Blog

J Oral Rehabil. 2022 Jan;49(1):47-53. doi: 10.1111/joor.13271. Epub 2021 Nov 15.

ABSTRACT

BACKGROUND: Obstructive sleep apnea (OSA) is the most common sleep disorder due mainly to peripheral causes, characterized by repeated episodes of obstruction of the upper airways, associated with arousals and snoring. Sleep bruxism (SB) is a masticatory muscle activity during sleep that is characterized as rhythmic (phasic) or nonrhythmic (tonic) and is not a movement disorder or a sleep disorder in otherwise healthy individuals. Given the potentially severe consequences and complications of apnea, the concurrent high prevalence of SB in daily dental practice, getting deeper into the correlation between these phenomena is worthy of interest..

STUDY OBJECTIVES: The aim of this study was to investigate the correlation between SB-related masseter muscle activity (MMA) and apnea-hypopnea events as well as to assess their temporal sequence.

METHODS: Thirty (N = 30) patients with sleep respiratory disorders and clinical suspicion of sleep bruxism (SB) were recruited. Ambulatory polygraphic recording was performed to detect apnea-hypopnea events (AHEs) and sleep bruxism episodes (SBEs). Pearson test was used to assess the correlation between apnea-hypopnea index (AHI) and SB index (SBI). A 5-s time window with respect to the respiratory events was considered to describe the temporal distribution of SBEs. Furthermore, SBI was compared between groups of patients with different AHI severity (i.e., mild, moderate and severe) using ANOVA.

RESULTS: On average, AHI was 27.1 ± 21.8 and SBI 9.1 ± 7.5. No correlation was shown between AHI and SBI. Most of SBEs (66.8%) occurred without a temporal relationship with respiratory events. Considering OSA, 65.7% of SBEs occurred within 5 s after AHEs, while in the case of central apnea (CA) 83.8% of SBEs occurred before the respiratory event. The participants with severe apnea (N = 9) show a tendency to have higher bruxism indexes when compared to patients with mild (N = 11) and moderate apnea (N = 10).

CONCLUSIONS: Findings suggest that: 1. At the study population level, there is no correlation between AHI and SBI, as well as any temporal relationship between SBEs and respiratory events. 2. Specific patterns of temporal relationship might be identified with future studies focusing on the different types of apnea-hypopnea events and bruxism activities.

PMID:34674282 | DOI:10.1111/joor.13271

Int Orthod. 2021 Dec;19(4):697-706. doi: 10.1016/j.ortho.2021.09.008. Epub 2021 Oct 22.

ABSTRACT

Two case reports are presented showing how the strategic use of skeletal anchorage via orthodontic miniscrews manages to solve the complex problems of orthodontic disimpaction of second mandibular molars with excellent anchorage control and reduction of the adverse effects common to the use of conventional methods. The temporary anchorage device (TAD)-mediated biomechanics used can be categorized as both “pulling from the distal side” and “pushing from the mesial side” techniques in which both direct and indirect anchorage mechanics were employed. Each of these mechanics has its advantages and disadvantages, which must be weighed and considered on a case-by-case basis. Based on the force application side and the type of anchorage, a simplified classification of TADs supported biomechanics for the recovery of fully or partially impacted second molars is proposed.

PMID:34696999 | DOI:10.1016/j.ortho.2021.09.008

Int Orthod. 2022 Mar;20(1):100599. doi: 10.1016/j.ortho.2021.11.001. Epub 2021 Dec 3.

ABSTRACT

INTRODUCTION: Midpalatal suture opening in young adults is often difficult to achieve, depending on the suture maturation stage. It has been suggested that it is possible to avoid surgery and still achieve a successful pure skeletal expansion if a bone-borne Miniscrew-Assisted Rapid Palatal Expander is chosen (MARPE).

CASE PRESENTATION: The following case report describes the use of a pure bone-borne miniscrew-assisted rapid palatal expander followed by lingual fixed appliance to correct a severe transversal discrepancy in an adult patient characterized by a hyperdivergent mandibular skeletal pattern.

