究

目的:研究成人与青少年正畸患者对正畸治疗的看法和认识差异.方法:对304名正畸初诊患者(分青少年组和成人组)进行有关正畸治疗的认识情况的问卷调查,主要调查内容包括正畸的主要目的、选择正畸的外部影响因素、对咬合及面型的关注程度和认识、治疗时关注因素,将调查结果进行统计学分析.结果:共收回有效问卷288份,显示成人组正畸治疗的目的更加多元化,其正畸治疗的主动性更强,对咬合、面型等更加关注,同时在治疗时的要求也更高.这些都与青少年组存在一定程度上的差异.结论:成年正畸患者对正畸治疗的目的和要求都高于青少年,需要更加慎重的对待.     

两种矫治器对正畸治疗中釉质脱矿影响的临床研究

目的研究自锁托槽直丝弓矫治器和传统直丝弓矫治器对釉质脱矿的影响。方法根据168例患者治疗前的釉质脱矿指数将其随机分为两组：一组患者采用自锁托槽直丝弓矫治器（自锁托槽直丝弓组）,另一组患者采用传统直丝弓矫治器（传统直丝弓组）。选择矫治期为18～19个月的102例患者矫治结束后再次检查釉质脱矿情况,计算釉质脱矿指数和釉质脱矿增加指数,比较两组患者治疗前后釉质脱矿指数和釉质脱矿增加指数的差异。结果自锁托槽直丝弓组治疗前后的釉质脱矿指数分别为0.026±0.048、0.158±0.085;传统直丝弓组治疗前后釉质脱矿指数分别为0.023±0.049、0.196±0.063。正畸治疗前两组患者釉质脱矿指数差异无统计学意义（F=0.345,P〉0.05）,两组正畸治疗后的釉质脱矿指数均高于治疗前水平（P〈0.001）,两组患者矫治后釉质脱矿增加指数差异有统计学意义（F=6.998,P〈0.01）。结论采用自锁托槽直丝弓矫治器可以降低釉质脱矿的程度。     

中药大黄对正畸固定矫治中龈炎的治疗研究

目的:评价中药大黄对正畸固定矫治中龈炎治疗的临床疗效。方法:选择牙周健康者20例(尚未矫治)和矫治6个月临床诊断为牙龈炎的患者60例为研究对象,牙周健康患者20例设为牙周健康组,60例牙龈炎患者随机分为3组:大黄组、明胶海绵组和对照组。分别于治疗前采集4组研究对象的牙周临床指数和龈沟液标本,使用ELISA法测量龈沟液中白介素-1β的含量,比较组间各项指标间的差异。对牙龈炎3组患者,其中大黄组用大黄明胶海绵药条,明胶海绵组用灭菌蒸馏水明胶海绵条,分别置于龈袋内,每周上药1次,共4次,对照组患者龈袋内不放任何药物。于4周后重新采样比较牙周治疗前后上述指标间的差异。结果:牙龈炎组治疗前牙周临床指数、龈沟液IL -1β浓度均显著高于牙周健康组(P＜0.05),大黄组、明胶海绵组与对照组比较无显著性差异。治疗后明胶海绵组上述指标与对照组比较无显著性差异,且明显高于牙周健康组(P＜0.05)。治疗后明胶海绵组和对照组分别与治疗前比较均无显著性差异。治疗后大黄组上述指标相比治疗前及对照组均明显降低(P＜0.05),与牙周健康组比较,龈沟出血指数(SBI)接近正常。结论:中药大黄对正畸固定矫治中龈炎具有明显的治疗效果。     

Perceptions of Dutch Orthodontic Patients and Their Parents on Oral Health-Related Quality of Life

