Research

13 pages, 7977 KiB

Open AccessArticle

Enhancing Diagnostic Accuracy in Orthodontics: Calibration and Validation of a New Tool for Dental Arch Measurements—Pilot Study

by Andrada-Nicoleta Nikolajević-Stoican, Vlad Tiberiu Alexa, Daniela Jumanca, Atena Galuscan, Roxana Oancea, Dacian Lalescu and Camelia Szuhanek

Appl. Sci. 2024, 14(6), 2272; https://doi.org/10.3390/app14062272 - 08 Mar 2024

Viewed by 392

Abstract

(1) Background: In the pursuit of enhancing diagnostic precision and treatment planning in orthodontics, accurate measurements in dental study casts of the different parameters of the dental arch stands as a critical element. Measurements such as dental arch perimetry, arch length or intermolar [...] Read more.

(1) Background: In the pursuit of enhancing diagnostic precision and treatment planning in orthodontics, accurate measurements in dental study casts of the different parameters of the dental arch stands as a critical element. Measurements such as dental arch perimetry, arch length or intermolar distance play a key role in achieving optimal results in orthodontics. Therefore, the aim of this study is to develop, calibrate and verify a new tool for determining dental arch measurements and to compare these measurements, carried out with the newly fabricated instrument, to two other conventional measurements used in orthodontics. (2) Methods: The study used 40 dental study casts for measuring the three mentioned arch parameters. The measurements were conducted following three methods: with the new instrument, with the help of a digital caliper and with the conventional method using a graduated ruler and metal wire. The difference between the values obtained by measuring with the new instrument and the other two methods was noted out in order to calculate the margin of error. Descriptive statistics, including mean, minimum, maximum, and standard deviation, were computed for all replicates, while normality was assessed using the Kolmogorov–Smirnov and Shapiro–Wilk tests; mean differences were examined using the Friedman test and the Wilcoxon signed-rank test, with statistical significance set at p-values < 0.05. Results: In the case of the arch perimeter measurement, the difference from the conventional measurement was −0.045 mm ± 0.006 and from the digital measurement was 0.025 ± 0.013. The measurement of the anterior arch length results shows that the difference from the conventional measurement was −0.0002 ± 0.014 and from the digital measurement 0.02 ± 0.0006. For the measurement of the intermolar distance of the upper permanent molars, the difference from the conventional measurement was −0.02 ± 0.01 and from the digital measurement −0.02 ± 0.001. The greatest differences were observed in the measurements of the parameter “Arch perimeter”, obtaining an average value of −0.045 ± 0.006 mm between the measurement with the new instrument and that with the conventional method using graduated rulers, as opposed to a value of 0.025 ± 0.013 for the difference from the digital measurement. Conclusions: the values obtained using the proposed instrument closely align with those obtained through traditional measuring methods like the graduated ruler and metal wire, demonstrating comparable results. Additionally, the measurements closely match those achieved through digital measurement using electronic calipers, showcasing the instrument’s accuracy in comparison to established techniques. Full article

(This article belongs to the Special Issue Advances in Orthodontics and Dental Medicine)

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19 pages, 17841 KiB

Open AccessArticle

The Surgical Guides for TADs: The Rational and Laboratory Procedures

by Aonuma Michiko, Shingo Shirahama, Atsumoto Shimizu, Cristian Romanec and George Anka

Appl. Sci. 2023, 13(18), 10332; https://doi.org/10.3390/app131810332 - 15 Sep 2023

Cited by 1 | Viewed by 2421

Abstract

The widespread and popular use of TADs for orthodontic anchoring has become a daily routine in clinical orthodontic treatment. However, as there have been many accidents over the past decade, safety action is needed to help reduce these accidents. We have advocated using [...] Read more.

