injuries and complications management with forsus appliance

Introduction: Forsus is a useful appliance for non-compliant Class II problems, however various problems can occur when using them.Objective: To demonstrate a comprehensive series of of critical situations that can occur using the Forsus device and to provide the possible solutions of each complication.Materials & Method: The clinical management of the Forsus appliance was analyzed for eighty consecutively treated patients. The Forsus was used five months on average and pictures and clinical record were registered each time a patient had a problem or an injury.Discussion: The most common problem was breakage of the appliance. Breakage could occur as debonding of the lower first premolars or unsoldering of the upper first molar tubes. Lower premolar debonding could be prevented and fixed with an extra layer of flow composite surrounding the bracket base. Lesions of the cheek mucosa were found in several patients. A soft cotton pad used as "wax" was an effective solution to allow soft tissue healing and to prevent spring rubbing against the cheek. Upper molar intrusion occurred mainly when second molars were not included in the upper arch. Some patients experienceddisconnection of the spring and the push rod while opening the mouth wide. They were taught to self-adjust the appliance.Conclusion: The use of the Forsus appliance may lead to relatively frequent problems that the orthodontist can easily preventand manage

Clinical effects of different prescriptions on the inclination of maxillary and mandibular incisors by using passive self-ligating brackets

Controlling the incisal inclination is fundamental in orthodontics. However, the relationship between the inclination prescription and its clinical outcome is not obvious, and the incisal inclination changes generated by different bracket prescriptions were investigated

MRI of the TMJ and sEMG of masticatory muscles in patients with arthrogenous temporomandibular disorders: a correlation analysis

The aim of this study was to verify if patients with arthrogenous temporomandibular disorders (TMD) with different Magnetic Resonance Imaging (MRI) diagnoses had some objective differences in the surface electromyography (sEMG) characteristics of their masticatory muscles. Twenty-four TMD patients were categorized according to the RDC/TMD [1]; MRI classified patients with disk displacement (DD, mean age 22 years, SD 5; M/F: 3/6), and osteoarthrosis and/or disk displacement (OA, mean age 37 years, SD 10; M/F: 4/11). sEMG of the right and left masseter and anterior temporalis muscles was performed according to a standardized protocol, recording teeth clenching on either cotton rolls or occlusal surfaces [2]. EMG data were compared to those collected in control subjects of similar age and sex, and EMG z-scores were computed. The comparison of EMG z-scores and MRI scores between the 2 patient groups using the Mann-Whitney test was statistically significant (P < 0.05): the patients with OA had larger scores than the patients with only DD. The linear correlation analysis run between the EMG and the MRI scores found significant correlations in both patient groups. The EMG characteristics allowed to well differentiate patients with MRI diagnosis of DD or OA. The objective recording of the masticatory muscle function and dysfunction through sEMG can be a first simple and low cost diagnostic approach to TMD patients

Injuries and Complications Management with Forsus Appliance

Introduction: Forsus is a useful appliance for non-compliant Class II problems, however various problems can occur when using them.Objective: To demonstrate a comprehensive series of of critical situations that can occur using the Forsus device and to provide the possible solutions of each complication.Materials & Method: The clinical management of the Forsus appliance was analyzed for eighty consecutively treated patients. The Forsus was used five months on average and pictures and clinical record were registered each time a patient had a problem or an injury.Discussion: The most common problem was breakage of the appliance. Breakage could occur as debonding of the lower first premolars or unsoldering of the upper first molar tubes. Lower premolar debonding could be prevented and fixed with an extra layer of flow composite surrounding the bracket base. Lesions of the cheek mucosa were found in several patients. A soft cotton pad used as "wax" was an effective solution to allow soft tissue healing and to prevent spring rubbing against the cheek. Upper molar intrusion occurred mainly when second molars were not included in the upper arch. Some patients experienceddisconnection of the spring and the push rod while opening the mouth wide. They were taught to self-adjust the appliance.Conclusion: The use of the Forsus appliance may lead to relatively frequent problems that the orthodontist can easily preventand manage

