Calendar of Meetings

Abstract

Over a 1-year period, all patients attending a consultant orthodontist's new patient clinics in North Derbyshire and whose treatment plans involved active appliance treatment, were accepted into a prospective longitudinal study. In all 294 patients were included in the study. Subsequent to the consultant's new patient clinic the patients' active treatments were undertaken in the Hospital, General, or Community Dental Services. Four years after the commencement of the study, 207 patients had completed active treatment and 50 had non-completed during active treatment. This gave an overall non-completion rare (NCR) of 19·5 percent for the study. Of the 50 patients who did not complete treatment during active treatment 23 (46 per cent) non-completed during the first 6 months of active treatment. A predictive model of non-completion of active orthodontic treatment (NCT) over time is suggested.     

The impact of personality on adult patients' adjustability to orthodontic appliances

Objective:To evaluate the impact of psychological traits on patients'' choice of orthodontic appliances and their adjustability to orthodontic treatment.Materials and Methods:The sample consisted of 68 adult patients divided into three groups (28 buccal, 19 lingual, and 21 clear aligners). Prior to treatment participants filled out the Brief Symptom Inventory to assess symptoms of mental distress and the Narcissistic Vulnerability Scale to assess narcissistic personality traits. During the first week after appliance delivery and on day 14, patients completed a Health-Related Quality of Life questionnaire to assess their perception of pain and four areas of dysfunction. The correlation between personality traits and patients'' reaction to treatment was evaluated.Results:Somatization was the only trait that affected the choice of lingual and clear aligner appliance. Reduced self-esteem regulation was associated with increased pain in all patients, while exploitation was associated with pain in lingual patients. Narcissistic vulnerability slightly influenced patients'' adaptability to orthodontic appliances. Although adjustability to lingual appliances was the most difficult, only two parameters were affected by personality features. In the buccal group, adjustability was affected by numerous parameters. Adaptation to the clear aligner appliance was relatively uneventful and least affected by psychological features.Conclusion:Anxious individuals tend to prefer lingual and clear aligner appliances. The selection of lingual and clear aligner appliances governs the patient''s response and recovery process, leaving little room for the effect of psychological features. On the other hand, the buccal appliance allows for greater impact of personality traits on adjustability.     

Effect of text message follow-up on patient's self-reported level of pain and anxiety

Objectives:To determine whether a text message reduces the severity of patient self-reported levels of pain and anxiety following initial placement of orthodontic appliances.Materials and Methods:Thirty-nine orthodontic patients were randomly assigned to one of two groups and matched for age, gender, and bracket type (self-ligating vs conventional). The subjects completed baseline questionnaires to ascertain their levels of pain and anxiety before initiating orthodontic treatment. Following the initial appointment, subjects completed the pain questionnaire and anxiety inventory at the same time daily for 1 week. One group received a structured text message showing concern and reassurance, while the second group served as a control and received no postprocedural communication.Results:There was a statistically significant difference in pain in relation to time between the text message group and the control group as it was demonstrated that demonstrated that compared with the text message group, mean pain intensity increased and selfreported discomfort was longer in the control group. Anxiety was determined to be at its peak the day following initial orthodontic appliance placement and gradually tapered off from that time point. No intergroup difference was noted when analyzing anxiety.Conclusions:This study demonstrated that a text message sent from an orthodontic office following initial appliance placement resulted in a lower level of patient''s self-reported pain. Additionally, patient anxiety is at its peak the day following the initial appointment and decreases from that point forward.     

