Hdp Chua

Bone anchor systems for orthodontic application: a systematic review

This systematic review was performed to investigate the usefulness and clinical effectiveness of skeletal anchorage devices to determine the most effective bone anchor system for orthodontic tooth movement. Literature on bone anchorage devices was selected from PubMed and the Cochrane Library from January 1966 to June 2010. 55 publications regarding miniplates, miniscrews, palatal implants and dental implants as orthodontic anchorage were identified for further analysis. All bone anchorage devices were found to have relatively high success rates and demonstrated their ability to provide absolute anchorage for orthodontic tooth movement. Significant tooth movement could be achieved with low morbidities and good patient acceptance. The reported success rates for the four groups of anchorage systems were generally high with slight variability (miniplates 91.4-100%; palatal implants 74-93.3%; miniscrews 61-100%; dental implants 100%). It was concluded that bone anchorage systems can achieve effective orthodontic movement with low morbidities. The success rate is generally high with slight variability between miniplates, palatal implants, miniscrews and dental implants. Owing to the lack of randomized controlled trials, there is no strong evidence to confirm which bone anchor system is the most effective for orthodontic tooth movement.

Maxillary distraction versus orthognathic surgery in cleft lip and palate patients: effects on speech and velopharyngeal function

This clinical randomized controlled trial was performed to compare the effects of distraction osteogenesis (DO) and conventional orthognathic surgery (CO) on velopharyngeal function and speech outcomes in cleft lip and palate (CLP) patients. Twenty-one CLP patients who required maxillary advancement ranging from 4 to 10 mm were recruited and randomly assigned to either CO or DO. Evaluation of resonance and nasal emission, nasoendoscopic velopharyngeal assessment and nasometry were performed preoperatively and at a minimum of two postoperative times: 3-8 months (mean 4 months) and 12-29 months (mean 17 months). Results showed no significant differences in speech and velopharyngeal function changes between the two groups. No correlation was found between the amount of advancement and the outcome measures. It was concluded that DO has no advantage over CO for the purpose of preventing velopharyngeal incompetence and speech disturbance in moderate cleft maxillary advancement.