Dental esthetics, orthodontic treatment, and oral-health attitudes in young adults.

INTRODUCTION: The aim of this study was to investigate whether young adults with varying dental esthetics and histories of orthodontic treatment also differ in oral-health attitudes, preventive behaviors, and self-perceived oral health. METHODS: The sample comprised 298 young adults, 18 to 30 years old, with at least 13 years of primary and secondary school education. The subjects were asked to complete questionnaires dealing with various measures related to oral-health attitudes, preventive behaviors, and perceptions of oral health. Dental esthetics were assessed by means of the aesthetic component of the index of orthodontic treatment need. Dental plaque accumulation was assessed in a subsample of respondents. RESULTS: Subjects with high dental-esthetics scores reported more favorable oral-health attitudes, such as internal control, dental awareness, value of occlusion, and preventive behavior expectations than subjects with lower scores. Subjects with previous orthodontic treatment showed greater internal control and dental awareness than those who had not previously been treated. Subjects ranking high in dental esthetics and those with previous orthodontic treatment reported stricter oral-hygiene adherence than others. Self-perceived oral health was better in high scorers on dental esthetics. Less plaque accumulation was found in subjects with higher dental esthetic scores and in those with previous orthodontic treatment. CONCLUSIONS: These findings suggest that favorable dental esthetics and previous orthodontic treatment might be important variables in explaining individual differences in oral-health attitudes and behaviors.     

Conservative adjunct to esthetic orthodontic treatment in young patients

The esthetic effect of orthodontic treatment in young patients may sometimes be incomplete without performing additional procedures related to the form and texture of the anterior teeth. Six young patients, aged 7 to 21 years, presented for orthodontic treatment to improve their dental esthetics. The problems of tooth staining, mutilation, congenitally missing teeth, tooth size/arch length discrepancy, and sequellae of dental trauma neccessitated a combined orthodontic-prosthodontic treatment. Changing morphology and texture by conservative prosthetic procedures proved to be a successful complement to orthodontic treatment.     

Dental esthetic satisfaction in adults

This study determined the influence of teeth, mouth, and face on self-image and personal esthetic satisfaction in adults. A random sample of 125 patients completed a five-item questionnaire about personal esthetic satisfaction and oral self-image. As a group, general dental variables were stronger predictors of esthetic satisfaction than orthodontic variables (P less than .01). Discrepancies between clinical findings and patterns of self-perception and satisfaction suggest the dentist and patient should plan together for esthetic dental treatment.     

The need for treatment and satisfaction with dental appearance among young Finnish adults with and without a history of orthodontic treatment.

The aim of this investigation was to evaluate orthodontic treatment need and patient satisfaction among young adults living in a city where free-of-charge orthodontic treatment was provided. A total of 281 18- to 19-year-old subjects randomly selected from the population register of the city of Vantaa took part in the study. The drop-out rate was 30%. Treatment need was clinically assessed according to the Index of Orthodontic Treatment Need (IOTN), consisting of a Dental Health Component (DHC) and an Aesthetic Component (AC). Information on previous orthodontic treatment was based on the patient records. Satisfaction of the subjects with their dental appearance and with the orthodontic treatment received was obtained using a questionnaire. The rate of orthodontic treatment among the subjects was 46% (54% for the females and 37% for the males, p < 0.05). 4% had discontinued treatment. A definite need for treatment (DHC 4 to 5/AC 8 to 10) was assessed in 15% of the subjects, and borderline/moderate need (DHC 3/AC 5 to 7) in 36%. No difference in IOTN scores between the treated and untreated subjects was found. Females had significantly more often no treatment need (DHC 1 to 2/AC 1 to 4) compared with males (p < 0.05). The majority of subjects (89%) reported that they were very or quite satisfied with their dental appearance. The odds of being satisfied were significantly higher for the treated subjects (OR = 2.71, p < 0.05) and lower for those at the non-attractive end of the AC scale (OR = 0.14, p < 0.01). Neither gender nor DHC grade significantly affected the odds of being satisfied among the subjects. The results indicate that the majority of young adults in this study were satisfied with their dental appearance regardless of objective treatment need of various degrees. The high treatment rate in relation to unnoticed treatment need calls for reevaluation of priorities in patient selection.     

