29 research outputs found
Effizienz der skelettierten Pendulum-K-Apparatur bei der kooperationsunabhängigen Distalisation von Oberkiefermolaren : Eine klinische Pilotstudie
Purpose
Conventional anchorage with exclusively intraorally anchored appliances for non-compliance molar distalization combines a palatal acrylic button with periodontal anchorage. This type of anchorage is critically discussed because of the temporary hygienic impairment of the palate and the uncertain anchoring quality of the button. A purely dentally/periodontally anchored Pendulum K appliance was developed, which is exclusively anchored via four occlusal rests. The aims of this pilot study were to examine the suitability of the skeletonized Pendulum K for distalization of maxillary molars, and to investigate the quality of this alternative anchoring modality.
Patients and methods
In all, 10 patients received skeletonized Pendulum K appliances attached to all maxillary premolars for bilateral molar distalization. Supporting anchorage through an acrylic button adjacent to the anterior palate was not used. The pendulum springs were initially activated on both sides with a distalization force of 220 cN each and provided with uprighting and toe-in bends. The specific force/moment system was regularly reactivated intraorally by adjustment of the distal screw.
Results
The study demonstrates the suitability of the skeletonized Pendulum K appliance for the distalization of maxillary molars (3.28 ± 0.73 mm). Side effects on the molars were slight distal tipping (3.50 ± 2.51°/PP, 3.00 ± 1.41°/SN) and mesial inward rotation (average 2.75 ± 7.50° and 4.50 ± 12.77°). Significant anchorage loss occurred in the form of mesialization of the incisors by 1.40 ± 0.82 mm and of the first premolars by 2.28 ± 0.85 mm.
Conclusion
The skeletonized Pendulum K appliance allows compliance-free upper molar distalization. Exclusively dental/periodontal anchorage resulted in a lower percentage of molar distalization compared to a conventional anchoring preparation of the Pendulum K with a palatal acrylic button. Anchorage loss had a comparatively stronger effect on the anchoring premolars but less on the incisors. Typical side effects on the molars such as distal tipping and mesial inward rotation were remarkably low
Prevalence of KIG-grades 3–5 in an orthodontic practice in North Rhine Westphalia compared with results of the DMS•6 and with KZBV data
Background and aim The prevalence of tooth and jaw malocclusions in 8- to 9-year-olds was surveyed in a nationwide setting as part of the orthodontic module of the Sixth German Study on Oral Health (DMS•6), using the orthodontic indication groups (KIG) as index. Aim of this study was the detection of the prevalence of malocclusions requiring treatment according to the KIG index in statutorily insured patients of an orthodontic practice in North Rhine
Westphalia, Germany, and to compare results with corresponding DMS•6 and KZBV data.
Patients and methods Between 2017–2021, n=953 statutorily insured patients called for an initial consultation
and subsequent determination of the KIG-classifcation and -grades. The malocclusions were classifed and graded
in the highest possible KIG-grade according to valid SHI guidelines. Multiple classifcations were not recorded.
KIG-grade>3 according to the valid guidelines was detected in n=815 patients. Since the DMS•6 does not contain
information on KIG classifcations "U" and "S", their inclusion was waived despite evaluation, leaving data from n=683
patients for analysis and comparison.
Results During the study period, n=235 patients (34.4%) had KIG-classifcation "D". More than 10% were classifed
as "K" (120 patients, 17.6%), "P" (98 patients, 14.2%), "M" (89 patients, 13.0%), and "E" (81 patients, 11.9%). Of 16 possible
classifcations with KIG-grade>3, "D4" was the most common with 26.6% (182 patients). The results confrm the fndings from the multicentric DMS•6 from2021 and corresponding KZBV data from 2020.
Conclusions Sagittal deviations described by classifcations "D" and "M" represent with 47.4% almost half
of the malocclusions with treatment need. KIG-grade D4 is the most frequent classifcation. There were no regional
deviations of the prevalence of KIG-grades 3–5 in the district of Viersen / North Rhine compared with the national
average, not even when scrutinizing a fve-year-period
Outcome differences after orthodontic camouflage treatment in hypo- and hyperdivergent patients - A retrospective cephalometric investigation
Objectives To compare diferences in outcome in skeletal and dental parameters in hypo- and hyperdivergent Class II patients
after extraction of upper frst premolars and comprehensive orthodontic treatment.
Materials and methods 37 Class-II-patients with dental camoufage treatment were divided into a hypo- (n=18) or a hyperdivergent (n=19) group depending on the mandibular plane angle (hypo:<34° or hyper:≥34°). Lateral cephalograms were
available before (T1) and after (T2) treatment and were analyzed with customized measurements. Data from a growth survey
served as a control and were used to calculate the actual treatment efect. Data were analyzed by one-sample Student’s t-tests
and independent Student’s t-tests. Statistical signifcance was set at p<0.05.
Results The measurements showed similar changes in both groups. The efects were mainly dentoalveolar. Hypodivergent
patients showed an almost equal increase in anterior and posterior facial height, while hyperdivergent patients only showed
an increase in anterior facial height.