The widespread and popular use of TADs for orthodontic anchoring has become a daily routine in clinical orthodontic treatment. However, as there have been many accidents over the past decade, safety action is needed to help reduce these accidents. We have advocated using the surgical guide and developed a procedure that can benefit patients and orthodontists. The first part of this paper is about the rationale for making the surgical guide for various implant placements that were observed. Due to their anatomical structure, some placements may require particular attention, which is focused on and discussed in length. The second part deals with fabricating the surgical guide in the laboratory procedure. The data from the intraoral SLT acquisition was extracted, and with the DICOM data from CBCT and in a 3-Shapes software, the guidance was designed. The detailed and step-by-step laboratory procedure, CAD/CAM, and 3D printers to make the surgical guide for TADs are explained. The procedure is performed in an easy-to-understand manner to make using the surgical guide possible for the daily practice of orthodontics (Pubmed). Full article

(This article belongs to the Special Issue Advances in Orthodontics and Dental Medicine)

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10 pages, 1718 KiB

Open AccessArticle

Maxillary Response Induced by Rapid Palatal Expansion vs. Clear Aligners: A Short-Term Retrospective Evaluation of the Dento-Alveolar Effects in Mixed Dentition

by Elisabetta Cretella Lombardo, Silvia Fanelli, Chiara Pavoni, Paola Cozza and Roberta Lione

Appl. Sci. 2023, 13(15), 8675; https://doi.org/10.3390/app13158675 - 27 Jul 2023

Viewed by 799

Abstract

Background: to analyze the dento-alveolar effects induced by two treatment appliances (i.e., RME and Clear Aligners) in growing subjects presenting with early mixed dentition and mild maxillary deficiency. Methods: digital casts of 32 children treated with RME (RG: 17 subjects) or with Clear [...] Read more.

Background: to analyze the dento-alveolar effects induced by two treatment appliances (i.e., RME and Clear Aligners) in growing subjects presenting with early mixed dentition and mild maxillary deficiency. Methods: digital casts of 32 children treated with RME (RG: 17 subjects) or with Clear aligners (CAG: 15 subjects) were collected. Linear and angular values were measured in both groups on the upper arch for both pre- (T1) and post-treatment (T2) models. An unpaired t-test was used to test significant differences between groups (p < 0.05). Results: the comparison of T2-T1 changes for linear measurements between groups showed a greater increase in the inter-canine width (+1.5 mm ± 0.5 mm) and in the first inter-deciduous molar width (+1.4 ± 0.4 mm), also at the trans-palatal level in the CAG group. Conversely, in the posterior region of the upper arch, a greater increase in the first inter-molar distal width was found in the RG group (+1.2 ± 0.4 mm) when compared with the CAG group. A significant increase in the crown angulation in the CAG group was found for all the teeth except for the first molars. Conclusions: the rapid palatal expander widened the palate, tipping the first upper molars buccally to a greater extent, whereas the Clear aligners caused a greater increase in the canine width. Full article

(This article belongs to the Special Issue Advances in Orthodontics and Dental Medicine)

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13 pages, 3120 KiB

Open AccessArticle

Interaction Phenomena between Dental Implants and Bone Tissue in Case of Misfit: A Pilot Study

by Chiara Giulia Fontanella, Emanuele Luigi Carniel, Andrea Parpaiola, Marco Toia and Arturo Nicola Natali

Appl. Sci. 2023, 13(10), 6004; https://doi.org/10.3390/app13106004 - 13 May 2023

Cited by 3 | Viewed by 1029

Abstract

The biomechanical response of cortical and trabecular bone tissues represents a fundamental aspect for the interpretation of the functional response of dental implants. In the case of misfit, the interaction phenomena occurring within the surgical and the subsequent healing phases must be interpreted [...] Read more.

The biomechanical response of cortical and trabecular bone tissues represents a fundamental aspect for the interpretation of the functional response of dental implants. In the case of misfit, the interaction phenomena occurring within the surgical and the subsequent healing phases must be interpreted primarily in the light of the response of bone tissue. This is influenced by the specific loadings induced, characterized by intensity and variable trends. The pilot study reported, which intentionally refers to a simple case of a two-implants frame, is addressed to define the method to approach the biomechanical investigation of the problem and to attest the necessity to integrate clinical competences with biomechanical analysis for interpreting different aspects of osseointegration. The action induced in cortical and trabecular bone regions depending on the implant frame conformation, the surgical procedure adopted, the varying condition at the bone–implant interface and the evolutionary trend of healing are the principal aspects to be considered to evaluate the osseointegration process. The biomechanical reliability of the specific implant frame is investigated in terms of bone–implant interaction by means of numerical models. This approach can offer valid information and support clinical practice under the fundamental condition that bone biomechanical behavior is properly characterized and represented in the model, in spite of the complex formulation to be adopted. Full article