Objective:To test the hypotheses that 1) there is no difference between orthodontic patients'' and their parents'' reports of patients'' oral health-related quality of life, and 2) there are no gender differences.Materials and Methods:The sample consisted of 182 orthodontic patients (age range, 8–15) and their parents. Respondents were required to complete the Child Oral Health Impact Profile (COHIP). Items were divided into five different subscales, and scores on all subscales were compared between and within groups. Also, scores on six additional items regarding treatment expectations and global health perception were compared. Two hypotheses were tested: first, that no differences between parents and patients would be detected, and second, that no differences between boys and girls would be found.Results:The first hypothesis could not be rejected. Only a few minor differences between parents and patients were found. The second hypothesis was rejected. Differences between boys and girls were found on the subscales Emotional Well-Being and Peer Interaction, indicating that girls experience more effects of oral health on their quality of life than do boys.Conclusions:Parents'' reports on their children''s oral health-related qualities of life were in agreement with reports of the orthodontic patients. This suggests that parents are suitable alternatives to their children in surveys measuring oral health-related quality of life.     

A Comparison of the Periodontal Health of Patients during Treatment with the Invisalign® System and with Fixed Orthodontic Appliances

Abstract Objective: Evaluation of the periodontal health in patients during treatment with either fixed orthodontic appliances or the Invisalign^® system. Study Design: The study was designed as a concomitant trial. The evaluation of the patients started in February 2002 and was completed in August 2003. Patients and Methods: Thirty consecutive patients each with fixed orthodontic appliances and with aligners were examined at three consecutive control visits for their periodontal condition. All individuals were part of the clientele of the Department of Orthodontics and Dentofacial Orthopedics of the Charité Berlin. The parameters evaluated were the modified Gingival Index, modified Plaque Index, modified Papillary Bleeding Index, and sulcus probing depth. The first three indices were recorded alternatively buccally and lingually in all permanent teeth from central incisor to first molar: buccally in the maxillary right and the mandibular left quadrants, lingually in the maxillary left and mandibular right quadrants. The sulcus depth was measured in four areas: mesially and distally, lingually and buccally in the 1st molar and the 1st premolar of each quadrant. Each control visit was concluded with a detailed, individualized oral hygiene instruction. Results: The modified Plaque Index was significantly lower in the Invisalign^® group overall. On the other hand, the periodontal condition of the two samples was nearly identical. Conclusion: Periodontal health is not jeopardized, even though the Invisalign^® system aligners cover all the teeth and the keratinized gingiva in part. This could be attributed to the fact that aligners are removable and thus allow unimpeded oral hygiene.     

Fixed Orthodontic Appliance Therapy and Its Impact on Oral Health-Related Quality of Life in Chinese Patients

Objective:To determine changes in oral health-related quality of life (OHRQoL) during fixed orthodontic appliance therapy in Chinese patients.Materials and Methods:Two-hundred fifty Chinese orthodontic patients completed six distinct intervals of the 14-item Oral Health Impact Profile (OHIP-14, Chinese version): before treatment (T0); after the placement of the fixed appliance at 1 week (T1), 1 month (T2), 3 months (T3), and 6 months (T4); and posttreatment (T5).Results:The overall response rate was 88.8% (222 of 250). Significant differences of overall OHIP-14 scores could be found between any two time points (P < .001), except for between T0 and T2 (P > .05) and between T3 and T4 (P > .05). Overall scores at T1 were significantly higher than the scores at the other intervals (P < .001), with a significant change in the scores on physical pain (P < .001), psychological discomfort (P < .001), and physical disability (P < .001). Scores at T5 were lowest among the six time points (P < .001).Conclusions:Fixed orthodontic appliance therapy did affect Chinese patients'' OHRQoL. Patients were considerably compromised in terms of their overall OHRQoL until approximately 1 month after insertion. The severity of the compromised condition in terms of overall OHRQoL was greatest at 1 week with the reported impact on physical pain, psychological discomfort, and physical disability. Patients'' OHRQoL was better after they completed the orthodontic treatment than before or during treatment.     