MANAGEMENT AND OUTCOMES: All treatment phases were digitally planned, starting with the miniscrews’ insertion with a three-dimensionally printed surgical guided (Miniscrew Assisted Palatal Application: MAPA system) and Tandem Skeletal Expander (TSE) appliance, to the lingual indirect bonding. The final outcomes confirmed that this orthodontic approach represented a valid alternative to orthognathic surgery, with a significant improvement of the patient’s occlusion and facial appearance.

DISCUSSION: The Tandem Skeletal Expander (TSE) design and the expansion protocol applied allowed to obtain a significant and stable skeletal increase of transversal diameters by digital planning of the insertion of miniscrews, with lower risks and costs than other surgical approaches.

PMID:34872832 | DOI:10.1016/j.ortho.2021.11.001

Angle Orthod. 2022 May 1;92(3):415-425. doi: 10.2319/061721-487.1.

ABSTRACT

The case describes the interdisciplinary treatment of a 23-year-old woman with a Class III malocclusion, missing an upper right lateral incisor, abrasion of the maxillary incisal edges, anterior gingival margin discrepancies, and gingival recession. Initially, the patient was treated with fixed appliances combined with orthognathic surgery. The extraction of the upper left lateral incisor and bilateral canine substitution plan was chosen. At the end of the surgical and orthodontic treatment, the restorative treatment with six veneers was accomplished to improve smile esthetics. Despite the missing lateral incisors, the patient showed a natural, good-looking final result. A symmetric incisal plane was established, a functional occlusion with average vertical and horizontal overlap was set, and the bone scallop and consequently the gingival margins were leveled. The interdisciplinary approach hid all of the initial esthetic defects of the case. The result highlights how to obtain a remarkable improvement of the smile outcome with a well-functioning masticatory system.

PMID:34969081 | PMC:PMC9020404 | DOI:10.2319/061721-487.1

Am J Orthod Dentofacial Orthop. 2022 May;161(5):659-665. doi: 10.1016/j.ajodo.2020.12.024. Epub 2022 Jan 5.

ABSTRACT

INTRODUCTION: The objective was to describe the dental and skeletal changes obtained using the Carriere Motion Appliance (CMA), lateral cephalogram, and the corresponding cephalometric tracings.

METHODS: A sample of 29 patients with Class II malocclusion (mean age, 12.6 ± 1.7 years) was retrospectively selected. All patients were treated at a single center using a CMA as the primary sagittal correction device. Cephalometric tracings at the beginning and end of treatment were compared. Each cephalometric tracing was performed 3 times by the same operator.

RESULTS: Using the CMA, the 29 patients studied reached dental Class I in 4.4 ± 0.98 months. All measurements were subjected to statistical analysis, paired t test, and all displayed differences between T0 and T1 (P <0.05) except for the SNA. At the end of treatment, the Wits and ANB values were reduced by 1.38 mm and 0.8°, respectively. Overbite and overjet were also reduced by 1.4 mm and 2 mm, respectively. The SNB, FMA, LAFH, and IMPA increased to a lesser extent (ie, 0.7°, 0.4°, 1.5 mm, and 1.5°, respectively).

CONCLUSIONS: The CMA is a rapid and efficient means of correcting Class II malocclusion. Its effects are predominantly dentoalveolar, with minimal skeletal alteration of little clinical significance.

PMID:34996664 | DOI:10.1016/j.ajodo.2020.12.024

Int Orthod. 2022 Mar;20(1):100602. doi: 10.1016/j.ortho.2021.100602. Epub 2022 Jan 7.

