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1.
Aims of this Study
(1) To highlight the role of intraoral submerged device in distraction osteogenesis (DO) of patients requiring two jaw surgeries for the correction of severe developmental maxillary hypoplasia (MH) and mandibular prognathism (MP) (2) To analyse the hard and soft tissue changes following maxillary DO and mandibular setback with bilateral sagittal split osteotomy (BSSO) in patients with severe MH and MP requiring two jaw surgeries.Materials and Methods
During the period Jan 2004 to Dec 2006, five patients with severe developmental MH along with MP were treated. In 1st stage maxillary distraction was done. Distraction started on 6th postoperative day, 1 mm distraction was carried out for 10–15 days on either side. Serial radiographs were taken immediate postoperative period for baseline comparison, post-distraction and at the end of distraction. After a period of 3–4 months of distraction 2nd stage was done. In 2nd stage, mandibular setback was done with BSSO and distractors were removed under general anesthesia. Radiographs were taken immediately and at 4 months post-operatively. Cephalometric tracings were carried out preoperatively, post DO and finally after mandibular setback with BSSO.Results
The mean horizontal movement of maxilla was 11.4 mm at ANS and 9.6 mm at A point. Upper incisor edge was advanced by 8.8 mms. SNA increased by 8.4° and SNB decreased by 4.6°. Nasal projection advanced by 4°. Nasolabial angle normalized in all patients, mean change achieved was 10.8°. Upper lip moved forward by 5.4 mm. Lower lip moved backward by 5.4 mm. Mandible positioned backward by 4 mm at B point. No vertical change occurred in the position of A, ANS and upper incisor edges. Mean increase in skeletal angle of convexity was 26.4°. Concave profile was significantly changed to convex in all patients.Conclusion
Maxillary DO and mandibular setback with BSSO was associated with improved facial balance and esthetics.2.
Amanda Lury Yamashita Lilian Cristina Vessoni Iwaki Gustavo Nascimento de Souza Pinto Bárbara Aline Gerke Mariliani Chicarelli Liogi Iwaki Filho 《Oral and maxillofacial surgery》2018,22(2):197-202
Purpose
The aim of this retrospective study was to evaluate the accuracy of two-dimensional (2D) virtual surgical planning (VSP) of pharyngeal airway space (PAS) in patients submitted to bimaxillary orthognathic surgery.Methods
This study was conducted with lateral cephalograms acquired through cone-beam computed tomography records of 33 patients, divided into group 1—patients submitted to maxillary advancement and mandibular setback (n?=?17) and group 2—patients submitted to maxillomandibular advancement (n?=?16). Records were taken 1 to 2 months prior to surgery, which was used to perform the 2D VSP (Tp), and 6 to 8 months after surgery (T1). In Dolphin Imaging software, the anteroposterior size of the PAS was calculated at the level of four craniometric points: A, occlusal plane (Mx), B, and pogonion (Pog). Two previously calibrated examiners performed these measurements. Statistical analyses were conducted using Kendall and t tests at a 5% level of significance.Results
There was a concordance between the two examiners at all points and times. In group 1, points A and B have statistically significant differences between the PAS measurements performed in Tp and T1, while in group 2, none of the PAS points showed statistically significant differences when comparing Tp to T1.Conclusions
2D computer-based cephalometric prediction in Dolphin Imaging software offers a good orientation to professionals during the surgical procedure of bimaxillary surgeries since its use is considered clinically relevant in daily practice.3.
