Journal & Issues

Volume 39 (2023): Issue 1 (January 2023)

Volume 38 (2022): Issue 2 (January 2022)

Volume 38 (2022): Issue 1 (January 2022)

Volume 37 (2021): Issue 2 (January 2021)

Volume 37 (2021): Issue 1 (January 2021)

Volume 36 (2020): Issue 2 (January 2020)

Volume 36 (2020): Issue 1 (January 2020)

Volume 35 (2019): Issue 2 (January 2019)

Volume 35 (2019): Issue 1 (January 2019)

Volume 34 (2018): Issue 2 (January 2018)

Volume 34 (2018): Issue 1 (January 2018)

Volume 33 (2017): Issue 2 (January 2017)

Volume 33 (2017): Issue 1 (January 2017)

Volume 32 (2016): Issue 2 (January 2016)

Volume 32 (2016): Issue 1 (January 2016)

Volume 31 (2015): Issue 2 (January 2015)

Volume 31 (2015): Issue 1 (January 2015)

Journal Details
Format
Journal
eISSN
2207-7480
First Published
01 May 1967
Publication timeframe
1 time per year
Languages
English

Search

Volume 34 (2018): Issue 1 (January 2018)

Journal Details
Format
Journal
eISSN
2207-7480
First Published
01 May 1967
Publication timeframe
1 time per year
Languages
English

Search

14 Articles
Open Access

An in vivo spectrophotometric evaluation of Vivera® and Essix® clear thermoplastic retainer discolouration

Published Online: 20 Jul 2021
Page range: 3 - 10

Abstract

AbstractAim

To assess the in vivo colour alterations of two different clear thermoplastic retainers.

Methods

Thirty patients were randomly allocated into two Groups (N = 15) following the completion of active orthodontic treatment. Group 1 received Vivera® and Group 2 Essix® C+ thermoplastic retainers. Each patient was provided with two fabricated retainers (one for use and the other to serve as a control). The CIELAB parameters of the patients’ upper central incisors were measured with a SpectroShade™ spectrophotometer immediately after retainer placement (T0) and again after 15 days (T1), one month (T2) and three months (T3). The measurements were also performed on teeth without the retainer in place. ΔE differences were calculated.

Methods

ΔE changes from T0 to Tp T2 or T3 showed no statistically significant differences between Groups 1 and 2 within any combination of measurements or teeth. ΔEļŢ3-Ţ0ļ changes for used retainers were 1.55 times higher than control appliances (p = 0.002) and 1.44 times higher than for teeth-only (p = 0.004). For used retainers, changes between T3 and T0 were 1.56 times higher than between T and T0 and 1.47 higher than between T2 and T0 (p < 0.001). There were no statistically significant differences in ΔE between teeth 11 and 21.

Results

Used retainers exhibited greater colour change than control appliances or teeth-only readings, and increased commensurate with the duration of use. Vivera® and Essix® retainers exhibited similar colour stability. All differences observed were considered clinically acceptable (ΔE < 3.7), although prolonged use could cause clinically significant colour changes.

Open Access

Evaluation of the posterior airway space following orthopaedic treatment of mandibular deficient Class II malocclusion – a pilot study

Published Online: 20 Jul 2021
Page range: 3 - 10

Abstract

AbstractBackground

The use of Twin Block therapy is a well-accepted functional treatment option for the correction of a Class II malocclusion. In addition to skeletal and dental changes, its use may also promote changes in airway structure and dimension, including the size of the posterior airway space (PAS). This may be of importance in reducing the risk of developing obstructive sleep apnoea syndrome (OSAS).

Materials and methods

Sixteen (16) subjects (eight females and eight males) underwent treatment of a Class II division 1 malocclusion via the use of a Sydney Bonded Twin Block (SBTB) appliance followed by full fixed orthodontic therapy (FFOA). Pretreatment (T1), post-twin block (T2) and post-fixed appliance (T3) lateral cephalograms were taken and skeletal and soft tissue landmarks were hand traced. A pairwise comparison was used to assess whether there were any significant differences in the cephalometric variables between each phase of treatment (T1, T2, T3).

Results

The skeletal variables SNB and ANB revealed a significant change between T1-T2 (p < 0.01). The sagittal size of the nasopharynx (RPAS) also recorded a significant change between T1-T3 (p < 0.05). There was no significant change in the PAS at any stage of treatment. There was an average reduction in the ANB angle of 2° (p < 0.01) between T1-T3.

