The prevalence of mandibular asymmetry in developmental age has been evaluated by a clinical and ... more The prevalence of mandibular asymmetry in developmental age has been evaluated by a clinical and photographic survey. The signs of dysfunction increased with age from 14 to 34.5%. The heterogeneous predisposing or concurrent factors are discussed, with special attention for postural and breathing problems.
The role of OPM and of the teleradiography in the diagnosis of the asymmetries and of the postura... more The role of OPM and of the teleradiography in the diagnosis of the asymmetries and of the postural problems of the orthodontic patients, is pointed out from this analysis on the group of 204 patients from mixed dentition to the adult age with different types of malocclusion. The evidence of a significant amount of patients with asymmetries and incorrected posture shows the utility of this radiological screening and gives advises for a therapeutic approach more corrected.
Conventional and digital lateral teleradiographs of the skull were performed on 6 consecutive pat... more Conventional and digital lateral teleradiographs of the skull were performed on 6 consecutive patients (3 men and 3 women). The study was aimed at comparing the diagnostic capabilities of the two imaging techniques to measure points and angles, as derived from different cephalometric analyses (see text for details). These variables were analyzed by three different operators: for both techniques, 18 cephalometric tracings were made, including a total of 414 points and 36 angles. Correlation coefficients between the two types of measurements (points and angles) were calculated; Wilcoxon's non-parametric test was also used. This study demonstrates digital radiography to be superior to conventional radiography to detect cephalometric landmarks, which is especially evident in the evaluation of the so-called "questionable" landmarks: the latter were 15 of 23 with conventional radiography and 9 of 23 with digital radiography. On the other hand, correlation coefficients and significance of the values of the considered angles were in close agreement with the two techniques. Therefore, its simultaneous demonstration of anatomical structures of different thickness--i.e., bone and soft tissues--and its lower exposure dose make digital radiography the diagnostic procedure of choice in cephalometrics, especially in the pediatric age, as well as in monitoring the patients.
Summary Background Facial and smile attractiveness are significant motivating factor for patients... more Summary Background Facial and smile attractiveness are significant motivating factor for patients to seek orthodontic treatment. Although there is a general belief that orthodontic treatment improves facial appearance, this has yet not been systematically evaluated. Objective The objective of this study was to assess the current evidence on the effect of orthodontic treatment on facial attractiveness. Search Methods Systematic and unrestricted search of nine databases were performed up to January 2022. Selection Criteria Studies evaluating facial attractiveness before and after orthodontic treatment. Data Collection and Analysis Extracted data included study design and setting, sample size and demographics, malocclusion type, treatment modality, and method for outcome assessment. Risk of bias was assessed with the ROBINS-I tool for non-randomized studies and with RoB-2 for randomized controlled trials (RCTs). Random-effects meta-analyses of mean differences and their 95% confidence intervals (CIs) were performed. Results Twenty studies were included in data synthesis; three randomized controlled clinical trials and 17 non-randomized clinical studies of retrospective or prospective design. One of the RCTs was found to have low risk of bias, one presented some concerns and the third showed a high risk of bias. All non-randomized studies showed either unclear or high risk of bias. Data syntheses showed that orthodontic treatment improved facial attractiveness ratings by 9% when compared with untreated controls (MD: 9.05/95% CI: 4.71; 13.39). A combination of orthodontics and orthognathic surgery also showed a positive effect of 5.5% (MD: 5.51/95% CI: 1.55; 9.47) when compared with orthodontic treatment alone. There was no difference in effect between extraction and non-extraction treatments (MD: −0.89/ 95% CI: −8.72; 6.94) or between different types of Class II correctors (MD: 2.21/95% CI: −16.51; 20.93). Limitations With the exception of two RCTs, included studies were of unclear or low quality. Conclusions Orthodontic treatment has a clinically weak effect on facial attractiveness when compared to no treatment. The same is true when a combined orthodontic/surgical treatment is compared to orthodontics alone. Registration PROSPERO #: CRD42020169904
Informationen aus Orthodontie und Kieferorthopädie, Sep 1, 2022
ZusammenfassungUm die Effektivität kieferorthopädischer Behandlungen in Hinblick auf die Behandlu... more ZusammenfassungUm die Effektivität kieferorthopädischer Behandlungen in Hinblick auf die Behandlungsdauer und die Ästhetik der verwendeten Apparaturen zu verbessern, sind unterschiedliche Geräte und Verfahren entwickelt worden.Durch die Einführung der skelettalen Verankerung hat sich die biomechanische Effektivität deutlich verbessert. Bei Verfahren, welche die biologische Antwort des Patienten beeinflussen, scheint die Kortikotomie mit oder ohne Knochenaufbau und Weichgewebetransplantation eher in Bezug auf die Qualität, als auf die Geschwindigkeit von Zahnbewegungen am vielversprechendsten zu sein. Eine Finite Elemente-Studie konnte zeigen, dass sich eine Translationsbewegung nach der Veränderung der Knochendichte schneller und länger durchführen lässt. Im Zusammenhang mit unsichtbaren bzw. weniger sichtbaren Apparaturen ist die Biomechanik im Rahmen der Lingualtherapie bei der Kontrolle der Inklination der unteren Schneidezähne sowohl bei Jump Bite-Geräten und bei der Retraktion überlegen. Der Enthusiasmus, mit dem die Aligner-Therapie eingeführt worden ist, hat inzwischen nachgelassen. Es ist klar geworden, dass diese Art der Behandlung bei einigen Zahnbewegungen nicht die biomechanischen Vorteile bieten kann, die festsitzende Geräte auszeichnen. Für einfachere Zahnbewegungen sind sie jedoch geeignet und hier besonders bei der hybriden Behandlung, bei der die biomechanischen Vorteile festsitzender Geräte mit den ästhetischen Vorteilen der Aligner kombiniert werden.
