Effect of RME and headgear treatment on the eruption of palatally displaced canines: a randomized clinical study.

Objective: To determine the effectiveness of orthodontic treatment finalized on the maintenance/ improvement the upper arch perimeter to assist in the successful eruption of palatally displaced maxillary canines (PDCs). Materials and Methods: The randomized prospective design comprised 64 subjects with PDCs who were randomly assigned to one of three groups: cervical pull headgear (HG); rapid maxillary expansion and cervical pull headgear (RME/HG); or untreated control group (CG). Panoramic radiographs and lateral cephalograms were evaluated at the time of initial observation (T1) and after an average period of 18 months (T2). At T2 the success of canine eruption was evaluated. A superimposition study on lateral cephalograms was undertaken to evaluate the T1–T2 changes in the sagittal position of the upper molars in the three groups. Results: The prevalence of successful eruption was 85.7% in the RME/HG group and 82.3% in the HG group. Both these prevalence rates were significantly greater than the success rate in untreated control subjects (36%). The cephalometric superimposition study showed a significant mesial movement of the upper first molars in the CG compared with the HG and RME/HG groups. Conclusions: The use of rapid maxillary expansion and headgear (or headgear alone) in PDC cases increases the success rate of eruption of the canine significantly (almost three times more than in untreated controls). (Angle Orthod. 2011;81:370–374.

Does rapid maxillary expansion induce adverse effects in growing subjects?

To assess the scientific evidence that rapid maxillary expansion (RME) causes Adverse Effects on the midpalatal suture, vertical dimension, dental and periodontal structures in growing subjects. MATERIALS AND METHODS: Electronic databases were searched for articles dated through December 2011. The quality of the studies was ranked on a 13-point scale in which 1 was the low end of the scale and 13 was the high end. RESULTS: Thirty relevant articles were identified. The amount of midpalatal suture opening ranged from 1.6 to 4.3 mm in the anterior region and from 1.2 to 4.4 mm in the posterior region. At the end of the active phase, RME resulted in slight inferior movement of the maxilla (SN-PNS +0.9 mm; SN-ANS +1.6 mm), increased tipping of anchored teeth from 3.4° to 9.2° and bending of the alveolar bone from 5.1° to 11.3°. In the long term, RME did not modify the facial growth patterns, and no significant changes on dentoalveolar structures were observed. Of the 30 studies, 2 were medium-high quality, 8 were medium quality, and 20 were low quality. CONCLUSIONS: RME always opened the midpalatal suture in growing subjects. The vertical changes were small and transitory. In the long-term evaluation, an uprighting of anchored teeth was observed and periodontal structures were not compromised

Long term therapeutic efficacy of a soft monobloc mandibular advancement device in adults with obstructive sleep apnea

To evaluate the long term (48 months) therapeutic efficacy of a soft monobloc mandibular advancement device in adult patients with mild or moderate obstructive sleep apnea

Prediction of Class III treatment outcomes through orthodontic data mining

Summary OBJECTIVE: To determine whether it is possible to predict Class III treatment outcomes on the basis of a model derived from a combination of computational analyses derived from complexity science, such as fuzzy clustering repartition and network analysis

Orthodontic treatment of an impacted dilacerated maxillary incisor: a case report

Dilaceration is one of the causes of permanent maxillary incisor eruption failure. It is a developmental distortion of the form of a tooth that commonly occurs in permanent incisors as result of trauma to the primary predecessors whose apices lie close to the permanent tooth germ. We present a case of post-traumatic impaction of a dilacerated central maxillary left incisor in a young patient with a class II malocclusion

