25 research outputs found

    Do orthodontists recommend Class II treatment according to evidence-based knowledge?

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    AbstractIntroductionThe adequate indications for the timing of treatment for Class II malocclusion are mandatory for the ethical and efficient practice of orthodontics, but clinicians are reluctant to accept new information that contradicts their preferred method of treatment.ObjectiveThe aim of this investigation was to assess the agreement regarding the indications for Class II malocclusion interceptive therapy between a group of international opinion-makers on early treatment and a group of orthodontists and to compare their treatment indications with the current evidence-based knowledge.Material and methodAn electronic survey containing photographs of mild, moderate and severe Class II malocclusions in children was sent to two panels of experts. Panel 1 (n=28) was composed of international orthodontists who had authored world-class publications on early orthodontic treatment, and Panel 2 (n=261) was composed of clinical orthodontists. Based on a 5-point Likert-type scale, the orthodontists selected their therapy option for each of the 9 Class II malocclusion cases.ResultThe Class II malocclusion treatment recommendations of Panel 2 were significantly different from those offered by Panel 1 with a skew of at least 1 scale point toward earlier treatment. The Class II malocclusion treatment recommendations of the members of Panel 1 members were in accordance with contemporary evidence-based knowledge.ConclusionClass II malocclusion overtreatment appears to be the tendency among clinical orthodontists but not among orthodontists who are academically involved with early treatment. There is a gap between the scientific knowledge and the practices of orthodontists

    Correction to: Mandibular response after rapid maxillary expansion in class II growing patients: a pilot randomized controlled trial

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    In the publication of this article (1) there is an error in the Methods section.https://deepblue.lib.umich.edu/bitstream/2027.42/144777/1/40510_2018_Article_231.pd

    Mandibular response after rapid maxillary expansion in class II growing patients: a pilot randomized controlled trial

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    Abstract Background The aim of this pilot randomized controlled trial (RCT) was to evaluate the sagittal mandibular response induced by rapid maxillary expansion (RME) therapy in mixed dentition patients with class II malocclusion, comparing the effects of bonded RME and banded RME with a matched untreated class II control group. Methods This RCT was designed in parallel with an allocation ratio of 1:1:1. The sample consisted of 30 children with a mean age of 8.1 ± 0.6 years who were randomly assigned to three groups: group 1 treated with bonded RME, group 2 treated with banded RME, and group 3 the untreated control group. All patients met the following inclusion criteria: early mixed dentition, class II molar relationship, transverse discrepancy ≥ 4 mm, overjet ≥ 5 mm, and prepubertal skeletal maturity stage (CS1–CS2). The expansion screw was activated one quarter of a turn per day (0.25 mm) until overcorrection was reached. For each subject, lateral cephalograms and plaster casts were obtained before treatment (T1) and after 1 year (T2). A randomization list was created for the group assignment, with an allocation ratio of 1:1:1. The observer who performed all the measurements was blinded to group assignment. The study was single-blinded in regard to statistical analysis. Results RME was effective in the correction of maxillary deficiency. Class II patients treated with both types of RME showed no significant improvement of the anteroposterior relationship of the maxilla and the mandible at both skeletal and occlusal levels. The acrylic splint RME had significant effects on reducing the skeletal vertical dimension and the gonial angle. Conclusions The orthopedic expansion did not affect the sagittal relationship of class II patients treated in the early mixed dentition when compared with the untreated control group. Additional studies with a larger sample are warranted to elucidate individual variations in dento-skeletal mandibular response to the maxillary expansion protocol in class-II-growing patients. Trial registration ClinicalTrials.gov NCT03159962

    3D mandibular superimposition: Comparison of regions of reference for voxel-based registration