面型对正畸支抗牙牙根吸收影响的临床研究

目的 探讨不同面型在正畸治疗中对支抗牙牙根吸收的影响。方法 选择120例经方丝弓矫治器治疗的患者,按面型分为高角型、正常型、低角型3个组,每组患者治疗前后分别拍摄头颅侧位定位片,配对测量分别被确定作为支抗的后牙或前牙正畸治疗前后牙根长度,将牙根长度改变量以计算机进行统计分析,并评价牙根吸收情况。结果3组病例正畸治疗前后支抗牙牙根长度改变有统计学意义(P<0.001)。3组之间相对应牙齿的牙根吸收量不同,高角型病例牙根吸收轻,而低角型病例牙根吸收重。组间不同的吸收量差异有统计学意义(P<0.01)。结论 在正畸治疗中不同面型对支抗牙牙根吸收程度有不同影响,面型是影响支抗牙牙根吸收的一个重要因素。     

不同民族固定矫治所致牙龈炎和前牙牙龈增生的临床研究

目的:探讨牙龈增生、牙龈炎在不同社会背景下的固定矫治患者中发病率及相关因素。方法:收集正畸治疗中或刚刚拆除矫治器的患者250名,随机分为2组。在接受矫治6~12个月和≥12个月时,由牙周专科医师检查菌斑及牙龈指数、牙周袋深度、附着丧失及牙龈增生程度。患者的社会经济背景,正畸治疗持续时间,正畸过程中牙线使用情况被记录下来。之间的相关性建立泊松回归模型,并使用多元性回归分析法进行分析。结果:牙龈出血(RR 1.02; 95% CI 1.01-1.02)和托槽周围多余的树脂残留(RR 1.04; 95% CI 1.04-1.05)跟牙龈增生有高度相关性。社会背景跟牙龈增生无相关性。结论:在正畸治疗患者中前牙牙龈出血和托槽周围多余树脂残留跟牙龈增生程度成正相关。     

两种局部用氟对预防正畸牙脱矿的临床研究

目的了解固定矫治器治疗后牙齿牙釉质脱矿的发生率及严重程度，评价用75％氟化钠处理牙面和使用含氟牙膏对减轻牙釉质脱矿的作用。方法选择固定矫治器治疗的患者93例随机分为3组，氟化钠糊剂组34例，含氟牙膏组28例，对照组31例，治疗前后对牙面脱矿情况进行临床观察。结果矫治前3组患者牙齿牙釉质脱矿发生率和脱矿程度差异均无统计学意义（P〉0．05）。矫治后氟化钠糊剂组牙釉质脱矿率为8．9％，含氟牙膏组为9．0％，对照组为15．6％，两种氟处理组其脱矿率明显低于对照组，差异有统计学意义（P〈0．001）。两种氟处理组发生1度脱矿的牙数高于对照组（P〈0．05），发生3度脱矿的牙数低于对照组（P〈0．05），3组发生2度脱矿的牙数差异无统计学意义（P〉0．05）。氟化钠组和含氟牙膏组EDI小于对照组（P〈0．001），而两种氟处理组间的脱矿率和EDI差异无统计学意义（P〉0．05）。结论正畸治疗中配合使用氟化物处理牙面，可预防牙釉质脱矿的发生。     

Dental Care with Manual Toothbrushes during Fixed Orthodontic Treatment—a New Testing Procedure

AbstractAim: The aim of this investigation was to employ a new in-vitro testing system for manual toothbrushes in order to distinguish the more effective from those less so for dental care during fixed appliance treatment.Materials and Methods: The testing apparatus consisted of a sliding carriage able to execute a horizontal brushing movement, and a row of artificial teeth upon which the various toothbrushes were manipulated. The artificial row of teeth was fixed on a sensor that recorded in all three dimensions the forces and moments caused by the toothbrushes on the toothbrush field. All the tests were executed with a weight of 110 g on a tooth field with a multibracket appliance. Tests were also carried out with five toothbrushes having weights of 200 g, 250 g and 300 g. Here, the decisive target values were 1) the degree of exertion necessary in the brushing direction to move a brush over the artificial teeth, and 2) the maximum force occurring in the brushing direction. High target values indicated high interaction between toothbrush bristles and the surfaces being brushed.Results: From testing five toothbrushes with four different weights, we have established profiles confirming the beneficial and less beneficial properties of certain toothbrushes involving various high contact forces.     

