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Comparison of two implant-supported molar distalization systems

OBJECTIVE To examine skeletal, dental, and soft tissue effects of the Miniscrew Implant Supported Distalization System (MISDS) and the Bone-Anchored Pendulum Appliance (BAPA). MATERIALS AND METHODS Among 28 patients displaying Angle Class II malocclusion, 14 patients with a mean age of 14.8 ± 3.6 years treated with MISDS were included in the first group, and 14 patients with a mean age of 14.5 ± 1.5 years treated with BAPA were included in the second group. The pretreatment and posttreatment lateral cephalograms were analyzed. Statistical evaluation was carried out using the paired Shapiro-Wilk test, the paired-sample t-test, and the unpaired t-test. RESULTS Upper posterior teeth were distalized successfully in both groups. Nearly bodily distalization was seen in the MISDS group, whereas significant distal tipping of the upper first molars was observed in the BAPA group (P < .001). There were no statistically significant changes in the sagittal position of the maxilla and mandible and in the position of the upper incisors as a result of treatment in either group. CONCLUSIONS Both methods provided absolute anchorage for distalization of posterior teeth; however, almost translatory distal movement was encountered in the MISDS group, and substantial distal tipping of the maxillary molars accompanied distalization in the BAPA group.

Influence on smile attractiveness of the smile arc in conjunction with gingival display

INTRODUCTION Many variables affecting smile esthetics and attractiveness have been evaluated. However, the influence of the interaction of several variables is not as well known. Furthermore, patients and dental professionals might view smile esthetics differently. Therefore, the purpose of this research was to evaluate the influence of the smile arc in conjunction with the amount of maxillary gingival display on the perception of smile attractiveness by orthodontists, dentists, and laypersons. METHODS A frontal intraoral photograph of ideally aligned teeth was modified using image-processing software. Photos showing 7 smile arcs, from flat to vaulted, were obtained, and these were combined with photos showing 4 different amounts of maxillary gingival display. The attractiveness of the 28 images of different smiles was evaluated by 3 groups of raters (orthodontists, dentists, and laypersons), each consisting of 70 persons. RESULTS Both smile arc (P <0.05) and gingival display amount (P <0.001) had statistically significant influences on the perception of smile attractiveness. Smile attractiveness scores with reference to gingival display amount showed a statistically significant (P <0.001) difference between the rater groups. A significant (P <0.05) interaction between smile arc and gingival display amount was observed. CONCLUSIONS Examining other components influencing the perception of smile attractiveness might help clinicians develop more satisfying treatment plans for their patients.

Comparison of the zygoma anchorage system with cervical headgear in buccal segment distalization

This prospective study aimed to evaluate the effects of the zygoma anchorage system (ZAS) in buccal segment distalization in comparison with cervical headgear (CH). Thirty patients with Class II dental malocclusions were included in the study and were divided into two equal groups: the first group (10 females and 5 males, mean age 14.74 years at T1) received buccal segment distalization with ZAS and the second group (8 females and 7 males, mean age 15.26 years at T1) with CH. The skeletal, dental, and soft tissue changes were measured on cephalograms obtained before (T1) and after (T2) distalization, and these changes were statistically evaluated using a repeated measures analysis of variance, Mann-Whitney U-test, and Wilcoxon test. The Class II buccal segment relationship was corrected to a Class I in an average period of 9.03 +/- 0.62 months in the ZAS group and 9.00 +/- 0.76 months in the CH group. Significant distalization was observed for the posterior teeth in both groups (P < 0.001). Distal tipping of all posterior teeth occurred in the CH group (P < 0.001), but only for the molars in the ZAS group (P < 0.001). The upper incisors retroclined, overjet decreased, and the upper and lower lips retruded in both groups. The ZAS provided absolute anchorage for distalization of the maxillary posterior teeth and can be used as an aesthetic and non-compliant alternative to extraoral traction in the treatment of Class II malocclusions.

Effect of zoledronic acid on bone healing subsequent to mini-implant insertion

OBJECTIVE To examine remodeling in bone supporting mini-implants by comparing a no drug (ND) group with a group that received a potent intravenous bisphosphonate in a canine model. MATERIALS AND METHODS Twelve skeletally mature (2- to 3-year-old) male dogs were divided into two groups. Seven dogs were administered 0.1 mg/kg/mo of zoledronic acid (ZA) for 16 weeks, while five age-matched dogs received no drug. Two mini-implants (Tomas, Dentaurum, Newton, Pa) were placed unilaterally in the maxilla and mandible (4 mini-implants per animal × 12  =  48). Serial fluorescent bone labels were administered in vivo. Postmortem, the bone blocks containing the mini-implants were harvested and used for histomorphometric analyses at two regions of interest (adjacent: within 1 mm of interface; distant: 1-4 mm from the interface) supporting the mini-implant. Data were analyzed using mixed models. RESULTS In general, the ZA group had a significantly lower bone formation rate than the ND group (P < .05) for all jaws/regions except for the adjacent region in the maxilla, P  =  .12. Despite the reduction, mean intracortical remodeling in the ZA group ranged from 35%-42% per year in the implant adjacent bone. This rate is substantially higher than that reported for noninjured sites in the jaw. CONCLUSIONS Bone remodeling is typically elevated in implant supporting bone. After ZA administration, the healing response represented by elevated turnover in implant supporting bone was diminished but was not abolished.