M. R. Greives A. A. Figueroa Russell R. Reid 《Journal of maxillofacial and oral surgery》2016,15(1):127-130
Introduction
Distraction osteogenesis is a powerful tool in craniomaxillofacial surgery, allowing for large advancements of osteotomized segments in the setting of a restrictive soft tissue envelope. Despite its benefits, distraction can have negative functional consequences. We present a case of a patient with Crouzon syndrome who developed reduced mouth opening capability after a Le Fort III midfacial advancement with rigid external distraction.Technique
Radiographic evaluation revealed that the coronoid process was restricting the normal excursion of the mandible by contacting the posterior zygoma. The patient was subsequently treated with a bilateral coronoidectomy via an intraoral approach, which improved his interincisal opening. Maximum interincisal distance was improved from 18 mm to 33 mm following bilateral cornoid resection.Conclusion
We report coronoid impingement as a potential complication after Le Fort III distraction. Such a finding suggests the need for a detailed vector analysis in cases undergoing midface advancement with distraction. Post-distraction coronoidectomy is a useful surgical procedure to treat mouth opening limitation due to coronoid impingement against the zygoma after midfacial advancement.4.
Wanderley da Silva Félix Junior Leandro Eduardo Klüppel Delson João da Costa Ângela Fernandes Rafaela Scariot Nelson Luis Barbosa Rebellato 《Oral and maxillofacial surgery》2017,21(4):419-423
Objective
The aim of this study was to evaluate alterations in condylar positioning through submentovertex projection (Hirtz Radiographic Technique) in patients who underwent orthognathic surgery for maxillary advancement and mandibular setback with stable internal fixation.Methods
A prospective longitudinal clinical study of 40 surgical patients presenting dentofacial deformity admitted in the Oral and Maxillofacial Surgery Department of Federal University of Paraná (UFPR) in the period between March 2013 and December 2015. We performed two submentovertex digital radiographs, one 7 days before surgery and the other one 30 days after the procedure. Cephalometric tracings were made using Radiocef® Studio 2 Software and measured the intercondylar and condylar angles (right and left).Results
There was a decrease in the intercondylar angle (p < 0.001) and an increase in condylar angles both the right and the left side (p < 0.001) when compared with the pre and postoperative period. There was a larger increase in condylar angle on the right side in males (p = 0.007).Conclusion
There is a tendency of decreasing of the intercondylar angle after orthognathic surgery, regardless of the alteration in the condylar angles, creating a new position of the condyle in the glenoid fossa. Patients with asymmetry may present greater alterations in the positioning of the opposite condylar to the deviation of the mandibular midline.5.
Objectives
The aim of this study was to evaluate the localization, angulation, and resorption features of maxillary impacted canines on cone-beam computed tomography (CBCT).Methods
This retrospective study examined the CBCT scans of 140 maxillary impacted canines in 102 patients (43 males, 59 females; mean age: 16.25 ± 6.31 years). The following impacted canine-related parameters were analyzed on the CBCT images: impaction side; location; root resorption levels of adjacent teeth; occlusal plane and midline distances of impacted canines; and angulations of impacted canines to midline, lateral incisor, and occlusal plane.Results
Bilateral canine impaction was found in 38 subjects, and unilateral canine impaction was present in 64 subjects. Severe resorption was found in 14 canines. There were no significant differences between the occlusal plane and midline distances to the impacted canine cusp tip and root apex (p > 0.05). The midline angulation of right maxillary impacted canines was significantly higher than that of left maxillary impacted canines (p < 0.05), while the occlusal plane angulation of left maxillary impacted canines was significantly higher than that of right maxillary impacted canines (p < 0.05).Conclusions
Maxillary canine impaction was more frequently seen in female subjects than in male subjects. Lateral incisors were more frequently affected than first premolars, and slight resorption was more frequently seen in adjacent teeth. CBCT assessment of maxillary impacted canines can provide accurate measurements of angular, linear, and resorption parameters.6.