(This article belongs to the Special Issue Advances in Orthodontics and Dental Medicine)

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11 pages, 1654 KiB

Open AccessArticle

Accuracy of Soft Tissue Prediction in Skeletal Type III Relationship Using a Computer-Aided Three-Dimensional Surgical Simulation Planning Program

by Jiratha Chantaraaumporn, Pongstorn Putongkam, Nathaphon Tangjit, Syrina Tantidhnazet and Somchart Raocharernporn

Appl. Sci. 2023, 13(9), 5623; https://doi.org/10.3390/app13095623 - 03 May 2023

Viewed by 1195

Abstract

Using a computer-aided, three-dimensional surgical simulation planning program, soft-tissue planning can help achieve adequate facial esthetics and patient satisfaction after orthognathic surgery. This study aimed to assess the Simplant O&O software’s soft tissue prediction accuracy. Fourteen skeletal type III patients who underwent orthognathic [...] Read more.

Using a computer-aided, three-dimensional surgical simulation planning program, soft-tissue planning can help achieve adequate facial esthetics and patient satisfaction after orthognathic surgery. This study aimed to assess the Simplant O&O software’s soft tissue prediction accuracy. Fourteen skeletal type III patients who underwent orthognathic surgery by the same surgeons were included in this prospective study, and they were separated into two groups: the one-jaw (n = 5) and two-jaw (n = 9) groups. The software was used to analyze the preoperative (T₀) and 4-month postoperative computed tomography data (T₁), as well as intraoral scans. Data from cone-beam computed tomography and stereolithography from a scanned dental cast were used to reconstruct a composite skull model. Based on the presurgical CT data, the program generated a predicted soft tissue image (T_P), which was then superimposed on the T₁. The distances between seven T₁ and T_P landmarks were measured and evaluated using a one-sample t-test. In the one-jaw group, the mean error for all linear measurements was 1.73 ± 1.14 mm, whereas the mean error of the two-jaw group was 1.03 ± 0.83 mm, and both measurements were within clinically acceptable limits. Pronasele had the best correlation (mean error of 0.63 ± 0.45 mm) while soft tissue pogonion and soft tissue point B had the worst correlations (mean error of 2.87 ± 2.22 mm and 1.31 ± 0.98 mm, respectively). Even though there were some limitations, it was possible to conclude that the ability to accurately predict soft tissue changes using Simplant O&O for skeletal type III patients makes it adequate for use in clinical practice. Full article

(This article belongs to the Special Issue Advances in Orthodontics and Dental Medicine)

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12 pages, 263 KiB

Open AccessArticle

Comparison of Clear Aligner Treatment in First-Treatment and Re-Treatment Patients: A Retrospective Cohort Study

by Lan Huong Timm, Ralf Rößler and Martin Baxmann

Appl. Sci. 2023, 13(7), 4303; https://doi.org/10.3390/app13074303 - 28 Mar 2023

Cited by 1 | Viewed by 1245

Abstract

This retrospective real-world study aimed to evaluate the outcomes of clear aligner treatment (CAT) and patient demographics of patients seeking orthodontic re-treatment who had previously received orthodontic treatment in childhood or adolescence. The study was conducted using anonymized data from DrSmile (Berlin, Germany), [...] Read more.

This retrospective real-world study aimed to evaluate the outcomes of clear aligner treatment (CAT) and patient demographics of patients seeking orthodontic re-treatment who had previously received orthodontic treatment in childhood or adolescence. The study was conducted using anonymized data from DrSmile (Berlin, Germany), a CAT provider in Europe. Data were collected from a total of 2080 patients in Germany (71.5% female, 28.5% male, ranging from 18–70 years, median 29.0 years), who completed their CAT between 1 June and 30 June 2022. Patients were divided into two groups: adult first-treatment patients (n = 1587) and adult re-treatment patients (n = 493). Results showed that re-treatment patients had a shorter treatment duration (p < 0.05), required fewer interproximal reductions (IPR) (p < 0.001), and had fewer clinical visits (mean 2.96 versus 4.14 visits) than first-treatment patients (p < 0.001). Data collected from adult orthodontic re-treatment and first-treatment patients indicated that the demographic characteristics of these two groups were very similar. No significant differences were found between re-treatment patients and first-treatment patients in terms of motives for orthodontic treatment (p = 0.068), types of insurance (p = 0.615), and treatment satisfaction (p = 0.673). The study highlights the need for orthodontists and dentists to provide adequate information to patients about long-term retention and decision-making for orthodontic treatment, especially for re-treatment. Full article