Corrigendum: Does low-frequency vibration have an effect on aligner treatment? A single-centre, randomized controlled trial (European Journal of Orthodontics, (2019) 41, 4 (434-443) DOI: 10.1093/ejo/cjy076)

Background: Low-frequency vibrations have been proposed as a means of accelerating tooth movement and reducing orthodontic treatment times. Objective: To determine any differences in the accuracy of dental movement in patients treated with a low-frequency vibration aligner protocol and/or by reducing the aligner replacement interval with respect to a conventional protocol. Design: This trial was designed as a single-centre, randomized controlled clinical trial. Methods: Participants: Patients (aged 27.1 ± 9.0 years) who required orthodontic treatment with aligners. Randomization: Patients were randomly allocated to three arms as determined by a computer-randomization scheme. Group A were assigned a conventional protocol (aligners replaced every 14 days); group B also used a low-frequency vibration device for 20 minutes per day; group C followed the same vibration protocol but replaced their aligners every 7 days. Blinding:The operator who performed the set-up and the one who analysed the data were blinded to the group of the patients. Outcome: Pre- and post-treatment digital models were analysed using VAM software to identify the accuracy/imprecision of dental movements. One-way analysis of variance (P < 0.05) and the Bonferroni post hoc test were used to identify any statistically significant differences between the three arms in terms of the accuracy of tooth movement versus the prescription. Results: Numbers analysed: A total of 45 patients (15 for group) were analysed (i.e. 2286 dental movements). Outcome: No statistically significant differences emerged between groups A and C in the upper arch, or among groups A, B, and C in the lower. Group B displayed significantly greater accuracy with respect to group A in upper incisor rotation (P = 0.016), and to group C in vestibulolingual (P = 0.007) and mesiodistal tipping (P = 0.029) of the upper canines, and vestibulolingual tipping of the upper molars (P = 0.0001). Harms: No adverse events or side-effects were registered. Conclusions: Considering all tooth and movement types of the 45 participants, the mean total imprecision was 2.1 ± 0.9 degrees, with respect to a mean prescription of 5.7 ± 2.2 degrees.There was no difference in accuracy between replacing the aligners accompanied by low-frequency vibration every 7 days and replacing them every 14 days without vibration. Moreover, low-frequency vibration seemed to improve the accuracy of a conventional protocol in terms of upper incisor rotation. © The Author(s) 2018. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved

Predictability of orthodontic movement with orthodontic aligners: a retrospective study

The aim of this study was to evaluate the predictability of F22 aligners (Sweden & Martina, Due Carrare, Italy) in guiding teeth into the positions planned using digital orthodontic setup

Sella turcica bridging and tooth agenesis in children with unilateral cleft lip and palate

Aim: To investigate differences in sella turcica size and bridging in children with unilateral cleft lip and palate (UCLP) with or without concomitant dental anomalies. Patients and methods: A cross-sectional study was carried out looking at 56 children with nonsyndromic UCLP. Lateral cephalograms, taken before alveolar bone grafting, were used to assess sella turcica height, width, area, and bridging. Panoramic radiographs were used to evaluate the presence of dental anomalies in the cleft area including agenesis, supernumerary, and peg-shaped lateral incisors. Differences between sella turcica measurements in the presence or absence of dental anomalies were assessed usingttests. Differences between the prevalence of dental anomalies and sella turcica bridging were assessed using χ2and Fisher exact tests. Multinomial logistic regression was used to investigate potential associations between sella measurements and dental anomalies. Results: Twenty-six of the 56 children presented with agenesis of the cleft-side lateral incisor, while 7 had a supernumerary, and 19 had a peg-shaped lateral incisor. With regard to sella turcica bridging, 27 children had no calcification, 25 partial and 4 complete calcification. Children with agenesis of the cleft-side lateral incisor showed a shorter sella maximum height (P= .010) and a smaller area (P= .019). When looking at sella turcica bridging, 100% of children with complete calcification showed agenesis of the cleft-side lateral incisor, compared with 52% and 33% of children with partial calcification and no calcification, respectively (P= .034). Conclusions: Children with UCLP and sella turcica bridging are more likely to present with agenesis of the cleft-side maxillary lateral incisor.</p