Conclusions

There was no significant change in the size of the PAS following SBTB treatment. However, an increase in RPAS was recorded following SBTB treatment which continued to improve during FFOA therapy.

Open Access

Accuracy of orthognathic surgery using 3D computer-assisted surgical simulation

Published Online: 20 Jul 2021
Page range: 17 - 26

Abstract

AbstractObjective

To evaluate the accuracy of maxilla and mandibular repositioning during two-jaw orthognathic surgery using computerassisted surgical simulation (CASS)

Materials and methods

Fifteen patients who underwent two-jaw orthognathic surgery using CASS (VSP,® Orthognathics by 3D Systems) were evaluated to assess the accuracy of the simulation. Translational and rotational discrepancies of the centroids of the maxilla and mandible and the translational discrepancy of the dental midline between the planned and actual outcomes were reported using the root mean square error (RMSE). The number of cases that exceeded limits set for clinical significance, the direction of the error in relation to the direction of planned movement and the differences between segmental and non-segmental procedures were evaluated as secondary outcomes

Results

The largest translational RMSE was 1.53 mm along the y-axis in the maxilla and 1.34 mm along the y-axis in the mandible. The largest rotational RMSE was 1.9° about the x-axis in the maxilla and 1.16° about the x- and y-axes in the mandible. The largest RMSE for the dental midline was 1.6 mm along the y-axis in the maxilla and 1.34 mm along the y-axis in the mandible. A tendency for insufficient advancement of the maxilla was noted

Conclusions

CASS is an efficient and accurate way to develop the surgical plan and transfer the plan to the patient intraoperatively. While CASS is accurate on a population level, there remains the potential for clinically significant errors to occur on an individual basis

Conclusion

The present case indicated that the timely extraction of palatally-placed maxillary lateral incisors facilitated functional appliance therapy in the management of a skeletal Class II problem. The crowding of the lower anterior teeth was relieved and alignment of the upper arch was achieved with full fixed appliance therapy, resulting in improved aesthetics and a stable occlusion at one year review

Open Access

Do combined glucosamine sulfate and chondroitin sulfate supplements affect condylar remodelling during functional appliance therapy?

Published Online: 20 Jul 2021
Page range: 27 - 35

Abstract

AbstractObjectives

The purpose of this study was to qualitatively and quantitatively analyse the effect of glucosamine sulfate and chondroitin sulfate supplements on condylar remodelling in conjunction with bite-jumping functional appliance therapy in rats.

Materials and methods

The study involved 140 three-week-old, female rats which were divided into a control group (CG), a supplementation group (SG), a functional appliance (bite-jumping) group (FG) and a bite-jumping appliance and supplement recipient group (FSG). The animals were sacrificed at Day 0, Day 7 and at Day 21 after appliance placement, as well as seven days following appliance removal. The condylar head from each animal was blindly scanned using micro-computed tomography (μCT). Qualitative evaluation and volumetric measurements of the condyles, including total condylar volume (TCoV), posterior condylar volume (PCoV), total cartilage volume (TCaV) and posterior cartilage volume (PCaV), were undertaken using VGStudioMax software.

Results

One hundred and thirty-five rats were analysed, some of which responded to the intervention with a protruded bite (Class III response) while others responded with a retruded bite (Class II response). The TCoV and PCoV of the CG decreased during the experimental period. The functional appliance alone and the combination of the functional appliance with the supplement had a significant effect on TCoV and PCoV over the intervention period (p < 0.01), peaking at Day 7. There was no statistically significant difference in TCaV between animals that experienced Class II and Class III bite responses at Days 21 and 28 (p > 0.05). However, at Day 21, the PCaV increased significantly in those animals which displayed a Class II bite response (p < 0.05). The shape of the condyles in FG and FSG varied significantly from that of the condyles in CG and SG.

Conclusion

Supplement therapy was found to enhance the normal biological response to functional appliance therapy in a rat model, particularly after the functional appliance was removed. Further research using an immuno-histochemical analysis of a modified bite-jumping appliance and improved food delivery is recommended.