(This article belongs to the Special Issue Advances in Orthodontics and Dental Medicine)

9 pages, 2316 KiB

Open AccessArticle

Accuracy of Three-Dimensional Printed Dental Models Based on Ethylene Di-Methacrylate-Stereolithography (SLA) vs. Digital Light Processing (DLP)

by Alexandru Vlasa, Vlad I. Bocanet, Mircea H. Muntean, Anamaria Bud, Bogdan Radu Dragomir, Sorana Nicoleta Rosu, Luminita Lazar and Eugen Bud

Appl. Sci. 2023, 13(4), 2664; https://doi.org/10.3390/app13042664 - 19 Feb 2023

Cited by 2 | Viewed by 1176

Abstract

Additive manufacturing is a technology that has many uses across a variety of fields. Its usage spans many fields, including the fields of art, design, architecture, engineering and medicine, including dentistry. The study aims to evaluate and compare the accuracy of three-dimensional printed [...] Read more.

Additive manufacturing is a technology that has many uses across a variety of fields. Its usage spans many fields, including the fields of art, design, architecture, engineering and medicine, including dentistry. The study aims to evaluate and compare the accuracy of three-dimensional printed dental models based on ethylene di-methacrylate using the SLA and DLP techniques. For evaluation, a reference model containing 16 maxillary permanent molars was chosen. An ATOS Capsule 3D scanner was used to scan the reference model. Using a photo-cured liquid resin, eight three-dimensional printed models were obtained using the reference model as benchmark. Four of the models (A1–A4) were obtained using SLA printing technology and four models (B1–B4) were manufactured using DLP printing technology. A standard best fit method was used to pre-align the reference and the printed model surfaces. The height of the teeth, and the mesial–distal and buccal–lingual distances were analyzed. The assessment of the two manufacturing methods was achieved by using non-parametric tests to compare the mean ranks for the assessed features. The results show that models obtained through DLP had a higher precision but also a higher bias. Both methods still are within the required accuracy range for dental models. Full article

(This article belongs to the Special Issue Advances in Orthodontics and Dental Medicine)

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Review

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11 pages, 2740 KiB

Open AccessReview

Elastodontic Therapy with Oral Bioactivator Devices: A Review

by Monica Macrì, Luisa Ritrovato, Elena Lucia Pisanelli and Felice Festa

Appl. Sci. 2023, 13(15), 8868; https://doi.org/10.3390/app13158868 - 01 Aug 2023

Cited by 3 | Viewed by 994

Abstract

Scientific studies have shown that dysfunctional problems associated with dysmorphisms are the base of malocclusion. The position of the mouth and the head is a component of the general postural arrangement, so any head misalignment creates disharmonies and tensions among the neck muscles. [...] Read more.

Scientific studies have shown that dysfunctional problems associated with dysmorphisms are the base of malocclusion. The position of the mouth and the head is a component of the general postural arrangement, so any head misalignment creates disharmonies and tensions among the neck muscles. Elastodontics is a treatment based on the use of removable elastomeric devices. These functional appliances are made of elastomeric material, acting tridimensionally on a neuromuscular system with orthopaedic and dental effects. Bioactivators have a vestibular and lingual flange with a free central area that permits them to position teeth without constraints. The flanges are linked by an occlusal plane that maintains the two skeletal bases and teeth in first-class normocclusion with propulsive and retropulsive effects on the maxilla and mandible. Elastomeric devices are generally well tolerated by patients requiring simple collaboration and management. This review aim is to describe the indications and limits of orthodontic therapy with elastomeric devices to provide an overview of elastodontics. Full article

(This article belongs to the Special Issue Advances in Orthodontics and Dental Medicine)