ABSTRACT

This case report demonstrates how the use of skeletal anchorage and appropriate orthodontic biomechanics can be used to resolve even complex cases, reducing unwanted dental movements and allowing the use of a partial vestibular appliance. It describes the complete mesialization of the left upper third molar and space closure following extraction of tooth UR7, due to vertical fracture one year after previous endodontic therapy for caries. This therapeutic choice was conditioned by the need not to alter the good pre-existing interarch relationships, and above all by the patient’s request to be treated conservatively, and therefore not to undergo prosthetic implant rehabilitation. The use of orthodontic miniscrews and the careful application of orthodontic biomechanics, based on both direct and indirect anchorage, enabled the treatment objectives to be achieved in a reasonable period of time with reduced treatment costs.

PMID:35012896 | DOI:10.1016/j.ortho.2021.100602

Int Orthod. 2022 Mar;20(1):100605. doi: 10.1016/j.ortho.2021.100605. Epub 2022 Jan 15.

ABSTRACT

This case report describes the complex situation of a young adult Class II hyperdivergent patient treated by premolar extraction with a straight wire lingual appliance. Despite the patient’s refusal to undergo surgical treatment, the dual goals of ideal occlusal relationship and profile improvement were achieved through a well thought-out biomechanical strategy with appropriate extraction choice and anchorage control during space closure. This case report demonstrates the possibility of successfully resolving severe sagittal and vertical discrepancies in an adult patient without surgical treatment using a completely invisible technique. This report also highlights the need for careful planning during the diagnostic and treatment phases.

PMID:35042658 | DOI:10.1016/j.ortho.2021.100605

J Orthod. 2022 Mar 24:14653125221088341. doi: 10.1177/14653125221088341. Online ahead of print.

ABSTRACT

A male patient aged 11 years presented a large dentigerous cyst in the lower left quadrant associated with retained deciduous lower lateral incisor and canine and impacted, unerupted corresponding permanent ones. The treatment consisted in marsupialisation and placement of a modified lingual arch that held a tube for decompression used for irrigation of the cystic cavity in a comfortable way for the patient and for the clinician.The same lingual arch was later used as an anchorage method for retained teeth traction. The final records showed complete resolution of the cyst and retained teeth were successfully placed in their correct position in the oral cavity.

PMID:35323071 | DOI:10.1177/14653125221088341

J Clin Orthod. 2021 Dec;55(12):739-749.

NO ABSTRACT

PMID:35358085

Prog Orthod. 2022 May 23;23(1):16. doi: 10.1186/s40510-022-00411-w.

ABSTRACT

BACKGROUND: To compare the fluorescent properties of 6 different orthodontic adhesives and provide useful information for clinicians in the adhesion choice, in order to remove it easily at the end of orthodontic treatment by using the Fluorescence-aided Identification Technique (FIT).

METHODS: Six orthodontic adhesives were included: Ortho Connect, Gradia LoFlo A3.5, Greengloo, Transbond XT, KommonBase Pink, and KommonBase Clear. The same thermoformed template with 1 mm shell thickness on the six anterior teeth was used for adhesive positioning; furthermore, an ultraviolet light-emitting diode flashlight was used for the FIT. The brightness of adhesive area and tooth area (L* color coordinate) were measured on the photographs by using the “color picker” tool of Photoshop software.

RESULTS: GC Ortho Connect, Gradia Direct LoFlo and KommonBase Clear showed the highest differences of brightness (15.5, 16.3 and 13.5, respectively), while Greengloo, Transbond XT and KommonBase Pink registered similar values between resin area and tooth area with FIT (- 0.5, – 0.8 and – 1.0, respectively). The high viscosity adhesive resins, as Greengloo and Transbond XT, showed a similar performance in terms of fluorescence to the KommonBase Pink, the lowest viscous resin adhesive considered.

CONCLUSIONS: The most used orthodontic adhesives showed different fluorescence properties. Some resins were brighter with the FIT, facilitating identification and subsequent removal. Other orthodontic adhesives presented no difference between adhesive and tooth. The viscosity of orthodontic adhesives did not influence the brightness emitted with FIT.

PMID:35599253 | PMC:PMC9124738 | DOI:10.1186/s40510-022-00411-w