Open Access

Sexual dimorphism related to occlusal traits in Australian children

Published Online: 20 Jul 2021
Page range: 36 - 44

Abstract

AbstractBackground

The aim of the present study was to assess sexual dimorphism related to occlusal variables recorded from dental casts of Australian twins and to compare trends across primary (T1), mixed (T2) and permanent (T3) dentitions in the same individuals.

Methods

The sample comprised 22 males and 25 females selected at random from monozygotic pairs and 19 males and 19 females from dizygotic pairs. Overjet, overbite, midline deviation, midline diastema, primary and permanent molar relationship, and primary and permanent canine relationships were measured in millimetres using a digital calliper

Results

The mean values for overjet in males in the permanent dentition and for overbite in the mixed and permanent dentitions were significantly greater than those for females. The other occlusal traits showed no sexual dimorphism. Midline diastemata were most prevalent in the primary dentition while coincident midlines were most prevalent at all stages for both genders. In addition, a mesial step deciduous molar relationship was more prevalent on the right side and a flush terminal plane present on the left. Furthermore, a Class II permanent molar relationship was predominant in T1/T2, while a Class I relationship was most prevalent in the permanent dentition. Class II primary and permanent canine relationships were most common at all stages

Conclusions

Significant sexual dimorphism was found for overjet and overbite at several occlusal developmental stages but sexual dimorphism was not found for the other occlusal traits studied

Open Access

Clinical evidence in the treatment of white spot lesions following fixed orthodontic therapy: a meta-analysis

Published Online: 20 Jul 2021
Page range: 45 - 60

Abstract

AbstractObjective

This systematic review aims to determine the most effective method of treatment to remineralise post-orthodontic white spot lesions (WSLs).

Method

Six databases were accessed and searched for articles. Screening and selection were conducted according to the PRISMA guidelines using predetermined inclusion and exclusion criteria. Two reviewers independently assessed and extracted identified studies and relevance disagreement was resolved through consensus. Experimental studies were included that involved (i) patients of any age who had WSLs after the removal of fixed appliances, (ii) any treatment to remineralise the WSLs compared with no treatment or a placebo, and (iii) measurement of the changes in enamel mineralisation status after treatment. Eligible articles were assessed for internal bias and underwent narrative synthesis. A meta-analysis using random-effects modelling was performed to calculate a pooled estimate and assess between-study variability using Cochran’s Q and I2.

Results

The nine articles included in this review were found to have a medium or high risk of bias. The qualitative assessment provided contrasting results between studies. The meta-analysis showed both CPP-ACP – pooled d of -0.28 (N = 5 studies; 95% CI = -0.48- -0.07) – and fluoride – pooled d of -0.25 (N = 4 studies; 95% CI = -0.48- -0.02) – to generate improvement in the enamel mineralisation status, with CPP-ACP producing more consistent results compared with fluoride.

Conclusions

The meta-analysis found that CPP-ACP and fluoride were effective in reducing post-orthodontic WSLs. Due to the heterogeneity of the included studies with regard to the fluoride concentrations and mode of delivery, the current meta-analysis could not accurately establish which remineralising agent, CPP-APP or fluoride, is more effective. Further high quality studies of long-term duration are required to determine best clinical practice.

Open Access

Craniofacial growth studies in orthodontic research — lessons, considerations and controversies

Published Online: 20 Jul 2021
Page range: 61 - 69

Abstract

Abstract

The distinguishing features of Class I, Class II and Class III craniofacial growth have been subjects of orthodontic research since the middle of the 20th century. However, the moral and practical issues related to studying craniofacial growth in modern times have presented unresolved challenges to researchers. While previous longitudinal growth investigations are typically based on historical data sets, the cephalometric growth studies of contemporary populations must now rely on cross-sectional data. Furthermore, clinical orthodontic research has faced similar ethical challenges in which therapeutic outcomes are analysed using historical control data. These limitations, amongst others, have obscured the conclusions that can be drawn from both types of studies. This article begins with a review of the defining characteristics of Class I, Class II and Class III growth and then explores the limitations of growth studies and the use of historical control groups in orthodontic research.