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    The aim was to evaluate three regions of reference (Björk, Modified Björk and mandibular Body) for mandibular registration testing them in a patients' CBCT sample.Mandibular 3D volumetric label maps were built from CBCTs taken before (T1) and after treatment (T2) in a sample of 16 growing subjects and labeled with eight landmarks. Registrations of T1 and T2 images relative to the different regions of reference were performed, and 3D surface models were generated. Seven mandibular dimensions were measured separately for each time-point (T1 and T2) in relation to a stable reference structure (lingual cortical of symphysis), and the T2-T1 differences were calculated. These differences were compared to differences measured between the superimposed T2 (generated from different regions of reference: Björk, Modified Björk and Mandibular Body) over T1 surface models. ICC and the Bland-Altman method tested the agreement of the changes obtained by nonsuperimposition measurements from the patients' sample, and changes between the overlapped surfaces after registration using the different regions of reference.The Björk region of reference (or mask) did work properly only in 2 of 16 patients. Evaluating the two other masks (Modified Björk and Mandibular body) on patients' scans registration, the concordance and agreement of the changes obtained from superimpositions (registered T2 over T1) compared to results obtained from non superimposed T1 and T2 separately, indicated that Mandibular Body mask displayed more consistent results.The mandibular body mask (mandible without teeth, alveolar bone, rami and condyles) is a reliable reference for 3D regional registration

    Condyle‐glenoid fossa relationship after Herbst appliance treatment during two stages of craniofacial skeletal maturation: A retrospective study

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    ObjectivesTo perform a three‐dimensional evaluation of the position of the condyles in patients treated with Herbst appliance (HA) in two stages of cervical vertebral maturation.Setting and sample populationRetrospective case‐control study. Pubertal Herbst group (PHG; n = 24, mean age 14.5 years, CS 3 and CS 4) and pre‐pubertal Herbst group (PPHG; n = 17, mean age 9.9 years, CS 1 and CS 2) were contrasted with comparison groups of non‐orthopaedically treated Class II patients in pubertal (PCG; n = 17, mean age 13.9 years) and pre‐pubertal maturational stages (PPCG; n = 18, mean age 10.6 years).Materials and MethodsCone‐beam computer tomography scans were taken before treatment (T0) and at T1 after 8 to 12 months. Point‐to‐point measurements of the displacement of the condyles between T0 and T1, relative to the glenoid fossae, were performed in the X, Y, Z and 3D perspectives. Qualitative assessments using semi‐transparent overlays and colour mapping also were produced.ResultsThe displacement of the condyles within the glenoid fossae in the treated groups was small ( .05). Relative to the glenoid fossa, condylar position at T1 was similar to T0 in pre‐pubertal and pubertal groups (P > .05). Similar condylar rotations from T0 to T1 were observed in Herbst and comparison groups, and no significant difference was found between pre‐pubertal and pubertal patients.ConclusionsRegardless the stage of skeletal maturation, HA treatment did not change the condyle‐glenoid fossa relationship.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151917/1/ocr12338_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151917/2/ocr12338.pd

    Displacement of the Mandibular Condyles Immediately after Herbst Appliance Insertion - 3D Assessment

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    Objective:To test the following two hypotheses regarding the consequences of Herbst appliance (HA) insertion: 1) a significant clockwise mandibular rotation will occur and 2) the displacement of the condyles will follow the same magnitude of the changes of overjet (OJ) and overbite (OB).Methods:Virtual 3D surface models of 25 patients were generated from cone-beam computed tomographs taken before treatment and immediately after HA insertion. Scans were registered on the cranial base and were analyzed using point-to-point measurements, color-coded maps, and semitransparent overlays. Statistical tests included correlation and simple regression analysis.Results:Pitch rotation, ranging from −2.2° to 2.2° (mean, 0.2°), was observed in clockwise and counterclockwise directions. Condylar sagittal displacement presented a positive correlation with OJ changes. Each millimeter of OJ correction resulted in an anterior condylar displacement of approximately 0.95 mm. Vertical condylar displacement correlated with OB changes and varied mostly between 2 mm and 4.5 mm.Conclusion:Immediately after HA insertion, no significant clockwise mandibular rotation was observed. The condyles were displaced anteriorly and inferiorly. Condylar anterior displacement and OJ correction presented a ratio close to 1:1. The vertical displacement of the condyles did not follow the same magnitude of OB changes

