Vanessa Paredes-Gallardo

Effectiveness of interceptive treatment of class III malocclusions with skeletal anchorage: A systematic review and meta-analysis

Recently, new strategies for treating class III malocclusions have appeared. Skeletal anchorage appears to reduce the dentoalveolar effects while maximising the orthopaedic effect in growing patients. The purpose of this systematic review and meta-analysis is to examine the effectiveness of bone anchorage devices for interceptive treatment of skeletal class III malocclusions. Searches were made in the Pubmed, Embase, Scopus and Cochrane databases, as well as in a grey literature database, and were complemented by hand-searching. The criteria for eligibility were: patients who had undergone orthodontic treatment with skeletal anchorage (miniplates and miniscrews). Patients with syndromes or craniofacial deformities or who had undergone maxillofacial surgery were excluded. The following variables were recorded for each article: author, year of publication, type of study, sample size, dropouts, demographic variables, treatment carried out, radiographic study (2D or 3D), follow-up time, and quality of the articles on the Newcastle-Ottawa Scale. The means and confidence intervals of the following variables were employed: Wits, overjet, ANB, SNA and SNB. Initially, 239 articles were identified. After removing the duplicates and applying the selection criteria, 9 were included in the qualitative synthesis and 7 in the quantitative synthesis (meta-analysis). It may be concluded that skeletal anchorage is an effective treatment for improving skeletal Class III malocclusion, but when compared with other traditional treatments such as disjunction and face mask, there is no clear evidence that skeletal anchorage improves the results.

Nonsurgical treatment of skeletal anterior open bite in adult patients: Posterior build-ups

OBJECTIVE To (1) evaluate the efficacy of build-ups in the correction of anterior open bite in adults, (2) evaluate their efficacy in producing molar intrusion, (3) analyze skeletal and dental changes, and (4) assess the long-term stability. MATERIALS AND METHODS The sample consisted of 93 lateral cephalograms from 31 patients with skeletal and dental anterior open bite. The patients had received orthodontic treatment consisting of bonded resin blocks on the maxillary molars combined with Tip-Edge Plus bracket appliances. Cephalometric measurements were performed on radiographs taken before treatment (T1), after treatment (T2), and after a retention period (T3), which were analyzed and compared. RESULTS Significant dental and skeletal changes were observed after treatment. Molar intrusion averaging 1 mm; 1.44 and 1.57 mm extrusion of mandibular and maxillary incisors, respectively; and a mean of 3.98 mm overbite increase were observed. The mandibular plane angle showed a mean closure of 1.19°, and there was a mean decrease in anterior facial height of 0.7 mm. A mild relapse tendency was observed, but long-term stability was acceptable. CONCLUSIONS Build-ups are an effective treatment alternative for anterior open bite in adults. Outcomes remain significantly stable during the retention period.

Evolución de las características de las arcadas dentarias en dos grupos de edad

Introduccion: se comparan las caracteristicas dimensionales de las arcadas dentarias entre dos grupos de edades diferentes, adolescentes y adultos jovenes. para analizar las variaciones asocia- das a la edad. sexo y a la influencia del tratamiento ortodoncico. Material y metodo: se utilizaron dos muestras: 88 pares de modelos de escayola de adolescentes (edad media 14.05 anos) y 65 de adultos (edad media 22.15 anos). 5e uso un metodo digital para la medicion de los diametros meslodistales de los dientes. distancias intercaninas e intermolares. longitudes de las arcadas y se obtuvo el apinamiento dentario inferior. Para el analisis estadistico se agruparon las muestras de cada grupo de edad por sexos y por tratadoS/no tratados con ortodoncia. Resultados; Los diametros mesiodistales de los chicos eran mayores a los de las chicas y los de los adolescentes mayores que los de los adultos. sobre todo en el sexo femenino. La distancia intercanina disminuyo con la edad en las chicas y la intermolar superior disminuyo en las chicas no tratadas. mientras Que la inferior aumenta en los chicos. Ambas longitudes de arcada tienden a disminuir en ambos sexos y sobre todo en los grupos de no tratados. Existio un aumento del apinamiento inferior con la edad en ambos sexos en los individuos tratados. Conclusiones: la perdida de material dentario con el paso de los anos unido a una mayor perdida de longitud de la arcada podria ser otro factor en el apinamiento terciario. A su vez, el desplazamiento dentario a mesial podria explicar la disminucion de los diametros transversales de canimos y molares, al ocupar una zona mas estrecha del arco dentario.