Quality of life in an adolescent orthodontic population:: Invisalign versus fixed appliances

ObjectivesTo investigate adolescent orthodontic patient experiences and quality of life with fixed appliances compared to Invisalign.Materials and MethodsAdolescent patients in active treatment with Invisalign or fixed appliances for a minimum of 6 months were provided with the Child Oral Health Impact Profile-Short Form 19 questionnaire, along with additional items of interest that were assessed separately. Pearson''s χ² test was used to compare responses (P < .05), and unpaired t-tests (P < .05) were used to test for differences in mean satisfaction, quality of life, and domain scores.ResultsIn total, 74 patients (37 in each treatment group) participated. Overall, no significant differences were noted in the mean quality of life, satisfaction, or domain scores between the two groups. A significant difference was noted in the time taken to adjust to appliances, with the Invisalign group demonstrating faster adaptation. Additionally, the fixed appliance group was 3.8 times more likely to report missing school because of their appliance (95% confidence interval [CI]: 1.2, 12.5) and 2.7 times more likely to report having difficulty eating certain foods (95% CI: 1.1, 7.1). When the sample of females between the ages of 14 and 18 was analyzed, the Invisalign group reported feeling attractive more often than the fixed appliance group.ConclusionsBoth treatment groups were generally very satisfied with their treatment modality. The overall quality of life of adolescent orthodontic patients undergoing treatment with fixed appliances and Invisalign for a minimum of 6 months was similar.     

Localized sequential use of resilient lining to generate orthodontic force in thermoformed active removable appliances

Abstract

A new modality of orthodontic treatment based on the thermoformed appliance was developed and trialled clinically. A light-cured resilient lining material commonly used for denture relining was placed locally and sequentially in thermoformed appliances to generate orthodontic forces. The new method appeared to be effective. All the presented cases showed substantial improvement in dental alignment. A number of orthodontic movements were demonstrated. Localized use of resilient lining in thermoformed orthodontic appliances appeared to be a promising alternative to other thermoformed active removable appliance (TARA) treatments. Further studies are required to optimize the procedures and explore its full potential.     

Lingual orthodontics and orthognathic surgery

Lingual orthodontics is an appealing option for patients requiring orthognathic surgical correction, since these patients are invariably adults or mature teenagers who are no longer at the usual "orthodontic age." Appearance is undoubtedly the most important motivating factor for adults seeking orthodontic treatment, and since the more physically attractive person has the advantage over the not-so-attractive person, it is self-evident that these patients would prefer an appliance that is less visible. Using the Ormco, Creekmore, or Begg lingual appliances in the maxillary arch and a labial appliance in the mandibular arch, the authors have successfully treated a variety of dentofacial deformities with a combined lingual orthodontic and surgical approach. The aim of this article is to establish some guidelines for the treatment of a variety of surgical cases and to highlight what are perceived to be the advantages and disadvantages of these 3 lingual appliances in the treatment of orthognathic cases and of the lingual orthognathic approach in general.     

The research component in orthodonticeducation:sniffingoutrats (SnOR)

Abstract

The evolution since 1900 of the removable orthodontic appliance is described. The effects upon this evolution of political and economic events, the introduction of new materials and the British approach to orthodontic treatment are discussed. Present opinion favours the increased use of fixed appliances but it seems likely that removable appliances will still be suitable in about half those cases requiring active treatment.     

两种材质磁力矫治器的临床应用比较

目的 研究自凝塑料和热压膜材料两种材质制作的磁力矫治器的临床应用效果,旨在为临床应用提供参考。方法 早期反畸形患者18例,随机平均分为A组戴用自凝塑料制作的磁力矫治器,B组戴用热压膜材料为主制作的磁力矫治器。观察指标包括：（1）临床及技工操作时间比较;（2）戴用矫治器以后的主观感觉;（3）1年后矫治效果模型的简单检查;（4）1年内因矫治器本身问题的复诊率。结果 热压膜材料为主制作的磁力矫治器,临床及技工操作时间分别为（19.44 ± 6.44） min和（3.11 ± 1.27） min,小于自凝塑料制作的磁力矫治器（P 〈 0.05）。戴用矫治器后患者主观认同,热压膜材料为主制作的矫治器在舒适度与异物感、美观、对吞咽功能的影响这些方面优于A组（P 〈 0.05）。1年内,A组的矫治器发生固位问题、折裂和变形情况的机会大于热压膜材料为主制作的矫治器（P 〈 0.05）。结论 结论 热压膜磁力矫治器在患者认同感以及临床和技工操作方面均表现出明显优越性,具有很好的应用前景,同时戴用效果未有明显差异,不易发生矫治器的固位,折裂或变形等问题。临床上根据热压膜磁力矫治器的优点,建议推广使用。     