Scandinavian Journal of Rheumatology, Dec 19, 2013
Temporomandibular joint (TMJ) inflammation in patients with juvenile idiopathic arthritis (JIA) m... more Temporomandibular joint (TMJ) inflammation in patients with juvenile idiopathic arthritis (JIA) may interfere with optimal joint and muscle function. Orofacial symptoms are common findings in relation to TMJ arthritis. Previous research on management of TMJ arthritis-related orofacial symptoms in patients with JIA has focused on pharmacological treatment modalities without involving physical pain management strategies. The aim of this study was to evaluate changes in orofacial pain and TMJ function after stabilization splint treatment. Twenty-eight consecutive patients with JIA and arthritis-related orofacial symptoms (mean age 15.5 years, range 8.2-25 years) were included in this prospective observational study. All patients received stabilization splint treatment. A comparable group of 110 healthy children served as controls for the assessments of TMJ mobility. After splint treatment for 8 weeks, a significant reduction in orofacial pain frequency and intensity was reported, and significant improvement in TMJ function was observed. However, TMJ mobility at follow-up remained significantly reduced when compared to the control group. The stabilization splint is a safe, reversible, low-cost treatment, and familiar to most dental practitioners. Based on our findings, we propose the implementation of stabilization splint therapy for the treatment of JIA patients with TMJ arthritis-related symptoms.
The prevalence of mandibular asymmetry in developmental age has been evaluated by a clinical and ... more The prevalence of mandibular asymmetry in developmental age has been evaluated by a clinical and photographic survey. The signs of dysfunction increased with age from 14 to 34.5%. The heterogeneous predisposing or concurrent factors are discussed, with special attention for postural and breathing problems.
The role of OPM and of the teleradiography in the diagnosis of the asymmetries and of the postura... more The role of OPM and of the teleradiography in the diagnosis of the asymmetries and of the postural problems of the orthodontic patients, is pointed out from this analysis on the group of 204 patients from mixed dentition to the adult age with different types of malocclusion. The evidence of a significant amount of patients with asymmetries and incorrected posture shows the utility of this radiological screening and gives advises for a therapeutic approach more corrected.
Conventional and digital lateral teleradiographs of the skull were performed on 6 consecutive pat... more Conventional and digital lateral teleradiographs of the skull were performed on 6 consecutive patients (3 men and 3 women). The study was aimed at comparing the diagnostic capabilities of the two imaging techniques to measure points and angles, as derived from different cephalometric analyses (see text for details). These variables were analyzed by three different operators: for both techniques, 18 cephalometric tracings were made, including a total of 414 points and 36 angles. Correlation coefficients between the two types of measurements (points and angles) were calculated; Wilcoxon's non-parametric test was also used. This study demonstrates digital radiography to be superior to conventional radiography to detect cephalometric landmarks, which is especially evident in the evaluation of the so-called "questionable" landmarks: the latter were 15 of 23 with conventional radiography and 9 of 23 with digital radiography. On the other hand, correlation coefficients and significance of the values of the considered angles were in close agreement with the two techniques. Therefore, its simultaneous demonstration of anatomical structures of different thickness--i.e., bone and soft tissues--and its lower exposure dose make digital radiography the diagnostic procedure of choice in cephalometrics, especially in the pediatric age, as well as in monitoring the patients.