Orthodontic treatment stability predictors: A retrospective longitudinal study

OBJECTIVE To examine medium- to long-term orthodontic treatment stability and its possible association with certain variables. MATERIALS AND METHODS In a retrospective longitudinal study of 70 postretention patients, the Peer Assessment Rating (PAR) index was measured at the start (T1) and end (T2) of treatment and between 4 and 10 years afterwards (T3). The stability was considered absolute when the T2 and T3 values were identical and relative when the difference was within the ±5 range. RESULTS Among the 70 patients, 65.8% were female and 34.2% were male. Their mean age was 14.5 years. The mean treatment length was 2.4 years. The mean retention phase was 3.3 years. The mean pre- and posttreatment PAR scores were 29.8 (T1) and 6.3 (T2). The mean T1-T2 difference was 23.6. The mean T2-T3 difference was -0.39. CONCLUSIONS Within the study, 7.1% presented absolute stability and 68.6% presented relative stability. Lower anterior segment alignment and overbite were the most unstable occlusal features and tended to worsen. Fixed retainer (odds ratio [OR] 0.31; 95% confidence interval [CI] 0.10-0.98) as a protective factor and years without retention (OR 1.32; 95% CI 1.03-1.68) as a risk factor are predictor variables of instability in the case of lower anterior segment alignment. The PAR value at the end of treatment (OR 1.29; 95% CI 1.08-1.54) and extractions (OR 4.76; 95% CI 1.05-21.6) before treatment are predictors for midline instability.

The effects of lasers on bond strength to ceramic materials: A systematic review and meta-analysis

Lasers have recently been introduced as an alternative means of conditioning dental ceramic surfaces in order to enhance their adhesive strength to cements and other materials. The present systematic review and meta-analysis aimed to review and quantitatively analyze the available literature in order to determine which bond protocols and laser types are the most effective. A search was conducted in the Pubmed, Embase and Scopus databases for papers published up to April 2017. PRISMA guidelines for systematic review and meta-analysis were followed. Fifty-two papers were eligible for inclusion in the review. Twenty-five studies were synthesized quantitatively. Lasers were found to increase bond strength of ceramic surfaces to resin cements and composites when compared with control specimens (p-value < 0.01), whereas no significant differences were found in comparison with air-particle abraded surfaces. High variability can be observed in adhesion values between different analyses, pointing to a need to standardize study protocols and to determine the optimal parameters for each laser type.

Accuracy and Reliability of Cone-Beam Computed Tomography for Linear and Volumetric Mandibular Condyle Measurements. A Human Cadaver Study

The accuracy of Cone-Beam Computed Tomography (CBCT) on linear and volumetric measurements on condyles has only been assessed on dry skulls. The aim of this study was to evaluate the reliability and accuracy of linear and volumetric measurements of mandibular condyles in the presence of soft tissues using CBCT. Six embalmed cadaver heads were used. CBCT scans were taken, followed by the extraction of the condyles. The water displacement technique was used to calculate the volumes of the condyles and three linear measurements were made using a digital caliper, these measurements serving as the gold standard. Surface models of the condyles were obtained using a 3D scanner, and superimposed onto the CBCT images. Condyles were isolated on the CBCT render volume using the surface models as reference and volumes were measured. Linear measurements were made on CBCT slices. The CBCT method was found to be reliable for both volumetric and linear measurements (CV < 3%; CCI > 0.90). Highly accurate values were obtained for the three linear measurements and volume. CBCT is a reliable and accurate method for taking volumetric and linear measurements on mandibular condyles in the presence of soft tissue, and so a valid tool for clinical diagnosis.

Linear and Volumetric Mandibular Asymmetries in Adult Patients With Different Skeletal Classes and Vertical Patterns: A Cone-Beam Computed Tomography Study

This study aimed to quantify the height of the mandibular condyle and ramus, condylar volume, and the asymmetry index in adult patients of different sex, skeletal class and vertical pattern using Cone-Beam Computed Tomography (CBCT), and to determine whether there were differences between these groups. The study used CBCT scans of 159 patients with a mean age of 32.32 ± 8.31 years. InVivoDental® software was used to perform both linear (condylar, ramal, and total height) and condylar volume measurements. Linear and volumetric asymmetries were calculated. There were not significant differences between right and left sides. The mean value obtained for condyle height was 7.27 mm, ramus height 42.3 mm, total height 49.6 mm and condyle volume 1907.1 mm3, with significant differences between men and women. Significantly higher values were found for condylar volume in hypodivergent patterns (p = 0.001) and for the asymmetry index of the condylar volume in Class II patients (p < 0.05). The prevalence of relevant asymmetry was high for condyle height and volume (73.1% y 75.6% respectively). Higher height and volume values were found among men, Class III, and hypodivergent patients. Linear and volumetric asymmetries were more prevalent among men, Class III and hyperdivergent patterns.