Objectives
The aim of this study was to evaluate the effect of the relationship between the horizontal position of the maxillary sinus floor and the tooth roots on maxillary sinus pathologies using cone beam computed tomography.Methods
The patients’ age, sex, presence or absence of apical abscesses, and horizontal relationship between the maxillary sinuses and tooth roots were recorded. In total, 228 maxillary sinuses of 114 patients were divided into case and control groups according to whether pathology was present. The horizontal relationship between the tooth roots and the lower wall of the maxillary sinus was categorized into three types. The variables were analyzed using the Chi-square test.Results
Of 42 apical abscesses, 13 (31 %) were present in the control group and 29 (69 %) were present in the case group. This difference was statistically significant (p = 0.003). Each of the 228 maxillary sinuses was classified according to its horizontal relationship to the tooth root. The most frequently seen relationship was Type II, followed by Type I and III, respectively. Although the control and case groups showed equilibrium in the distribution of Type II and III relationships, maxillary sinus pathologies were significantly less common in Type I (p < 0.001).Conclusions
This study shows that positioning of the maxillary sinus toward the buccal side (Type I) poses an obstacle to the spread of odontogenic infection to the sinus and that the presence of apical abscesses is correlated with maxillary sinusitis.7.
8.
Objectives
The purpose of this study was to evaluate the prevalence of anatomical variations of the nasal cavity and ethmoid complex on cone-beam computed tomography (CBCT) images.Methods
The CBCT images of 322 patients were evaluated retrospectively. The anatomical variations of the bilateral nasal cavity and ethmoidal complex were evaluated in four categories, namely nasal septum, turbinates, ethmoid air cells, and crista galli.Results
The patients comprised 134 males (41.6 %) and 188 females (58.4 %), with an age range of 18–83 years. One or more nasal septum variations were observed in 76.7 % of patients, while variations in the turbinate and ethmoid cell categories were present in 89.4 and 62.1 % of patients, respectively. Overall, 5 % of patients showed pneumatized crista galli.Conclusions
The detailed radiographic examination of the nasal cavity and ethmoid complex is possible and successful on the CBCT images.9.
Neelam Noel Andrade Paul C. Mathai Sriram Ganapathy Neha Aggarwal Kamil Rajpari Trupti Nikalje 《Oral and maxillofacial surgery》2018,22(4):409-418
Introduction
In severe TMJ ankylosis cases, the lack of growth of the mandible creates an anatomically narrow airway with a reduced pharyngeal airway space [PAS] which predisposes these patients towards obstructive apnoea [OSA]. There is evidence in the literature that such patients experience severe discomfort during physiotherapy if such airway abnormalities are not corrected prior to ankylosis release. This eventually leads to non-compliance towards physiotherapy and increases the risk of re-ankylosis.Objective
In our study, pre-arthroplastic mandibular distraction osteogenesis [DO] was used to increase the PAS and resolve the underlying OSA prior to releasing the ankylosis.Materials and methods
Twenty-five cases of TMJ ankylosis with micrognathia and OSA were included in this prospective observational sleep study. They were further divided into a paediatric group [14 subjects] and an adult group [11 subjects]. All cases presented with a history of onset of ankylosis during childhood [before the completion of craniofacial growth] as result of which there was a lack of forward growth of the mandible. Subjects included in our study underwent initial DO of the mandible followed by a second procedure for distractor removal and ankylosis release. Questionnaires, lateral cephalograms and sleep studies were taken pre-operatively (T0), immediate post-distraction to the desired length (T1) and 12 months post the distractor removal and ankylosis release (T2). The parameters studied were PAS width, apnoea hypopnea index [AHI], O2 saturation, mouth opening and mandibular advancement.Results
The paediatric group variables were as follows: mean PAS width which increased from 3.5 mm [T0] to 9 mm [T2], mean AHI which decreased from 48.04 [T0] to 3.60 [T2], mouth opening which increased from 4.5 mm [T0] to 34 mm [T2] and mean O2 saturation which increased from 89.86% [T1] to 96.88% [T2]. The adult group variables were as follows: mean PAS width which increased from 5 mm [T0] to 11 mm [T2], mean AHI which decreased from 31.45 [T0] to 1.43 [T2], mouth opening which increased from 5 mm [T0] to 34 mm [T2] and mean O2 saturation which increased from 92.01% [T0] to 96.84% [T2]. Statistical analysis revealed that DO of the mandible significantly improved OSA by increasing the PAS which was evident by the lower AHI score. Mouth opening was also significantly improved post ankylosis release and maintained at the T2 interval. Ten subjects followed up beyond the T2 interval [mean 28 months post ankylosis release] and their data also revealed positive compliance towards physiotherapy, adequate mouth opening and maintenance of normal AHI.Conclusion
Pre-arthroplastic mandibular DO has proved to be a successful modality for treatment of OSA in TMJ ankylosis patients with stable results at 12 months. By resolving the narrow airway and OSA, compliance towards physiotherapy was improved thus reducing the risk of re-ankylosis in the long term.10.