Success of Zygomatic Plate-Screw Anchorage System

PURPOSE To evaluate the success of zygomatic plate-screw anchorage and to define the key points that help to improve the success of this system. MATERIALS AND METHODS A total of 74 zygomatic plate-screw anchors were applied to 37 patients from 2 groups receiving orthodontic treatment. The first group consisted of 19 patients, and the zygoma anchors were applied bilaterally to distalize the maxillary buccal segment. The second group consisted of 18 patients, and the zygoma anchors were applied bilaterally to stabilize the maxillary molars during maxillary canine retraction. The orthodontic force was applied 1 week after the insertion of the plates. In the first group, 450 g of direct force and in the second group 150 g of indirect force were applied to the zygomatic plates. The success rate of the zygomatic plate-screw anchorage system was evaluated. RESULTS One plate was lost and the others remained stable all through the orthodontic treatment. Mild gingival inflammation was observed in 1 patient (2 plates), and pus formation was detected in 1 patient (2 plates). One plate was covered because of mucosal hypertrophy. CONCLUSION Zygomatic plate-screw anchorage system is a reliable technique to obtain orthodontic anchorage and may eliminate the need for extraoral force. However, the surgical insertion technique, position of the plates, and oral hygiene status of the patients certainly influence the success of the system.

Orthodontic and surgical treatment of hemimandibular hyperplasia.

Correction of facial asymmetries is still a major problem in need of an adequate solution. In this case report, the differential diagnosis and treatment strategies of hemimandibular hyperplasia are described with the present patient.

Palatal implant versus zygoma plate anchorage for distalization of maxillary posterior teeth

This study aimed to examine the skeletal, dental, and soft tissue effects of the implant-supported pendulum (ISP) and the zygoma anchorage system (ZAS) used for the distalization of maxillary posterior teeth. Among 30 patients showing Angle class II malocclusion, 15 patients with a mean age of 14.3±1.6 years and treated with ISP were included in the first group; 15 patients with a mean age of 14.7±2.5 years and treated with ZAS were included in the second group. The predistalization and postdistalization lateral cephalograms were analysed. Statistical evaluation was carried out using SPSS. Point A and upper incisors protruded in the ISP group, retruded in the ZAS group. Upper posterior teeth were distalized in both groups, but more in the ZAS group. Significant differences were observed between the groups for the sagittal movements of Point A, incisors, and posterior teeth. Overbite decreased in the ISP group, overjet decreased in the ZAS group, upper and lower lips retruded only in the ZAS group. Both methods provided absolute anchorage for distalization of posterior teeth, but the skeletal and soft tissue outcome and distalization obtained was greater in the ZAS group. Both methods can be used as alternatives to extraoral traction and conventional molar distalization appliances with different patient requirements.

A Simple Technique for Increasing the Length of the Distracted Area: Technical Note

D Intraoral distraction osteogenesis is a relatively new procedure for lengthening of the jaws and alveolar bone. In this procedure the newly formed bone is maintained in a more physiologic way. Alveolar distraction osteogenesis (ADO) shows various advantages in rehabilitation of alveolar bone defects resulting from congenital or acquired bone deficiencies. There are some reports evaluating the risks and complications of ADO. However, none of these reports mentioned the inadequacy of the distractor length. Because intraoral distractors are miniaturized devices, the amount of distraction is limited with the length of the distractor rod. The length of the rods of the alveolar distractors available on the market is about 1.5 cm, and this mount of lengthening is less than sufficient in most ases. Sagittal (anterior-posterior) distraction of the lveolus is a recently applied version of this crest engthening procedure, and the desired amount of agittal lengthening is longer than vertical lengthenng. Distractors longer than 1.5 cm can hardly be used intraorally because they are intolerable and unesthetic. In addition, rods longer than 1.5 cm may not be rigid and steady. More rigid distractors may be manufactured by increasing the diameter of the rod, but bulky distractors cannot be used intraorally.

Minivida İmplant Destekli Distalizasyon Sisteminin Dentoalveoler Etkileri

OZET Amac: Bu prospektif klinik calismanin amaci Sinif II malokluzyona sahip hastalarda minivida implant destekli distalizasyon sisteminin tedavi etkilerini incelemektir. Bireyler ve Yontem: Calisma ornegi 14.9 ortalama yasa sahip 10 hasta (5 kiz ve 5 erkek) icerir. Iki titanyum intermaksiller fiksasyon vidasi anterior paramedyan bolgede insiziv foramenin her iki yanina yerlestirilmistir. Aljinat olculer alinmis ve apareyler model kaliplar uzerinde yapilmistir. MISDS ust birinci molarlara simante edilmis ve minividalara metalik ligatur-lerle baglanmistir. Aparey acik sarmal yaylarin sikistirilmasiyla aktive edilmistir. Her bir taraftan 2O0 g distalizasyon kuvveti uygulanmistir. Lateral sefalomet-rik radyograflar distalizasyon oncesi (TO) ve sonrasi (T1) olculmustur. Veri SPSS kullanarak analiz edilmistir. Bulgular: Ortalama maksiller birinci molar distalizasyonu 2,45 mm (p<0.05) dir ve 1° (p<0.05) lik hafif devrilme distali-zasyona eslik etmistir. Maksiller ikinci molarlar 4.35 mm (p<0.05) distalize olmus...