Accidental ingestion of fractured part of a pendulum appliance

PurposeHow to deal and the precautions to be taken to avoid any injury from accidental, ingestion of an appliance or a part of an orthodontic appliance during a chair-side procedure or later Case History Patient ingested a foreign body (wire) of orthodontic (pendulum appliance) origin.ResultsThe radiographs showed a wire in the lumbar region which was excreted out within 3 days.Clinical recommendations/conclusionConstant and proper care of the appliance in every visit.     

Effects of fixed labial orthodontic appliances on speech sound production

Objective:To explore the impact of fixed labial orthodontic appliances on speech sound production.Materials and Methods:Speech evaluations were performed on 23 patients with fixed labial appliances. Evaluations were performed immediately prior to appliance insertion, immediately following insertion, and 1 and 2 months post insertion. Baseline dental/skeletal variables were correlated with the ability to accommodate the presence of the appliances.Results:Appliance effects were variable: 44% of the subjects were unaffected, 39% were temporarily affected but adapted within 2 months, and 17% of patients showed persistent sound errors at 2 months. Resolution of acquired sound errors was noted by 8 months post–appliance removal. Maladaptation to appliances was correlated to severity of malocclusion as determined by the Grainger’s Treatment Priority Index. Sibilant sounds, most notably /s/, were affected most often.Conclusions:(1) Insertion of fixed labial appliances has an effect on speech sound production. (2) Sibilant and stopped sounds are affected, with /s/ being affected most often. (3) Accommodation to fixed appliances depends on the severity of malocclusion.     

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.     

Effects of orthodontic treatment with aligners and fixed appliances on speech:: A randomized clinical trial

ObjectivesTo evaluate effects of orthodontic treatment with aligners and conventional fixed appliances on production of speech.Materials and MethodsThis was a parallel, randomized clinical trial. Patients with Angle Class I malocclusion, moderate crowding, and no speech impairment were randomly allocated to two groups: patients with orthodontic aligners (OAs; n = 20; mean age = 23.60 ± 5.65 years) and those with conventional fixed appliances (n = 20; mean age = 20.56 ± 4.51 years) and treated at the University of North Parana''s clinic in Londrina, Brazil. Evaluation of speech production was performed semiobjectively by a speech therapist (myofunctional orofacial examination) and subjectively (self-assessment) at five time points: baseline, immediately after insertion of appliances, and subsequently at 3, 30, and 180 days after insertion. For intergroup comparison, independent t, χ², Fisher exact, and Mann-Whitney tests were used; for intragroup comparison, the Friedman test was applied (α = 5%).ResultsIn the semiobjective evaluation, patients with OAs exhibited a change in production of speech production, compared with patients with fixed appliances, immediately and 3 days after insertion of appliances (P < .001). Thirty days after insertion, the groups were similar (P = .487), an outcome that was unchanged at 180 days. However, in the self-assessments, patients in both groups reported significant speech difficulties immediately and 3 days after insertion of appliances, but such impairment was no longer perceived at 30 days or 180 days.ConclusionsAlthough the speech therapist identified changes in speech production at the start of treatment in the OA group only, patient self-assessments demonstrated that orthodontic treatment, regardless of the type of appliance used, interfered with their perception of speech.     