用隐适美矫治器进行正畸治疗时的牙齿漂白

目的:本研究旨在确定无储槽托盘（将隐适美矫治器或Vivera保持器用作漂白托盘）的牙齿美白效果,先对数据进行有限元分析,随后采用分光光度法进行临床研究。材料和方法:研究采用有限元分析技术确定漂白凝胶在牙齿和矫治器之间（体外实验）的理想分布。分别分析了上颌中切牙上应用凝胶的三个样本区域（切端、中部和龈缘）。由于与有限元分析的结果有关,研究采用分光光度法确定漂白凝胶的临床效果。具体来说就是对漂白凝胶作用在对照组（下颌右侧中切牙和下颌左侧侧切牙,有储槽）与在实验组（下颌左侧中切牙和下颌右侧侧切牙,没有储槽）上分别获得的色度变化进行比较。结果:有限元分析结果表明,当2mm3的凝胶施加到托盘中牙齿唇/颊面的中心时达到最佳凝胶分布。就临床研究而言,实验组和对照组之间的美白效果没有显著的差异。两组的美白均有效并且患者对此也十分满意。结论:患者在使用隐适美矫治器进行正畸治疗期间接受牙齿美白的优势是显而易见的,该方法省时省钱。需要进一步的临床研究来评估该方法的有效性。     

Dental status of adults with and without periodontitis

All 30- to 59-year old subjects (N = 757) from a representative sample of adult Finns (total sample = 1,105), showing advanced periodontitis (marginal bone loss more than 30%, n = 125), were compared with their age- and sex-matched pairs showing no marginal bone loss (n = 291) with respect to the number of intact teeth (no caries experience) present. Both male (n = 83) and female (n = 42) subjects with advanced periodontitis had more intact teeth and intact molars than their matched pairs (113 men and 178 women) (P less than or equal to 0.01 for intact teeth and P less than or equal to 0.05 for intact molars in both groups). The total number of teeth present did not differ significantly between the compared groups. Contrary to earlier hypotheses, our results suggest that periodontitis and dental caries do not necessarily share a common etiology.     

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目前,口腔种植已经成为临床常用的修复方式,但在有种植要求的人群中会有许多复杂情况,如伴有不同程度的咬合问题,单纯的种植修复难以达到理想治疗目的,需要正畸等专科医生的参与等。反之,正畸治疗中常遇到的磨牙早失、恒牙先天缺失等难题,也需要通过种植获得满意的治疗效果。口腔多专业联合治疗目前已成为一种发展趋势。对某些牙列缺损患者进行以后期种植修复为导向的正畸治疗正在成为共识,而正畸治疗中应用种植技术辅助完成矫治的情况也不罕见。本文将就种植-正畸联合治疗的特点和优越性等方面进行阐述,为部分复杂病例的临床治疗提供参考经验。     

TMJ function with and without orthodontic treatment

In order to evaluate the functional status of the stomatognathic system of former orthodontic patients, a review of current literature is given. In addition, a sample of orthodontically-treated subjects and a control group was investigated by means of clinical functional analysis. The figures found in the literature and the results of this study failed to reveal orthodontic treatment as a frequent cause of stomatognathic dysfunction symptoms. Instead, we found the functional status and occlusal parameters of our former orthodontic patients to be more harmonious than in the control group.     

Soft- and hard-tissue augmentation by orthodontic treatment in the esthetic zone

A technique that may effectively create a greater volume of available hard and soft tissue in the vertical plane without surgical intervention is reported and explained. Limitations of the forced eruption are also discussed. Creating an esthetic implant-supported restoration is a challenge in patients who have alveolar resorption and/or attachment loss, especially when they present with a high smile line. Many methods to augment this loss of tissue have been proposed; most involve surgical procedures to add bone or bone substitutes to compensate for the loss of alveolar tissue. This case report presents an alternative to bone augmentation procedures with the use of orthodontic tooth movement in the esthetic zone of a 62-year-old woman. The tooth movement facilitated implant placement by increasing soft-tissue volume and facial bony contours.     

Dental implants following trauma in young adults

Various statistics have shown that avulsion (total displacement of tooth out of its socket) following traumatic injuries is relatively infrequent, ranging from 0.5 to 16% of traumatic injuries in the permanent dentition. The maxillary central incisors are the most frequently avulsed teeth. Avulsion of teeth occurs most often in children from 7 to 9 years of age, when the permanent incisors are erupting. Most frequently, avulsion involves a single tooth; but multiple avulsion are occasionally encountered. Fractures of the alveolar socket wall are often associate with avulsion. After the tooth is lost, an almost certain sequelae is the rapid resorption of alveolar bone. In many cases, only a very thin crestal bony lamella remains after healing of the alveolus, with clinically obvious horizontal and vertical depressions. In a young patient missing an anterior tooth, the operator may find implant insertion, in the proper anatomical position, difficult or impossible, because of inadequate bone volume. This situation aggravates with time because of continuous resorption and relative growth of the adjacent alveolar bone around the teeth. New and predictable bone augmentation techniques allow compensation for bone reduction while waiting for completion of growth. In cases of localized ridge augmentation, the amount of initial bone volume and its shape dictate whether implant insertion and bone augmentation will be performed simultaneously. The indications for this approach are: sufficient bone volume to achieve initial implant stability and a predictably high success rate for the augmentation. When bone volume and shape do not allow for initial stability, there is indication for a staged approach, in which the bone is initially augmented, the results are evaluated and the implant is then inserted. The first stage, the bone regeneration phase, may last between 8-10 months. The second, the implant integration period, may take an additional 6-8 months. The effect of growth on the augmented bone is not quite clear and there is only a paucity of information concerning the use of bone regeneration procedures in growing patients. Clinical decision when to start implant treatment after avulsion is dependent not only on the timing of implant insertion, but also on bone regeneration procedures. When most of horizontal and vertical bony walls of the extraction site is lost, augmentation procedure as a measure to reduce the deficiency, may be considered even in preadolescents. Three cases describing different clinical situations following avulsion, tooth replacement, resorption, regeneration treatment and implant insertion are discussed.     