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17 pages, 754 KiB

Open AccessReview

Passive Self-Ligating Bracket Systems: A Scoping Review of Their Claims Regarding Efficiency and Effectiveness in Orthodontic Treatment

by Eduard Radu Cernei, Alice Chehab, Daniel Nicolae Olteanu, Cristian Romanec, Tinela Panaite and Irina Nicoleta Zetu

Appl. Sci. 2023, 13(10), 6322; https://doi.org/10.3390/app13106322 - 22 May 2023

Cited by 1 | Viewed by 2194

Abstract

Passive self-ligating bracket systems (PSLBs), such as the Damon^® system (Ormco, US) and SmartClip (3M Unitek^®, US) claim advantages over other types of brackets regarding efficiency and effectiveness. However, some studies have questioned their qualities, particularly during the alignment stage, [...] Read more.

Passive self-ligating bracket systems (PSLBs), such as the Damon^® system (Ormco, US) and SmartClip (3M Unitek^®, US) claim advantages over other types of brackets regarding efficiency and effectiveness. However, some studies have questioned their qualities, particularly during the alignment stage, in arch development, and regarding stability of results. This article aims to conduct a scoping review from the past decade’s literature (2013–2023) regarding these assertions about PSLBs. A comprehensive search was performed on several databases. With at least one comparison between PSLBs and the other two bracket types, the inclusion criteria were restricted to English-written randomized controlled trials and split-mouth design studies involving patients receiving orthodontic treatment using PSLB, active self-ligating bracket systems (ASLBs), or conventional/traditional bracket systems (CBs). After screening and manual analysis of the selected studies, only 39 were chosen for the review. Most of the efficiency and effectiveness results from research conducted in the past ten years did not indicate any appreciable differences between the three different types of brackets; therefore, the evidence on whether PSLB is better than CBs and ASLBs is equivocal. Further research is necessary to understand the distinctions between passive self-ligating and other bracket systems and establish the optimal utilization of each system in clinical settings. Full article

(This article belongs to the Special Issue Advances in Orthodontics and Dental Medicine)

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Other

Jump to: Research, Review

19 pages, 998 KiB

Open AccessSystematic Review

Impact of Non-Surgical and Surgically Assisted Rapid Maxillary Expansion Procedures upon the Periodontium: A Systematic Review

by Garret N. Curtis, Holly A. Weber, Vy Tran, Christopher A. Childs, Kyungsup Shin and Carlos Garaicoa-Pazmino

Appl. Sci. 2024, 14(4), 1669; https://doi.org/10.3390/app14041669 - 19 Feb 2024

Viewed by 564

Abstract

Background: Scarce evidence is available regarding the occurrence and prevalence of hard/soft tissue deficiencies among patients undergoing surgically assisted rapid maxillary expansion (SARME) as compared to non-surgical rapid maxillary expansion (NSRME) approaches. The purpose of this study is to evaluate the effect of [...] Read more.

Background: Scarce evidence is available regarding the occurrence and prevalence of hard/soft tissue deficiencies among patients undergoing surgically assisted rapid maxillary expansion (SARME) as compared to non-surgical rapid maxillary expansion (NSRME) approaches. The purpose of this study is to evaluate the effect of NSRME and SARME upon the periodontal structures. Methods: A literature search was performed to identify studies that fulfilled pre-established eligibility criteria, evaluating changes in the periodontium (e.g., probing depths) and hard/soft tissue deficiencies (e.g., bone levels, gingival recession) within patients undergoing NSRME and SARME procedures. Results: A total of 21 articles were included in the present review. Four of them evaluated the outcomes of both NSRME and SARME procedures, while six and eleven studies analyzed NSRME alone and SARME alone, respectively. The incidence of hard (e.g., changes in buccal bone width/height) and soft tissue deficiencies (e.g., gingival recession, keratinized tissue, and clinical attachment level) is slightly increased among patients undergoing maxillary expansion with worsened outcomes during NSRME procedures. Conclusions: The impact of NSRME and SARME upon the periodontium remains inconclusive. Full article

(This article belongs to the Special Issue Advances in Orthodontics and Dental Medicine)