Abhishek Budharapu Ramen Sinha David P. Tauro Prabhat K. Tiwari 《Journal of maxillofacial and oral surgery》2018,17(2):233-241
Aims
The aim of this study was to evaluate cephalometrically the stability of hard tissues and soft tissue changes of advancement genioplasty 2 years after surgery.Methods
A prospective study was conducted which comprised of 25 patients, who underwent advancement genioplasty alone with no other orthognathic surgical procedures. Immediate pre-operative, 6 months postoperative, and 2 years postoperative lateral cephalograms were compiled and assessed.Results
The mean surgical advancement planned was around 8 mm. Six months post-surgery, the relapse rate was 15% of the surgical advancement which was considerably reduced in the following 18 months to 7%. The ratio of soft tissue to bony advancement at pogonion was 0.9:1. There are significant alterations in the soft tissue profile in terms of decrease in the soft tissue thickness, facial convexity angle, deepened mentolabial sulcus and minimal increase in the lower lip height.Conclusion
Advancement genioplasty was considered as a relatively stable procedure, if adequate muscular pedicle and internal rigid fixation were maintained. The present study was of 2 years, and we can expect further changes in the hard and soft tissues, which are clinically irrelevant.11.
Shashidhara Kamath Kateel Amit Agarwal Gagan Kharae Vijay Prakash Nautiyal Anant Jyoti P. Narayana Prasad 《Journal of maxillofacial and oral surgery》2016,15(2):144-155
Introduction
Canine distraction was introduced as an alternative treatment to retract the canines in minimum possible period of 3 weeks. It involved rapid canine retraction through distraction of the periodontal ligament. Another technique for rapid canine distalization involved osteotomies surrounding the canines to achieve rapid movement of the canines in the dentoalveolar segment known as dentoalveolar distraction. The present study is intended to assess and evaluate canine retraction by the above two mentioned methods of distraction osteogenesis.Materials and Methods
Eight orthodontic patients who required first premolar extractions were selected and 16 canines were distracted into the extraction space, using a distraction screw.Results
The distraction procedure was completed in 15.38 ± 1.51 days on the side of periodontal ligament distraction while it took 14.50 ± 2.45 days on the side of dentoalveolar distraction. No significant anchorage loss was seen in both the sides. The distal displacement of the canines was 6.63 ± 0.90 mm on the periodontal distraction side at the rate of 0.43 ± 0.05 mm/day and 6.91 ± 1.16 mm on the side of dentoalveolar distraction at the rate of 0.48 ± 0.08 mm/day. An angulation change of 14.94° ± 7.58° was observed in canine inclination in periodontal distraction side while change of 14.88° ± 3.15° was seen in the dentoalveolar distraction side.Conclusion
No significant differences in the various parameters were found between both the techniques of canine retraction by distraction osteogenesis, while reducing orthodontic treatment duration by 6–9 months without any unfavorable short-term effects on the periodontium.12.