Perception of Esthetic Orthodontic Appliances: An Eye Tracking and Cross-sectional study

ObjectiveTo evaluate the perception of esthetic orthodontic appliances by means of eye-tracking measurements and survey investigation.Materials and MethodsEn face and close-up images with different orthodontic appliances (aligner appliance [a], aligner appliance and attachments [b], lingual appliance [c], ceramic brackets [d], no appliance [e; control]) were shown to 140 participants. Eye movement and gaze direction was recorded by eye-tracking system. For different anatomical areas and areas of the appliances, time to first fixation and total fixation time were recorded. The questions included in a visual analog scale regarding individual sentiency were answered by the participants.ResultsFor all groups, the anatomical landmarks were inspected in the following order: (1) eyes, (2) mouth, (3) nose, (4) hair, and (5) ears. Only in group d, first fixation was on the mouth region (1.10 ± 1.05 seconds). All appliances except the lingual appliance (1.87 ± 1.31 seconds) resulted in a longer fixation on the mouth area (a, 2.97 ± 1.32 seconds; b, 3.35 ± 1.38 seconds; d, 3.29 ± 1.36 seconds). For close-up pictures, the fastest (0.58 seconds) and longest (3.14 seconds) fixation was found for group d, followed by group b (1.02 seconds/2.3 seconds), group a (2.57 seconds/0.83 seconds), and group c (3.28 seconds/0.05 seconds). Visual analog scale scoring of questions on visibility were consistent with eye-tracking measurements. With increasing visibility, the feeling of esthetic impairment was considered higher.ConclusionsLingual orthodontic appliances do not change how the face is perceived. Other esthetic orthodontic appliances may change the pattern of facial inspection and are different in subjective perception.     

Effectiveness of a New App in Improving Oral Hygiene in Orthodontic Patients: A Pilot Study

ObjectivesThe aim of this randomised clinical trial was to evaluate the effects of a mobile application (app) on the oral hygiene (OH) of adolescents undergoing fixed orthodontic treatment.MethodsEight volunteers (14–19 years old) were randomly allocated to the experimental or control groups. Volunteers in the control group received standard OH (SOH) instructions, whilst volunteers in the experimental group received SHO + OH guidance and motivation through an app tailor-made for this study. Clinical assessments were made using the visible plaque index (VPI) and gingival bleeding index (GBI) at 5 different time points: before orthodontic device installation (T0); at baseline (T1); and 30 (T2), 60 (T3), and 90 (T4) days after randomisation. Significant differences were evaluated using Student t test and multilevel logistic regression analysis.ResultsAlthough no significant difference could be observed, VPI at T1 and T2 were lower for volunteers in the experimental group (33.20 ± 19.29; 32.10 ± 7.72) than for the volunteers in the control group (42.11 ± 8.56; 43.59 ± 34.71). The same was observed for GBI, in which volunteers in the experimental group presented lower GBI at T1 and T2 (12.70 ± 8.10; 13.72 ± 7.39) than volunteers in the control group (27.53 ± 17.89; 20.38 ± 9.95). Good acceptance for using the app was shown by volunteers.ConclusionsThis study shows the potential utility of the mobile app for improving the OH of adolescents.     

Gloves: A Recommended aid in Cross Infection Control in Orthodontics A Comparison of Gloves available from UK Supply Houses

Abstract

Friction in fixed appliance systems has received considerable attention in recent literature, although that attributable to varying second order (tip) and third order (torque) adjustments in either the bracket or the archwire has not been fully investigated. The ex vivo study of 0·022 × 0·028-inch slot Minitwin®, Activa®, and Standard Straight Wire® brackets investigates friction when known values of tip or torque were applied to 0·018 × 0·025-inch stainless steel wires. The resistance to sliding of the wire through the ligated brackets was measured on a vertically-mounted Instron testing machine.

