Francisco Ajalmar Maia

Long-term stability of surgical-orthodontic open-bite correction

INTRODUCTION The objective of this study was to evaluate the long-term stability of open-bite surgical-orthodontic correction. METHODS Thirty-nine patients at an initial mean age of 20.83 years were evaluated cephalometrically at pretreatment (T1), immediately after treatment (T2), and at the last recall (T3), with a mean follow-up time of 8.22 years. The surgical protocol included single-jaw or double-jaw surgery. Because the patients had different anteroposterior malocclusions, the sample was divided into a Class I and Class II (I-II) subgroup (3 Class I, 20 Class II malocclusion patients) and a Class III subgroup (16 patients). The dentoskeletal characteristics of the total sample and the subgroups were compared at T1, T2, and T3 with dependent analysis of variance (ANOVA). RESULTS Overbite relapse in the posttreatment period was statistically significant in the whole sample and the Class I-II subgroup. Fourteen patients of the whole sample (35.9%) had clinically significant open-bite relapse (negative overbite). CONCLUSIONS There was a statistically significant open-bite relapse in the overall sample and in the Class I-II subgroup. The clinically significant values of long-term open-bite correction stability were 64.11%, 47.82%, and 87.50% in the overall sample, the Class I-II subgroup, and the Class III subgroup, respectively.

Unusual Orthodontic Correction of Bilateral Maxillary Canine–First Premolar Transposition

Tooth transposition is a subject that intrigues orthodontists because of the associated treatment planning. Approximately 0.3-0.4% of the population has this type of tooth disharmony, and in the literature, most authors are in disagreement about the treatment approach. In this article, a case is presented of bilaterally maxillary canine-first premolar transposition associated with bilaterally upper lateral incisor agenesis treated in a very unusual way. The transposed teeth were orthodontically reversed to their normal sequence and the missing lateral incisor spaces closed. We choose this approach because once the decision was made to close the upper lateral incisor agenesis spaces, it was inadequate to position the upper first premolars in contact with the central incisors.

Factors associated with long-term patient satisfaction

OBJECTIVE To identify factors associated with patient satisfaction at least 5 years after orthodontic treatment. MATERIALS AND METHODS A total of 209 orthodontic patients were included in the study. All subjects were treated with upper and lower fixed orthodontic appliances. Dental casts (n = 627) were examined using the Peer Assessment Rating (PAR) Index pretreatment (T1), at the end of treatment (T2) and at a long-term follow-up (mean, 8.5 years; T3). At T3, a Dental Impact on Daily Living questionnaire was used to assess the long-term effects of orthodontic treatment on daily living and satisfaction with the dentition. Multiple regression analyses were used to quantify associations between patient satisfaction and changes produced by the orthodontic treatment (PAR T2-T1), posttreatment stability (PAR T3), age at the start of treatment (T1), treatment duration (T2-T1), gender, and extraction. RESULTS Orthodontic treatment produced a significant improvement of 94.2% in the PAR Index (T2-T1), but this change was not associated with the level of satisfaction when the patient was questioned at least 5 years after treatment. Regression analysis showed that satisfaction was significantly associated only with the long-term posttreatment PAR index (r(2) = 0.125, P < .0001). No significant association was observed with the severity of malocclusion at the beginning (PAR-T1) or end of the orthodontic treatment (PAR-T2), age at T1, the amount of time taken during orthodontic treatment, gender, or extraction. CONCLUSIONS Over the long term, patient satisfaction is slightly associated with the stability of the orthodontic treatment regardless of the initial occlusal condition or the final result of the orthodontic treatment.