Purpose
This research is designed to obtain a better understanding and provide more insight of this phenomenon through evaluating the prevalence of congenital absence of maxillary lateral incisors in a Syrian population.Methods
The method involved clinical examination of 8000 school children with an equal number of males and females (age range 12–15 years) to identify students only affected by bilateral or unilateral congenital absence of maxillary lateral incisors. Agenesis was determined based on radiological evidence.Results
The results of this study showed that the prevalence of isolated maxillary lateral incisors agenesis was 1.15%. In the sample studied, 66.3% of the patients were female and 33.7% were male (p < 0.05). Absence was bilateral in 47.8% of patients and unilateral in 52.2%. Of the unilateral cases, 48% occurred on the right side and 52% on the left side, and the contralateral maxillary incisor was found to be microdont in 43.75%, right lateral in 47.6%, and left lateral in 52.4%.Conclusion
The results of this study allow the conclusion that the prevalence of isolated maxillary lateral incisors agenesis in a Syrian population is within the average range with regard to other populations. A significant familial component to the etiology of maxillary lateral incisors agenesis was found.13.
Lucas Borin Moura Rubens Spin-Neto Cássio Edvard Sverzut Marcelo da Silva Monnazzi Alexandre Elias Trivellato Marisa Aparecida Cabrini Gabrielli Valfrido Antonio Pereira-Filho 《Oral and maxillofacial surgery》2016,20(3):255-258
Purpose
Surgically assisted rapid maxillary expansion is performed to correct transverse deficiencies of the maxilla, and it is indicated in specific clinical situations. The literature presents different opinions in several aspects, mainly regarding the effect of disjunction of the pterygoid plates. The aim of this study was to evaluate the pattern of maxillary expansion obtained with two surgical techniques, with and without disjunction of the pterygoid plates.Methods
Twenty patients treated with surgically assisted rapid maxillary expansion for correction of transversal discrepancies were included in this retrospective study and divided into two groups: (G1) patients operated without disjunction of pterygoid plates and (G2) patients treated with release of the pterygoid plates.Results
There were seven male and 13 female patients, and the mean age was 29.9 years. Cone beam computed tomography images obtained after final activation of the expansion device were evaluated and complete disjunction of the midpalatal suture (type I) was present in 75 % of the patients whereas incomplete disjunction of the midpalatal suture (type II) was observed in 25 %. Chi-square test showed no statistically significant difference between groups (p = 0.606).Conclusion
No difference was found in relation to the maxillary disjunction pattern irrespective of the treatment given to pterygoid plates.14.
Objectives
To evaluate the change in masticatory efficiency and quality of life of patients treated with mandibular Kennedy class I removable partial dentures (RPDs) and maxillary complete dentures at the Department of Dentistry of the Federal University of Rio Grande do Norte.Materials and methods
A total of 33 Kennedy class I patients were rehabilitated with maxillary complete dentures, and mandibular RPDs were selected for this non-randomized prospective intervention study. The patients had a mean age of 59.1 years. Masticatory efficiency was evaluated by colorimetric assay using fuchsin capsules. The measurements were conducted at baseline and 2 and 6 months after prosthesis insertion. Quality of life was evaluated using the Oral Health Impact Profile (OHIP-14) at baseline and 6 months after denture insertion. The Kolmogorov-Smirnov normality test was applied. Masticatory efficiency was evaluated by repeated measures ANOVA. Oral health-related quality of life was compared using the paired t test.Results
There was no statistically significant difference in masticatory efficiency after denture insertion (p?=?0.101). Significant differences were found (p?=?0.010) for oral health-related quality of life. A significant improvement in psychological discomfort (p?<?0.01) and psychological disability (p?<?0.01) was observed. Mean difference value (95 % confidence interval) was 6.8 (3.8 to 9.7) points, reflecting a low impact of oral health on quality of life, considering the 0–56 range of variation of the OHIP-14 and a Cohen’s d of 1.13.Conclusion
According to the results of the present study, rehabilitation with Kennedy class I RPDs and complete dentures did not influence masticatory efficiency but improved oral health-related quality of life.Clinical relevance
The association between the patient’s quality of life and the masticatory efficiency is important for treatment predictability.15.