The results showed that the self-ligating Activa® brackets consistently produced less friction than the other conventionally tied brackets. Minitwin® brackets were slightly more resistant to movement than the Standard® brackets during torquing, but the converse was found when tip was applied. Increasing tip and torque (ranges tested 0–6 degrees and 0–25 degrees, respectively) produced almost linear increases in friction for all brackets, although increasing tip had the more profound effect on friction, particularly in Activa brackets.     

Correction of Unilateral Condylar Hyperplasia and Posterior Open Bite with Proportional Condylectomy and Fixed Orthodontic Treatment

A 29-year-old female patient with unilateral condylar hyperplasia (UCH) of the left side presented with facial asymmetry, maxillary transverse occlusal plane (MXTOP) cant, posterior open bite, and Class III relationship. Treatment consisted of proportional condylectomy of the left condyle for management of UCH, and fixed orthodontic treatment with intrusion of the left maxillary molars to correct the MXTOP cant and remaining chin point deviation (CPD). Proportional condylectomy with a 14-mm resection of the left condylar head improved the CPD from 11.5 mm to 7.8 mm and resolved the posterior open bite on the left side. However, it produced a Class II relationship on the right and left sides, posterior open bite on the right side, and anterior open bite. Fixed orthodontic treatment with 1.8-mm intrusion of the left maxillary molars using miniscrews corrected the MXTOP cant from 3.5 mm to 1.7 mm, reduced the remaining CPD from 7.8 mm to 3.7 mm, produced counterclockwise rotation of the mandible, and resolved the posterior open bite on the right side and the anterior open bite. After 16 months of total treatment, normal overbite/overjet and Class I relationship were obtained. Treatment results were well maintained after 5 years of retention. For the correction of UCH, it is important to determine the amount of condylar head resection and accurately simulate the correction of CPD and MXTOP cant through intrusion of the maxillary molars.     

固定矫治器对牙龈状况与龈沟液中内毒素含量影响的研究

目的：探讨固定矫治对牙龈状况的影响和有效控制牙龈炎症的方法。方法：将临床就诊采用固定矫治器进行治疗的患者作研究对象，临床就诊的100例患者，分别于矫治前，矫治后1、3、6个月，矫治结束前，结束后3个月的牙龈炎症指数，龈沟液细菌内毒素进行测试比较，统计学处理。结果：1)牙龈炎症指数：固定矫治器戴于后1个月牙龈指数最高，3个月后趋于稳定，此时牙龈炎症指数接近正常，6个月后至矫治结束时基本无明显变化，矫治结束后3个月牙龈组织恢复完全正常；2)细菌内毒素：细菌内毒素含量与牙龈炎症指数呈正相关关系。结论：1)固定矫治器对牙龈组织的健康有一定的影响，但患者只要掌握正确的刷牙方法，养成良好的口腔卫生习惯，就可以是牙龈组织的炎症得到有效控制。2)固定矫治过程中的牙龈炎性反应同细菌内毒素含量有非常密切的正相关关系，而细菌内毒素是G^-菌的裂解产物，故对于固定矫治过程中出现的牙龈炎症，可以应用对G^-菌有效的抗菌素进行有效控制。     

微螺钉种植体支抗的并发症分析

目的 研究自攻型微螺钉正畸支抗的并发症.方法 选择36例应用微螺钉的正畸患者,共植入82枚微螺钉,观察微螺钉种植体支抗并发症的表现,计算微螺钉相关并发症的发生率.结果 70枚微螺钉完成正畸支抗, 10枚松动, 3枚发生周围炎, 1枚植入后出血.结论 微螺钉种植体是正畸的有效支抗,同时应重视并防治其并发症的发生.