Open Access

Multidisciplinary treatment of a severe facial asymmetry

Published Online: 20 Jul 2021
Page range: 70 - 77

Abstract

Abstract

This case report presents the multidisciplinary treatment of an adult female who presented with a previously repaired right unilateral cleft lip and palate. The patient had been referred with a complaint of facial asymmetry, eating difficulties and a missing right central incisor. A clinical evaluation revealed severe facial asymmetry created by a mandibular deviation to the right side and a compensatory transverse cant of the maxillary occlusal plane. After pre-surgical orthodontic treatment, a Le Fort I osteotomy and a bilateral sagittal split osteotomy were performed. During post-surgical orthodontic treatment and, as a result of the rotational surgery, the maxillary left central incisor became the right central incisor. The left lateral incisor was subsequently moved toward the midline and reshaped with a composite buildup to serve as a new left central incisor. The combination of orthodontic, orthognathic and restorative treatment established a favourable occlusal and aesthetic result.

Open Access

Management of multiple adjacent asymmetric intruded teeth by differential curve of Spee mechanics: a case report

Published Online: 20 Jul 2021
Page range: 78 - 84

Abstract

AbstractIntroduction

Of the types of dental trauma, intrusive luxation is considered to have the worst prognosis. When forceful intrusion affects multiple adjacent teeth, orthodontic repositioning may be required; however, orthodontic treatment can be complicated by the development of a cant in the occlusal plane, especially when the affected teeth are not symmetrically located from the midline and corrective forces and anchorage are unbalanced. Designing an appropriate mechanism to overcome this problem is essential.

Case presentation

The present case report describes a 28-year-old male who suffered the traumatic intrusion of multiple teeth, with accompanying alveolar bone fractures, following a road traffic accident. The intruded teeth were repositioned using orthodontic traction, following which, endodontic treatment was performed. After initial alignment, differential curve of Spee mechanics were applied to correct the occlusal plane and an acceptable result was achieved. The overall outcome was maintained at a 24-months review.

Conclusion

This report demonstrates the importance of the early repositioning of intruded teeth to avoid dento-alveolar ankylosis, as well as the use of differential curve of Spee mechanics which provides effective force application in the management of a canted occlusal plane.

Open Access

Skeletal Class II open-bite malocclusion with idiopathic condylar resorption: a case report

Published Online: 20 Jul 2021
Page range: 85 - 93

Abstract

AbstractBackground

The orthodontic treatment of patients with idiopathic condylar resorption (ICR) remains controversial. The effect of molar intrusion using temporary anchorage devices (TADs) and the consequential gradual counterclockwise rotation of the mandible in patients with ICR remains unclear.

Aims

To present the long-term treatment result of an adult skeletal Class II open-bite malocclusion with a history of ICR corrected by the combination of orthognathic surgery and TADs.

Methods

After six months of occlusal splint therapy, a surgically-assisted intrusion of the maxillary molars was performed using TADs, followed by a bilateral sagittal split osteotomy (BSSO) and genioplasty.

Results

The five-year post-treatment records showed a good facial appearance, occlusion and mandibular/condylar position with no progress in the condylar resorption.

Conclusion

Based on a single case, this treatment option is an effective alternative to a bimaxillary osteotomy for patients presenting with ICR.

Open Access

A skeletal Class III malocclusion with agenesis and canine-bicuspid transposition: a non-surgical approach

Published Online: 20 Jul 2021
Page range: 94 - 102

Abstract

AbstractBackground

The present case report describes the orthodontic management of a patient who presented with a skeletal Class III malocclusion combined with other dental anomalies. The malocclusion was complicated by agenic maxillary lateral incisors and a lower right second premolar, in company with the transposition of the maxillary canines and premolars.

Methods

Dentoalveolar compensation of the anteroposterior jaw relationship was performed. The upper deciduous lateral incisors were extracted and the spaces closed, so that the first premolars replaced the missing lateral incisors while the canine transposition was maintained

Results

Satisfactory results were obtained which provided an improvement in function and occlusal stability, as well as smile and profile aesthetics.

Conclusion

This case demonstrates the importance of an accurate diagnosis when many treatment options are available and clearly addressed.

Open Access

Congenitally absent maxillary lateral incisors. A case report illustrating the use of a Mesialslider and a customised lingual appliance

Published Online: 20 Jul 2021
Page range: 103 - 116

Abstract

AbstractBackground

A young adolescent female, aged 17 years and one month, presented seeking orthodontic treatment to address the congenital absence of her maxillary lateral incisors.

Aims

The therapeutic aims were to provide an adequate aesthetic and functional occlusion, coupled with sound adjunctive periodontal tissue relationships and a favourable long-term prognosis.