Objectives
To determine the prevalence of odontogenic maxillary sinus pathologies and their relationship with periapical pathologies in the maxillary posterior teeth using cone-beam computed tomography (CBCT).Method
Maxillary posterior CBCT scans of consecutive patients aged 20–77 years were evaluated retrospectively. Patients with at least one maxillary posterior tooth were included. Patients with edentulous maxillae or having one or more maxillary implants were excluded. Finally, 461 CBCT images were evaluated. Demographic data, such as age and sex, and pathologic findings of the right and left maxillary sinuses and adjacent teeth were recorded. Statistical analyses were performed using the Chi square test and binary logistic regression.Results
The prevalence of right and left odontogenic maxillary sinusitis was 59.5 and 64 %, respectively. Maxillary sinus pathology was more common in males, and there was no relationship with age. Regarding the maxillary sinus pathology, 64 % had mucosal thickening, 19 % had partial opacification, 5 % had total opacification, and 12 % had polypoidal mucosal thickening. Right and left maxillary sinus pathologies were approximately twice as prevalent in patients with periapical pathology in at least one maxillary posterior tooth. Periapical pathologies in the right maxillary first molar and left maxillary first and second molars significantly increased the risk of maxillary sinus pathology with odds ratios of 2.53, 1.83, and 3.12, respectively.Conclusions
Odontogenic maxillary sinus pathologies were present in >50 % of the study population. Periapical pathologies in the maxillary first and second molar teeth significantly increased maxillary sinus pathologies.16.
Karan S. Mehta Kavitha Prasad Vibha Shetty Krishnappa Ranganath R. M. Lalitha Jayashree Dexith Sejal K. Munoyath Vineeth Kumar 《Journal of maxillofacial and oral surgery》2017,16(4):471-478
Purpose
Bone loss following extraction is maximum in horizontal dimension. Height is also reduced which is pronounced on the buccal aspect. Various surgical procedures are available to correct the bone volume viz. GBR, onlay bone grafting, alveolar distraction and sandwich osteotomy. Sandwich osteotomy has been found to increase the vertical alveolar bone height successfully.Objectives
The objective of the study was to assess the effect of alveolar segmental sandwich osteotomy on alveolar height and crestal width.Materials and Methodology
A prospective study was undertaken from December 2012 to August 2014. Seven patients with 12 implant sites with a mean age of 36 years were recruited. All seven patients with 12 implant sites underwent alveolar segmental sandwich osteotomy and interpositional bone grafting. Alveolar bone height was assessed radiographically preoperatively, immediate post-op, and at 3 months post-op. Alveolar bone width was assessed radiographically preoperatively and at 3 months post-op. Statistical significance was inferred at p < 0.05.Results
The mean vertical augmentation at immediate post-op was 6.58 mm (p = 0.001). The vertical augmentation that was achieved 3 months post-op was a mean of 3.75 mm which was statistically significant (p = 0.004). The change in alveolar height from immediate post-op to 3 month post-op was a mean 1.69 mm. The mean change in alveolar crestal width at 3 months was a mean of ?0.29 mm (p = 0.57).Conclusion
Sandwich osteotomy can be used as an alternative technique to increase alveolar bone height prior to implant placement. Moderate alveolar deficiency can be predictably corrected by this technique.17.