The association between Occlusion Time and Temporomandibular Disorders

Introduction: Recently, some published studies show there is a multifactorial origin for Temporomandibular Disorders, but the dental occlusion's contribution to the development of Temporomandibular Disorders, and how it may influence the adaptive capacity of the Stomatognathic system, it's still unclear. The aim of this study is to evaluate the correlation between the Occlusion Time and Temporomandibular Disorders. Methods: A total of 54 patients were enrolled in the study (24 males and 30 females, mean age 27.94±8.21years). The TMD group (8 males and 10 females) consisted of subjects who presented with at least 1 of the following signs of Temporomandibular Disorders: Temporomandibular Joint sounds (clicking or crepitation), Temporomandibular Joint locking episodes, limited mandibular opening, painful limitation of mandibular movements, pain to palpation of the Temporomandibular Joint or of the masticatory muscles. The control group (16 males and 20 females) presented as free from Temporomandibular Disorders. The T-Scan III computerized occlusal analysis system was to record the subjects' Occlusion. Times during eight mandibular opening-closing movements. Results: The two-ways ANOVA test analyzed the variations for group and sex, showing that the TMD group mean Occlusion Time (0.64±0.21s) was statistically significantly longer than the control group mean Occlusion Time (0.45±0.17s) (p<0.001). Significant differences were also found for gender where the mean OT of female subjects was longer than males one with statistical significance (p-value<0.01). Conclusions: The computerized analysis of the Occlusion Time in patients affected by TMJ problems has to be carefully considered as adjunctive instrumental device

Dalla malposizione all'inclusione del canino mascellare: diagnosi e previsione di eruzione

obiettivi. Scopo del lavoro è illustrare le più recenti strategie di trattamento intercettivo in una fase di dentizione mista precoce nei pazienti con malposizione del canino permanente mascellare. Materiali e metodi. Dopo aver eseguito la diagnosi di dislocamento del canino è possibile attuare una serie di manovre di terapia intercettiva per favorire la sua eruzione. Sono descritte singolarmente tutte le metodiche di trattamento proposte dalla letteratura, specificando per ogni opzione l’apporto e la validità scientifica. Risultati. Da un’attenta analisi e revisione bibliografica emerge come l’approccio terapeutico nei confronti di una malposizione canina abbia subito un’importante evoluzione nel corso degli anni. Si passa infatti da un metodo di tipo passivo/ osservazionale, che prevede la semplice estrazione del canino deciduo e il monitoraggio radiografico, a interventi di terapia attiva più complessi che possono prevedere l’espansione del mascellare superiore, in associazione o meno alla distalizzazione dei settori latero-posteriori. Discussione. Nei casi di diagnosi precoce, il recupero del canino malposto prevede un nuovo approccio che integra le manovre già descritte con l’estrazione del canino e del primo molare decidui come elementi determinanti nella programmazione ortodontica. Conclusioni. L’obiettivo del trattamento intercettivo del canino mascellare è quello di aumentare le percentuali di successo di eruzione spontanea del canino permanente mascellare diagnosticato in una fase precoce di sviluppo, evitando meccaniche ortodontiche più complesse e biologicamente invasive per il paziente

Thin-plate spline analysis of mandibular morphological changes induced by early class III treatment: a long-term evaluation

To evaluate the long-term mandibular morphological changes induced by early treatment of class III malocclusion with rapid maxillary expansion (RME) and facial mask (FM)

Intersession reliability of a posturo-stabilometric test, using a force platform

To evaluate the intersession reliability of a posturo-stabilometric examination. METHODS: Single blind clinical trial conducted in two sessions over two weeks. 44 healthy volunteers free from postural and temporomandibular disorders. All the subjects complied with the criteria for completing the study. All the subjects underwent two sessions of posturo-stabilometric examinations in different visual and mandibular conditions. Sway area, sway length and the coordinates of the center of pressure were evaluated and statistically analyzed using the Intraclass correlation coefficient (ICC). RESULTS: All the posturo-stabilometric parameters seemed to have an excellent reproducibility with overall ICCs higher than 70% and good confidence intervals except for the sway area (ICC 0.422 with CI 0.283-0.560 with open eyes and ICC 0.554 with CI 0.424-0.683 with closed eyes). CONCLUSIONS: The posturo-stabilometric examination carried out using a force platform has a good intrasession and intersession reliability, especially considering sway velocity, COP X and COP Y parameters. The force platform usefulness in analyzing static posture is confirmed in any medical field

Effects of cervical headgear and pendulum appliance on vertical dimension in growing subjects: a retrospective controlled clinical trial

Summary OBJECTIVE : To analyze the effects on vertical dentoskeletal dimension produced by cervical headgear (CHG) or Pendulum (P) both followed by full fixed appliances in growing patients with Class II malocclusion