Three-dimensional technology improves the range of orthodontic treatment with esthetic and removable aligners

The orthodontic field continues to evolve with advances in technology. New three-dimensional technology has given the clinician the opportunity to perform comprehensive full-treatment plans. This case report illustrates diagnostic and treatment planning aspects of virtual treatments, in addition to successful orthodontic treatment results with removable aligners.     

Perception of orthodontic treatment need among Swedish children,adolescents and young adults

Objective: Perceptions of orthodontic treatment need and perceptions of dental aesthetics was investigated among subjects ages 10, 15 and 19.

Materials and methods: A total of 489 subjects completed a questionnaire after inspecting 10 photographs in the Aesthetic Component scale of the Index of Orthodontic Treatment Need to (i) reveal the lower limit for orthodontic treatment need and (ii) rate their dental aesthetics by selecting the most similar photo.

Results: The mean lower limit for orthodontic treatment need was significantly higher (and closer to literature-based standards) among subjects, age 10 (4.2?±?1.5), than among subjects, age 15 (3.6?±?1.2) (p?=?.0009), and subjects, age 19 (3.5?±?1.2) (p?=?.00002). Among subjects ages 15 and 19, the lower limit for orthodontic treatment need was lower in groups with (i) self-perceived orthodontic treatment need (p?=?.002 and .001, respectively) and (ii) previous orthodontic treatment (p?=?.005 and .035, respectively). Self-perceived orthodontic treatment need was present in more than one-third of subjects, age 19, who had previously received orthodontic treatment. Subjects of foreign origin reported that their dental aesthetics were worse (p?=?.002) and those same subjects, age 19, set the lower limit for orthodontic treatment lower (p?=?.047) than Swedes, age 19.

Conclusions: The lower limit for orthodontic treatment need among subjects, age 10, was higher – compared to subjects, ages 15 and 19 – and closer to literature-based standards. Subjects with self-perceived orthodontic treatment need, subjects with previous orthodontic treatment, and subjects age 19 of foreign origin, have higher aesthetic demands.     

Dental trauma in children and young adults visiting a University Dental Clinic

Abstract –  The aim of the study was to present the distribution of traumatic dental injuries in the permanent anterior teeth in 447 consecutively selected patients in the age interval of 6 to 25 years treated at the Department of Paediatric Dentistry at the University Dental Clinic in Rijeka, Croatia, in the period from 2001 to 2006. Data on age, gender, number of injured teeth and type of injury were taken from the dental records. Of all 447 consecutively selected patients with traumatic dental injury 56.2% were boys and 43.8% were girls with a male/female ratio 1.28:1 ( P  < 0.01). The highest frequency of tooth injuries occurred among 10- to 13-years-old children. Among 30.6% of the cases, two or more teeth were injured (38.6% in boys and 21.4% in girls). Traumatic injuries affecting teeth in the upper jaw were more frequent ( P  < 0.001). The most commonly affected teeth were the maxillary central incisors (42.4% of right central incisors and 38% of left central incisors). The most frequent injury was enamel and dentin fracture without pulpal involvement (38.7%). In conclusion, more attention should be paid to preventive measures.     

Concern for dental appearance among Norwegian young adults in region with low uptake of orthodontic treatment

Abstract – The purpose of the present study was to examine orthodontic concern among orthodontically untreated young adults living in an area where the relative number of children receiving treatment was only 15–20% and to compare orthodontic concern among these individuals with that of untreated persons from an area with a higher treatment frequency. All the subjects were clinically examined and impressions for dental study casts, radiographs and photographs were taken. The subject's occlusion was classified according to two methods: 1) allocation to one of four groups according to the national Need for Orthodontic Treatment Index (NOTI), and 2) allocation to one of three groups according to presence or absence of six Anterior Occlusal Traits (AOT). Frequencies of NOTI scores demonstrated that in the study group more individuals were in need of treatment relative to the comparison group. Reported concern was at the same level in both groups, and significantly related to NOTI and AOT scores. The individuals in the area with the low treatment frequency were generally less aware of their anterior traits compared to the individuals in the area with a higher treatment frequency. The results indicated that a long-term low uptake of orthodontic treatment among children in the particular area was not accompanied by a similar increase in concern about own dental appearance in early adulthood.