Ratichanok Nantanee Busayarat Santiwong Chutima Trairatvorakul Hidenori Hamba Junji Tagami 《Clinical oral investigations》2016,20(6):1151-1157
Objectives
The aim of the present study was to evaluate the percent mean mineral density (MD) change of early caries lesions after the application of silver diamine fluoride (SDF) or glass ionomer cement (GIC).Materials and methods
This double-blind, crossover study involved two experimental phases of 28 days each. Thirty-two pairs of enamel slabs were created from the proximal surfaces of 16 premolars. Each pair of artificial carious slabs was randomly divided into the control or test group (38 % SDF or GIC). The slabs were attached to orthodontic brackets and bonded to the maxillary first permanent molars of 16 subjects for 28 days. After a 7-day washout period between phases, the subjects received the other material for the second phase. The mean MD of the lesions was measured by microcomputed tomography.Results
SDF yielded a percent mean MD increase at a depth of 0–84 μm, although increase in the GIC group was observed at a depth of 24–108 μm. The percent mean MD changes of the SDF and GIC groups were similar (p?=?0.100) and significantly higher than in control (p?<?0.001, p?=?0.003, respectively).Conclusions
The two materials increased the percent mean MD change of early proximal caries lesions to a similar extent, but with different spatial patterns.Clinical relevance
Due to deeper level of GIC remineralization, the refractive index of the GIC applied enamel might be closer to sound enamel. Hence, GIC is recommended for remineralization of anterior teeth. SDF staining makes it unsuitable for use in anterior teeth; thus, it is reserved for use in posterior teeth.18.
Ana Márcia Viana Wanzeler Maria Daniela Oliveira Renda Maria Eduarda de Oliveira Pereira Sérgio Melo Alves-Junior Fabricio Mesquita Tuji 《Oral and maxillofacial surgery》2017,21(3):341-346
Introduction
The objective of this study was to establish the anatomical relation between nasal septum deviation (NSD) and oropharynx volume in different facial patterns using cone beam computed tomography (CBCT).Methods
Ninety CBCT examinations were analyzed. InVivoDental software was used to evaluate cephalometric image reconstructions in terms of facial type, determined from cephalometric measurements indicative of growth direction; the presence of NSD was also evaluated. ITK-SNAP software was employed for delimitation of the oropharynx. Intra-examiner error methods were recorded. The results were subjected to parametric and non-parametric tests using Bioestat 5.0.Results
A comparison of facial types revealed a significantly lower prevalence of NSD in the dolichofacial group compared with the brachyfacial and mesofacial groups (P = 0.0101 and 0.0149, respectively). In the total sample, there was a very strong positive relation between the presence of NSD and oropharynx space volume (P = 0.0162). The oropharynx volume was larger in all facial patterns in the presence of NSD.Conclusion
The presence of NSD was not associated with facial type, although the oropharynx volume in patients with NSD increased. Therefore, deviation of the septum influences oropharynx volume.19.
Xue Li Zhen-Rui Xu Na Tang Cui Ye Xiao-Ling Zhu Ting Zhou Zhi-He Zhao 《Clinical oral investigations》2016,20(8):1849-1859
Objectives
This study aims to determine the effectiveness of a messaging app (WeChat) in improving patients’ compliance and reducing the duration of orthodontic treatment (DOT).Materials and methods
A randomized controlled trial was performed in a dental hospital and a clinic from August 2012 to May 2015. Orthodontic patients were included at the beginning of treatment. Patients with multiphase treatment or braceless technique were excluded. Participants were randomized to WeChat group (received regular reminders and educational messages) or control group (received conventional management) and were followed up until the treatment was completed. Primary outcome measure was DOT. Others were late and failed attendance, bracket bond failure, and oral hygiene condition.Results
One hundred twelve patients in each group participated and completed the trial. DOT in WeChat group were 7.3 weeks shorter (P = 0.007). There were less failed attendance (3.1 vs. 10.9 %, P < 0.001), late attendance (20.1 vs. 29.9 %, P < 0.001), and bracket bond failure (11.8 vs. 16.1 %, P < 0.001) in WeChat group than control. There was no difference in orthodontic plaque index nor modified gingivitis index between the two groups before and after treatment. Number of failed attendances was identified as an independent factor affecting DOT (P = 0.004; HR = 0.89, 95 % CI 0.84 to 0.95).Conclusions
The intervention with WeChat is effective in reducing the treatment duration and bracket bond failure, and improving the attendance in orthodontic patients.Clinical relevance
DOT can be reduced by improving patient’s compliance. The messaging app is useful for outpatient education and management.20.