Relationship between perception of smile esthetics and orthodontic treatment in Spanish patients

One of the main objectives of orthodontic treatment is to achieve an esthetic smile. This study set out to analyze differences in the perception of smile esthetics among patients before and after receiving orthodontic treatment. 250 Spanish patients analyzed a single photograph in which, by means of computer software, midline diastema, black triangle, gingival margin of the left central incisor, and gingival (“gummy”) smile were altered. Each patient analyzed these images before and after undergoing orthodontic treatment. Patients scored the photographs on a scale from 1 to 10. Statistical analyses of each group’s level of perception were carried out, identifying significant differences in evaluations before and after treatment, and in relation to subjects’ gender and age. Patients presented significant differences in the esthetic perception of midline diastema and gummy smile anomalies after they had completed orthodontic treatment. Gender influenced the perception of smile esthetics, whereby women were significantly more critical of midline diastema, black triangle and gingival margin of the upper central incisor than men. The age variable also showed significant differences in the perception of midline diastema and black triangle anomalies. The perception of smile esthetics of some dental anomalies changes as a result of orthodontic treatment. Gender influences the perception of some of the dental anomalies studied.

Associations between mandibular symphysis form and craniofacial structures

ObjectivesThis study aimed to (1) analyze the relationships between mandibular symphysis characteristics (height, prominence, inclination, concavity, and convexity) and facial pattern, skeletal class, lower incisor position, and sex, and (2) determine the associations between the symphysis soft tissue dimensions and the underlying osseous structures.MethodsCone-beam computed tomography (CBCT) images were selected for 385 patients (206 women and 179 men). The patients were classified according to their skeletal class and vertical pattern. The lower incisor inclination (IMPA) was recorded. Twelve measurements were taken for each mandibular symphysis using Invivo5 software (Anatomage, San Jose, CA, USA).ResultsSymphyseal measurements were larger in males than in females. Skeletal Class II and III hyperdivergent patients showed the highest symphysis height values. Hypodivergent individuals showed lower symphysis convexity angles. Concavity of the symphysis was greater for Class II hyperdivergent patients. Lower incisor inclination showed a positive correlation with symphysis concavity and inclination. Moderate and weak correlations were found between hard tissue and soft tissue parameters.ConclusionsOnly a few characteristics of symphysis morphology depend on sex, incisor position, skeletal class, and vertical pattern. More significant relationships are found when the vertical pattern and skeletal class are analyzed in combination. The shape of the symphysis soft tissue is not directly correlated with the underlying skeletal structures.

Craniofacial cephalometric morphologies in different cleft types: a retrospective cross-sectional study of 212 patients

ObjectiveThe aim of this study was to evaluate and compare the craniofacial cephalometric morphologies among different cleft types in a Spanish population.MethodsA retrospective cross-sectional study was carried out on 212 patients. The patients were subdivided into four groups according to their cleft types: unilateral cleft lip and palate; bilateral cleft lip and palate; cleft lip; and cleft palate. Angular and linear cephalometric measurements were taken on lateral radiographs.ResultsUnilateral cleft lip and palate was associated with a dolichofacial growth pattern, skeletal Class III with correct maxillary position, and lingual incisor inclination. Bilateral cleft lip and palate was associated with a mesofacial growth pattern, skeletal Class I with protruded maxillary position, and lingual incisor inclination. Cleft palate was associated with a mesofacial growth pattern, skeletal Class III with correct maxillary position, and lingual incisor inclination. Cleft lip was associated with a brachyfacial growth pattern, skeletal Class I with protruded maxillary position, lingual upper incisor inclination, and corrects lower incisor inclination. Significant correlations were observed between cleft types and their craniofacial cephalometric measurements.ConclusionsThe present information can be used for the determination of orthodontic treatment and even future orthognathic surgery planning, a requirement in most cleft patients.