    Superimposition of 3D maxillary digital models using open-source software

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    Abstract Historically, whether for research purposes or clinical monitoring, orthodontic evaluation of dental movements has been done using plaster study models and two dimensional (2D) radiographs. However, new frontiers for the diagnosis, planning and outcome assessment of orthodontic treatments have arisen, due to the revolutionary digital tools which enable a three dimensional (3D) computerized analysis of dental movements by means of digital models. However, the software for 3D analysis are often costly, resulting in limited access to orthodontists. The present study aims to describe, through a clinical case presented to the Brazilian Board of Orthodontics and Dentofacial Orthopedics, a method for the superimposition of maxillary digital models using an open-source software to evaluate dental movements

    Do orthodontists recommend Class II treatment according to evidence-based knowledge?

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    AbstractIntroductionThe adequate indications for the timing of treatment for Class II malocclusion are mandatory for the ethical and efficient practice of orthodontics, but clinicians are reluctant to accept new information that contradicts their preferred method of treatment.ObjectiveThe aim of this investigation was to assess the agreement regarding the indications for Class II malocclusion interceptive therapy between a group of international opinion-makers on early treatment and a group of orthodontists and to compare their treatment indications with the current evidence-based knowledge.Material and methodAn electronic survey containing photographs of mild, moderate and severe Class II malocclusions in children was sent to two panels of experts. Panel 1 (n=28) was composed of international orthodontists who had authored world-class publications on early orthodontic treatment, and Panel 2 (n=261) was composed of clinical orthodontists. Based on a 5-point Likert-type scale, the orthodontists selected their therapy option for each of the 9 Class II malocclusion cases.ResultThe Class II malocclusion treatment recommendations of Panel 2 were significantly different from those offered by Panel 1 with a skew of at least 1 scale point toward earlier treatment. The Class II malocclusion treatment recommendations of the members of Panel 1 members were in accordance with contemporary evidence-based knowledge.ConclusionClass II malocclusion overtreatment appears to be the tendency among clinical orthodontists but not among orthodontists who are academically involved with early treatment. There is a gap between the scientific knowledge and the practices of orthodontists

    Perceived quality factors that discriminate parents of orthodontic patients according to their satisfaction

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    Purpose – Monitoring the perception of quality by parents and the satisfaction with their children’s treatment is crucial in developing high-level health-care services. The purpose of this paper is to identify the perceived quality factors by parents of paediatric orthodontic patients according to the levels of satisfaction. Design/methodology/approach – A survey with 316 parents of paediatric orthodontic patients of 45 offices in a big Brazilian city was conducted. The questionnaires included statements on the parents’ satisfaction and perception of quality concerning their children’s treatment. The data were analysed using multivariate statistics (exploratory factor analysis, cluster analysis and discriminant analysis). Findings – Parents were classified into three clusters according to their level of satisfaction. This survey identified 11 quality factors perceived by parents of patients regarding their children’s orthodontic treatment. Among them, five factors discriminated the clusters: orthodontist’s technical skills, administrative organisation, location (accessibility and convenience), treatment duration and dental supplies. Practical implications – This research identified the perceived quality factors that most impacted parents of orthodontic patients’ satisfaction, contributing to dentists in developing strategies and actions to improve the quality of services in dental offices. Originality/value – This paper included 11 perceived quality factors in the hypothetical model, identified through literature review and a qualitative phase. Moreover, multivariate statistical analyses confirmed the validity and reliability of the questionnaires, classified respondents in clusters and identified the perceived quality factors that most discriminated them. Therefore, the current investigation presented a more comprehensive and robust analysis than the previous studies on this topic.info:eu-repo/semantics/publishedVersio
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