Residents’ journal review

Posttreatment stability after treatment with a self-ligating system

Basciftci FA, Akin M, Ileri Z, Bayram S. Long-term stability of dentoalveolar, skeletal, and soft tissue changes after non-extraction treatment with a self-ligating system. Korean J Orthod 2014;44:119-27

The explosion of self-ligating bracket systems over the last decade has been fueled largely by claims of quicker treatment times and less need for premolar extractions. The purpose of this retrospective study was to assess dentoalveolar, skeletal, and soft-tissue changes and posttreatment stability after nonextraction treatment with a self-ligating system. Twenty-four adolescent patients were included in the study. All subjects were treated by 1 investigator using the Damon 3 appliance (0.022-in slot). Treatment records were obtained before treatment (T1), immediately after treatment (T2), 6 months after treatment (T3), and 2 years after treatment (T4). The retention protocol included lingual retainers and a maxillary Hawley that was worn for 6 months. All transverse dental cast measurements significantly increased (range, 0.8-5.1 mm) with treatment ( P <0.05). No relapse was observed at T3; however, significant posterior relapse was noted in both arches at T4 ( P <0.01). The Mx1-Sn angle did not show a significant increase from T1 to T2, but IMPA increased significantly ( P <0.01) from T1 to T2, remained stable from T2 to T3, and increased slightly from T3 to T4. The results suggest that maxillary crowding was resolved primarily through transverse arch expansion, and mandibular crowding was alleviated with a combination of transverse arch expansion and incisor proclination. Although the posterior transverse relapse from T2 to T4 was statistically significant, the actual values were less than 0.4 mm and might have minimal clinical significance. Maxillary and mandibular canine widths and incisor angulations remained stable during retention, as is expected with lingual retainers. The authors concluded that self-ligating brackets correct crowding through dental compensations, without inducing clinically significant changes in the hard and soft tissues of the face.

Reviewed by Matthew Brown

Advancement of the premaxilla with distraction osteogenesis

Cakmak F, Turk T, Sumer M. Advancement of the premaxilla with distraction osteogenesis. Eur J Orthod 2014;36:321-30

Distraction osteogenesis is a biologic process of new bone formation between bone segments that are gradually separated by incremental traction. Advancement of the premaxilla has been previously used to treat cleft and noncleft patients. The authors of this study focused on noncleft patients and aimed to evaluate the dental, skeletal, and soft-tissue effects of premaxillary advancement with distraction osteogenesis after anterior segmental osteotomy. The sample consisted of 19 noncleft patients with skeletal Class III malocclusions due primarily to maxillary deficiency. The patients had Angle Class I molar relationships and a negative or null overjet with some anterior crowding and retrusive upper lips. The tooth-borne distraction device was cemented right after the surgical mobilization of the anterior maxilla. After a latency period of 1 week, the screws were activated 0.8 mm a day until overjet correction was obtained. The appliance remained in place for a 5-week consolidation period, and nonextraction treatment was then performed in all patients. Lateral cephalometric tracings at pretreatment, after the consolidation period, and at posttreatment were superimposed, and 41 cephalometric variables were used to evaluate the changes in the dentofacial structures and soft tissues. The authors used Friedman and Wilcoxon tests to analyze the data and found significant differences between the different time points. Some relapse was noted between the consolidation period and the posttreatment data, but in all cases the anterior crossbite was corrected, and the soft-tissue profile improved with some anterior movement of the nose and the upper lip. The authors emphasized the need for more research but concluded that this procedure can be a treatment option for patients with a Class I molar relationship and an anterior crossbite caused by a retrusive maxilla.

Reviewed by Camille Guez

Advancement of the premaxilla with distraction osteogenesis

Cakmak F, Turk T, Sumer M. Advancement of the premaxilla with distraction osteogenesis. Eur J Orthod 2014;36:321-30

Distraction osteogenesis is a biologic process of new bone formation between bone segments that are gradually separated by incremental traction. Advancement of the premaxilla has been previously used to treat cleft and noncleft patients. The authors of this study focused on noncleft patients and aimed to evaluate the dental, skeletal, and soft-tissue effects of premaxillary advancement with distraction osteogenesis after anterior segmental osteotomy. The sample consisted of 19 noncleft patients with skeletal Class III malocclusions due primarily to maxillary deficiency. The patients had Angle Class I molar relationships and a negative or null overjet with some anterior crowding and retrusive upper lips. The tooth-borne distraction device was cemented right after the surgical mobilization of the anterior maxilla. After a latency period of 1 week, the screws were activated 0.8 mm a day until overjet correction was obtained. The appliance remained in place for a 5-week consolidation period, and nonextraction treatment was then performed in all patients. Lateral cephalometric tracings at pretreatment, after the consolidation period, and at posttreatment were superimposed, and 41 cephalometric variables were used to evaluate the changes in the dentofacial structures and soft tissues. The authors used Friedman and Wilcoxon tests to analyze the data and found significant differences between the different time points. Some relapse was noted between the consolidation period and the posttreatment data, but in all cases the anterior crossbite was corrected, and the soft-tissue profile improved with some anterior movement of the nose and the upper lip. The authors emphasized the need for more research but concluded that this procedure can be a treatment option for patients with a Class I molar relationship and an anterior crossbite caused by a retrusive maxilla.

Reviewed by Camille Guez

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Apr 6, 2017 | Posted by in Orthodontics | Comments Off on Residents’ journal review
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