Summary Background Facial and smile attractiveness are significant motivating factor for patients... more Summary Background Facial and smile attractiveness are significant motivating factor for patients to seek orthodontic treatment. Although there is a general belief that orthodontic treatment improves facial appearance, this has yet not been systematically evaluated. Objective The objective of this study was to assess the current evidence on the effect of orthodontic treatment on facial attractiveness. Search Methods Systematic and unrestricted search of nine databases were performed up to January 2022. Selection Criteria Studies evaluating facial attractiveness before and after orthodontic treatment. Data Collection and Analysis Extracted data included study design and setting, sample size and demographics, malocclusion type, treatment modality, and method for outcome assessment. Risk of bias was assessed with the ROBINS-I tool for non-randomized studies and with RoB-2 for randomized controlled trials (RCTs). Random-effects meta-analyses of mean differences and their 95% confidence intervals (CIs) were performed. Results Twenty studies were included in data synthesis; three randomized controlled clinical trials and 17 non-randomized clinical studies of retrospective or prospective design. One of the RCTs was found to have low risk of bias, one presented some concerns and the third showed a high risk of bias. All non-randomized studies showed either unclear or high risk of bias. Data syntheses showed that orthodontic treatment improved facial attractiveness ratings by 9% when compared with untreated controls (MD: 9.05/95% CI: 4.71; 13.39). A combination of orthodontics and orthognathic surgery also showed a positive effect of 5.5% (MD: 5.51/95% CI: 1.55; 9.47) when compared with orthodontic treatment alone. There was no difference in effect between extraction and non-extraction treatments (MD: −0.89/ 95% CI: −8.72; 6.94) or between different types of Class II correctors (MD: 2.21/95% CI: −16.51; 20.93). Limitations With the exception of two RCTs, included studies were of unclear or low quality. Conclusions Orthodontic treatment has a clinically weak effect on facial attractiveness when compared to no treatment. The same is true when a combined orthodontic/surgical treatment is compared to orthodontics alone. Registration PROSPERO #: CRD42020169904
Informationen aus Orthodontie und Kieferorthopädie, Sep 1, 2022
ZusammenfassungUm die Effektivität kieferorthopädischer Behandlungen in Hinblick auf die Behandlu... more ZusammenfassungUm die Effektivität kieferorthopädischer Behandlungen in Hinblick auf die Behandlungsdauer und die Ästhetik der verwendeten Apparaturen zu verbessern, sind unterschiedliche Geräte und Verfahren entwickelt worden.Durch die Einführung der skelettalen Verankerung hat sich die biomechanische Effektivität deutlich verbessert. Bei Verfahren, welche die biologische Antwort des Patienten beeinflussen, scheint die Kortikotomie mit oder ohne Knochenaufbau und Weichgewebetransplantation eher in Bezug auf die Qualität, als auf die Geschwindigkeit von Zahnbewegungen am vielversprechendsten zu sein. Eine Finite Elemente-Studie konnte zeigen, dass sich eine Translationsbewegung nach der Veränderung der Knochendichte schneller und länger durchführen lässt. Im Zusammenhang mit unsichtbaren bzw. weniger sichtbaren Apparaturen ist die Biomechanik im Rahmen der Lingualtherapie bei der Kontrolle der Inklination der unteren Schneidezähne sowohl bei Jump Bite-Geräten und bei der Retraktion überlegen. Der Enthusiasmus, mit dem die Aligner-Therapie eingeführt worden ist, hat inzwischen nachgelassen. Es ist klar geworden, dass diese Art der Behandlung bei einigen Zahnbewegungen nicht die biomechanischen Vorteile bieten kann, die festsitzende Geräte auszeichnen. Für einfachere Zahnbewegungen sind sie jedoch geeignet und hier besonders bei der hybriden Behandlung, bei der die biomechanischen Vorteile festsitzender Geräte mit den ästhetischen Vorteilen der Aligner kombiniert werden.
Scandinavian Journal of Rheumatology, Dec 19, 2013
Temporomandibular joint (TMJ) inflammation in patients with juvenile idiopathic arthritis (JIA) m... more Temporomandibular joint (TMJ) inflammation in patients with juvenile idiopathic arthritis (JIA) may interfere with optimal joint and muscle function. Orofacial symptoms are common findings in relation to TMJ arthritis. Previous research on management of TMJ arthritis-related orofacial symptoms in patients with JIA has focused on pharmacological treatment modalities without involving physical pain management strategies. The aim of this study was to evaluate changes in orofacial pain and TMJ function after stabilization splint treatment. Twenty-eight consecutive patients with JIA and arthritis-related orofacial symptoms (mean age 15.5 years, range 8.2-25 years) were included in this prospective observational study. All patients received stabilization splint treatment. A comparable group of 110 healthy children served as controls for the assessments of TMJ mobility. After splint treatment for 8 weeks, a significant reduction in orofacial pain frequency and intensity was reported, and significant improvement in TMJ function was observed. However, TMJ mobility at follow-up remained significantly reduced when compared to the control group. The stabilization splint is a safe, reversible, low-cost treatment, and familiar to most dental practitioners. Based on our findings, we propose the implementation of stabilization splint therapy for the treatment of JIA patients with TMJ arthritis-related symptoms.
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