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17 pages, 583 KiB

Open AccessSystematic Review

Non-Compliance Distalization Appliances Supported by Mini-Implants: A Systematic Review

by Nikolaos Karvelas, Bogdan Radu Dragomir, Alice Chehab, Tinela Panaite, Moschos A. Papadopoulos and Irina Zetu

Appl. Sci. 2023, 13(8), 5176; https://doi.org/10.3390/app13085176 - 21 Apr 2023

Cited by 1 | Viewed by 1783

Abstract

Background: A common strategy for the correction of Class II malocclusion is to initially distalize the maxillary molars to create a Class I relationship. Material and Methods: PubMed, Embase, Cochrane Library, Google Scholar, and Clinicaltrials.gov databases were searched to identify and retrieve orthodontic [...] Read more.

Background: A common strategy for the correction of Class II malocclusion is to initially distalize the maxillary molars to create a Class I relationship. Material and Methods: PubMed, Embase, Cochrane Library, Google Scholar, and Clinicaltrials.gov databases were searched to identify and retrieve orthodontic articles that evaluated non-compliance distalization appliances supported by mini-implants up to 11 November 2022. Results: A total of 505 articles were initially identified, and after applying the inclusion criteria, 28 studies were enlisted for evaluation. For the prospective studies, the Risk of bias in non-randomized studies of interventions assessment tool was used, and for the retrospective studies, the Newcastle-Ottawa quality assessment scale. Regarding the palatal devices with mini-implants, the maxillary molars were distalized with a mean value ranging from 2.4 to 5.9 mm, along with a distal tipping ranging between 0.01° and 11°, while when Pendulums were used with mini-implants, the maxillary molars were distalized with a mean value from 1.8 mm to 7.9 mm, and the distal tipping ranged from 7.34° to 22.8°. Further, in the second subgroup, including the appliances placed buccally, the maxillary molars were distalized with a mean value ranging from 1.83 mm to 4.2 mm and a distal tipping ranging between 0.6° and 4.8°. Conclusions: Non-compliance appliances supported by mini-implants are effective in maxillary molar distalization, presenting no anchorage loss of the anterior dental unit in most of the appliances, while distal tipping was found to be more pronounced when the mini-implants were used with Pendulums. Full article

(This article belongs to the Special Issue Advances in Orthodontics and Dental Medicine)

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21 pages, 2221 KiB

Open AccessSystematic Review

Complications Arising Due to Orthodontic Treatment—A Systematic Review and Meta-Analysis

by Mohammad Khursheed Alam, Bushra Kanwal, Huda Abutayyem, Haytham Jamil Alswairki, Ahmed Ali Alfawzan, Abedalrahman Shqaidef, Laila Hamad Almakrami, Sultan Fadhel Shuaibi Alaqidi, Almothana Ali Alaskar, Ibrahim Ayiz Almutairi, Abdullah Sultan Alotaibi, Deepti Shrivastava and Kumar Chandan Srivastava

Appl. Sci. 2023, 13(6), 4035; https://doi.org/10.3390/app13064035 - 22 Mar 2023

Cited by 3 | Viewed by 2814

Abstract

A variety of metals and alloys are employed in the field of orthodontics, of which the construction of wires happens to be predominant. Through this systematic review, our primary goal was to review and assess studies focusing on complications that emerged during or [...] Read more.

A variety of metals and alloys are employed in the field of orthodontics, of which the construction of wires happens to be predominant. Through this systematic review, our primary goal was to review and assess studies focusing on complications that emerged during or directly after the completion of an orthodontic treatment plan. We then used a meta-analysis to determine how these complications affected the patients who were receiving orthodontic treatment. A total of 634 documents were discovered after a thorough search of online journals, and 416 of the papers were initially selected. In the end, 14 papers, including in vitro experiments, literature reviews, comparative analyses, observational studies, and retrospective studies, were chosen that met the requisite inclusion and exclusion criteria. There were difficulties related to orthodontic treatment in all of the studies listed in our systematic review, but their severity varied greatly. The effects of gingival mucosa and root resorption were two of the most often mentioned periodontal problems in this review. More long-term studies are required to confirm the involvement of an orthodontic component in these issues, but the majority of the complications were assessed to initially arise after the treatment plan had begun and to resolve with time. Full article

(This article belongs to the Special Issue Advances in Orthodontics and Dental Medicine)

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