Conclusions In hyperdivergent patients, the anterior facial height increases despite camoufage treatment. This indicates a
tendency towards bite opening and backward rotation of the mandible. Hypodivergent patients do not experience deepening
of the bite.
Clinical relevance In hyperdivergent patients with upper frst premolars extraction the anterior facial height increased diferently than in hypodivergent patients. This should be considered if a bite opening is a possible contraindication to treatment
Frequency and severity of malocclusions in patients with statutory health insurance in a German orthodontic practice in North Rhine Westphalia – a multi‑part cross‑sectional study over a 20‑year period
Objective Since 2002, patients with statutory health insurance in Germany must undergo an assessment of orthodontic treatment need using the "Kieferorthopädische Indikationsguppen" (KIG; orthodontic indication groups) classifcation system.
According to this system, tooth and jaw misalignment are divided into 11 subgroups and fve grades. The objectives of this
study were to determine the distribution of KIG classifcations in patients with statutory insurance of a German orthodontic
practice (North Rhine, Germany) and to analyze changes over a 20-year period.
Materials and Methods Since the introduction of the KIG index in 2002, 4940 statutorily insured patients over a 20-year
period (2330 m, 2610 f, min 3.2, max 49.5 years, peak between 10 and 12 years) were classifed at their frst appointment.
According to the valid guidelines of the statutory health insurance (GKV), the division was made into the highest possible
KIG classifcation. Multiple entries were thus not made. In accordance with the operating cycles of the practice, the progression was divided into four 5-year periods.
Results Over a 20-year period, 24.98% of the patients were assigned to the classifcation "D". 86.52% of the patients were
among the 6 most frequently ("D", "E", "K", "S", "P" and "M",>10% each) and only 13.49% among the 5 least frequently
recorded classifcations ("U", "B", "T", "O" and "A",<5% each).
Conclusion The distribution of the 6 most frequent and the 5 least frequent KIG classifcations was constant over a 20-yearperiod. Among all possible tooth and jaw misalignment variants, the sagittal classifcations "D" and "M" represent the most
frequent malocclusions.
Clinical relevance The results and their comparison with historical data show that both frequency and severity of tooth
and jaw misalignment with orthodontic treatment need appear identical for patients with statutory health insurance over a
20-year period
Effects of fixed functional orthodontic treatment in hypodivergent and hyperdivergent class II patients : a retrospective cephalometric investigation
Objective To compare skeletal and dentoalveolar changes after orthodontic treatment of class II malocclusion in patients
with hypodivergent and hyperdivergent growth patterns through cast splint fxed functional appliances (FFA).
Materials and methods N=42 out of n=47 patients with mandibular plane angles<34° or≥34° were divided into a hypodivergent (n=24) and a hyperdivergent (n=18) group. All patients received a single-step mandibular advancement protocol
through an FFA. Lateral cephalograms were analyzed after initial leveling and alignment (T1) and immediately after FFA
removal (T2). The therapeutic efect was calculated through comparison with age-matched controls from a growth survey.
Statistical signifcance was set at p<0.05.
Results Hypodivergent and hyperdivergent patients showed diferent treatment outcomes, but signifcant diferences existed
only for overbite and interincisal angle. Nearly all measurements suggested similar treatment-related changes for both groups
with exception for dentoalveolar parameters.
Conclusion Treatment with FFA causes similar skeletal and dentoalveolar efects in hypodivergent and in hyperdivergent
patients. The correction of overjet and molar relationship is mainly caused by dentoalveolar changes.
Clinical relevance Hyperdivergent patients do not respond unfavorably to FFA treatment compared to hypodivergent patients.
Lower incisor protrusion occurs more pronounced in hypodivergent patients. The growth pattern ought to be considered
when choosing FFA for class II treatment
Zahn- und Kieferfehlstellungen – gesundheitliche Relevanz und Behandlung
Malocclusions are among the most common human diseases impairing oral health. The present paper gives an overview on their etiology, prevalence, and consequences. It further presents the corrective and preventive potential of orthodontic treatment and gives information on the treatment-associated legal framework in Germany. The use and quality of the orthodontic health service will be described in the international context.The etiology of malocclusions has genetic, epigenetic, functional, and environmental components, which can seldomly be differentiated on the individual level. Previous small, cross-sectional studies show that up to 80% of children in Germany are affected. Eating, drinking, chewing, speaking, and breathing may be impaired and the predisposition for periodontal disease and overuse injuries of the temporomandibular joint and the masticatory musculature increase. A proclination of the upper incisors increases the risk for dental trauma. Furthermore, malocclusions may have negative psychosocial effects and impair quality of life. In cooperation with other dental and/or medical disciplines, orthodontics make positive preventive and curative contributions to oral health, general health, and quality of life.Against this background, orthodontics has a substantial potential for the enhancement of dental prevention in healthcare. This is especially true as the German social health insurance (GKV) allows for a widespread orthodontic treatment coverage of the population at an internationally accepted, high-quality level. To further improve prevention, the implementation of a systematic orthodontic screening at the age of 7-8 years in the form of a systematic preventive measure is recommended