Impacts on daily performances related to wearing orthodontic appliances

OBJECTIVE: To assess the prevalence, intensity, and extent of the impacts on daily performances related to wearing different types of orthodontic appliances. MATERIALS AND METHODS: A total of 1657 students, 15 to 16 years old, were randomly selected from those attending all secondary schools in Bauru, S?o Paulo, Brazil. Only those wearing orthodontic appliances at the time of the survey were included. Face-to-face structured interviews were done to collect information about impacts on quality of life related to wearing orthodontic appliances, using the Oral Impact on Daily Performances (OIDP). Adolescents were also clinically examined to assess the type of orthodontic appliance they were wearing. Comparisons, by type of orthodontic appliance and covariables, were performed using nonparametric statistical tests. RESULTS: Three hundred fifty-seven adolescents (36.1% boys and 63.9% girls) undergoing orthodontic treatment participated in the study. The prevalence of condition-specific impacts related to wearing orthodontic appliances was 22.7%. Among adolescents with impacts related to wearing orthodontic appliances, 35.8% reported impacts of severe or very severe intensity and 90.1% reported impacts on only one daily performance, commonly eating or speaking. The prevalence, but not the intensity or the extent, of condition-specific impacts differed by type of orthodontic appliance (P = .001). CONCLUSIONS: One in four Brazilian adolescents undergoing orthodontic treatment reported side effects, specific impacts on daily living, related to wearing orthodontic appliances. Such impacts were higher among adolescents wearing fixed rather than removable or a combination of fixed and removable orthodontic appliances. This information could help to inform patients about the frequency and intensity of sociodental impacts during the course of their treatment.     

The American Orthodontics BOS MOrth Cases Prize 2005

Abstract

This paper describes the orthodontic treatment of two cases that were successfully entered for the 2005 American Orthodontics MOrth Cases Prize. The first case is that of a patient presenting with a Class II division 2 malocclusion treated with upper and lower fixed appliances plus headgear. The second case demonstrates the use of a twin-block appliance, followed by fixed appliances to correct a moderate Class II division 1 malocclusion.     

Foreign body ingestion and aspiration in dentistry: a review of the literature and reports of three cases

This article reviews several cases of foreign body ingestion or inhalation reported in the literature. Prevention, complication and management of this event are discussed and three case reports presented. Two of the cases were bridge ingestion and one was ingestion of an orthodontic band. The three cases were managed by watchful waiting and the ingested foreign bodies came out in the stools without complications.     

The impact of orthodontic appliances on eating — young people’s views and experiences

Abstract

Objectives:

Orthodontic appliances are known to cause patients difficulty with eating. Learning more about the issues patients face, while eating with orthodontic appliances in place, will allow us to create more informative and relevant patient information, thereby improving patient compliance and treatment success. This study aims to understand how orthodontic appliances impact on eating in the broader context and to explore adolescent patients’ perceptions of eating with orthodontic appliances. Methods: Purposive sampling was used and 19 participants currently undergoing orthodontic treatment and aged 11–14 years were selected for either a focus group or semi-structured interview to explore eating-related issues. Data collection and analysis were carried out as an iterative process broadly following principles of thematic analysis. Data collection ceased when no new themes emerged. Results: Two main themes relating to eating problems emerged: restriction of food choice and problems associated with the eating process. Participants reported restricting food choice due to physical aspects of the appliance, advice given by their orthodontist, fear of breakage and also to minimize embarrassment. Participants also reported problems with the time taken to eat, chewing problems, taste change and being messy while eating. Additionally, time in treatment, the location of eating and relationship with those present during eating influenced emotions. Some participants indicated a positive impact of orthodontic appliances on their diet. Conclusions: These results can be used to further inform dietary advice offered to patients. Factors were identified which may not be considered in clinical practice but which could improve the value of dietary advice given to patients.     

应用CBCT研究不同矫治器正畸拔牙矫治对前牙区牙根及牙槽骨的影响

目的 应用CBCT研究无托槽隐形矫治及传统固定矫治器正畸拔牙对前牙区牙根及牙槽骨的变化情况.方法 选择成人拔牙矫正的患者60例,随机分为无托槽隐形矫治器组及传统固定矫治器组(N=30).正畸治疗前后拍摄CBCT,测量两组正畸患者上下颌中切牙、侧切牙、尖牙的牙根长度及牙槽骨的厚度变化情况.结果 固定矫治器组较无托槽隐形矫...     

Headache Improvement Through TMD Stabilization Appliance and Self-management Therapies

Abstract

The purpose of this study was to assess headache response of unselected neurology clinic chronic headache patients to TMD stabilization appliance and self-management therapies, and to identify features of patients whose headaches are more likely to improve from these therapies. Twenty chronic headache patients in a nontreatment control period were provided appliance and self-management therapies, evaluated five weeks after therapy, and those who chose to continue using their appliances were evaluated three months later. The mean pretreatment Headache Disability Inventory (HDI) score of 64.5 suggested the headaches were severe. After five weeks, the mean HDI score decreased by 17 percent (p<0.003), headache medication consumption dropped by 18 percent (p<0.0001), and headache symptoms decreased by 19 percent (p<0.002). Comparing the three months with pretreatment follow-up, the fourteen participants who chose to continue using their appliances had a mean HDI score decrease of 23 percent (p<0.003), headache medication consumption drop of 46 percent (p<0.001), and headache symptom decrease of 39 percent (p<0.001). There was no correlation between response and headache type (p=0.722). These results suggest appliance and self-management therapies can be beneficial for many severe headache patients, irrespective of the headache type (tension-type, migraine without aura, and migraine with aura).     

Outcome assessment of lingual and labial appliances compared with cephalometric analysis,peer assessment rating,and objective grading system in Angle Class II extraction cases

Objective:To validate our hypothesis that there would be significant differences in treatment outcomes, including cephalometric values, degree of root resorption, occlusal indices, and functional aspect, between cases treated with labial and lingual appliances.Materials and Methods:Twenty-four consecutively treated Class II cases with extractions and lingual appliance were compared with 25 matched cases treated with extraction and labial appliance. Orthodontic treatment outcomes were evaluated by cephalometric analysis, peer assessment rating, and an objective grading system (OGS). Additionally, functional analysis was also performed in both groups after orthodontic treatment. Statistical comparison was performed using the Wilcoxon signed rank test within the groups, and the Mann-Whitney U-test was used to compare between the labial and lingual groups.Results:The only significant difference between the groups was that the interincisal angle was larger in the lingual group than in the labial group. OGS evaluation showed that control over root angulation was significantly worse in the lingual group than in the labial group. There was no significant difference between groups in the amount of root resorption or in functional evaluation.Conclusions:Generally, lingual appliances offer comparable treatment results to those obtained with labial appliances. However, care should be taken with lingual appliances because they are more prone to produce uprighted incisors and root angulation.     

Self-Ligating Brackets in Orthodontics: A Systematic Review

Objective:To evaluate the clinical differences in relation to the use of self-ligating brackets in orthodontics.Materials and Methods:Electronic databases were searched; no restrictions relating to publication status or language of publication were applied. Randomized controlled trials (RCTs) and controlled clinical trials (CCTs) investigating the influence of bracket type on alignment efficiency, subjective pain experience, bond failure rate, arch dimensional changes, rate of orthodontic space closure, periodontal outcomes, and root resorption were selected. Both authors were involved in study selection, validity assessment, and data extraction. Disagreements were resolved by discussion.Results:Six RCTs and 11 CCTs were identified. Meta-analysis of the influence of bracket type on subjective pain experience failed to demonstrate a significant advantage for either type of appliance. Statistical analysis of other outcomes was unfeasible because of inadequate methodological design and heterogenous designs.Conclusions:At this stage there is insufficient high-quality evidence to support the use of self-ligating fixed orthodontic appliances over conventional appliance systems or vice versa.