Methods

The malocclusion was managed by customised lingual orthodontic appliances and the adjunctive use of direct skeletal anchorage derived from two palatal mini-implants.

Results

The treatment objectives of good aesthetics, a functional occlusion, normal function, a healthy periodontium and a balanced profile were readily achieved. The retention records demonstrate the stability of the correction. The treatment duration was approximately 41 months, which encompassed the use of full fixed customised lingual appliances over a period of 24 months.

Open Access

Orthodontic treatment in conjunction with distraction osteogenesis and orthognathic surgery for severe facial asymmetry

Published Online: 20 Jul 2021
Page range: 117 - 125

Abstract

Abstract

The present case report describes the combination of orthodontic treatment and two-stage surgery used to treat a 16-year-old female with a severe maxillary occlusal cant and a mandibular deviation. The patient was diagnosed with right temporomandibular joint ankylosis six months after suffering a facial injury at five years of age. A unilateral condylectomy was performed 12 months later. A hybrid functional appliance was used between nine and 16 years of age to prevent deterioration of the maxillary occlusal cant. At 16 years and six months, it was determined that the patient required a combination of surgical and orthodontic treatment, the pre-surgical orthodontic phase of which was completed at 19 years. The surgery was performed in two stages, which involved a Le-Fort 1 procedure to intrude the maxilla in the left molar region and to extrude in the right molar region. Distraction osteogenesis was performed to achieve a lengthening of the right mandibular ramus. The second operation was a unilateral sagittal split ramus osteotomy to achieve a forward and upward rotation of the left hemimandible. As a result, the patient’s facial asymmetry and occlusion significantly improved. The improvements were well maintained and the patient remained stable after one year of retention.

Open Access

Two-phase treatment of iatrogenic periodontitis: an eight-year follow-up

Published Online: 20 Jul 2021
Page range: 126 - 132

Abstract

Abstract

The mixed dentition is often accompanied by transient malocclusions, such as a midline diastema. The general principle is to monitor development to ascertain the appropriate timing of possible intervention. The present clinical article reports the case of a seven-year-old boy who suffered from severe iatrogenic periodontitis of the maxillary incisors due to direct closure of a diastema by a rubber band. The incisors survived and exhibited periodontal and pulpal health at an eight-year review. Carefully-sequenced interdisciplinary management and co-operation, appropriate biomechanics aided by temporary anchorage devices, and a longterm follow-up are noted as key factors determining success when clinicians encounter such challenges.

14 Articles
Open Access

An in vivo spectrophotometric evaluation of Vivera® and Essix® clear thermoplastic retainer discolouration

Published Online: 20 Jul 2021
Page range: 3 - 10

Abstract

AbstractAim

To assess the in vivo colour alterations of two different clear thermoplastic retainers.

Methods

Thirty patients were randomly allocated into two Groups (N = 15) following the completion of active orthodontic treatment. Group 1 received Vivera® and Group 2 Essix® C+ thermoplastic retainers. Each patient was provided with two fabricated retainers (one for use and the other to serve as a control). The CIELAB parameters of the patients’ upper central incisors were measured with a SpectroShade™ spectrophotometer immediately after retainer placement (T0) and again after 15 days (T1), one month (T2) and three months (T3). The measurements were also performed on teeth without the retainer in place. ΔE differences were calculated.

Methods

ΔE changes from T0 to Tp T2 or T3 showed no statistically significant differences between Groups 1 and 2 within any combination of measurements or teeth. ΔEļŢ3-Ţ0ļ changes for used retainers were 1.55 times higher than control appliances (p = 0.002) and 1.44 times higher than for teeth-only (p = 0.004). For used retainers, changes between T3 and T0 were 1.56 times higher than between T and T0 and 1.47 higher than between T2 and T0 (p < 0.001). There were no statistically significant differences in ΔE between teeth 11 and 21.

Results

Used retainers exhibited greater colour change than control appliances or teeth-only readings, and increased commensurate with the duration of use. Vivera® and Essix® retainers exhibited similar colour stability. All differences observed were considered clinically acceptable (ΔE < 3.7), although prolonged use could cause clinically significant colour changes.

Open Access

Evaluation of the posterior airway space following orthopaedic treatment of mandibular deficient Class II malocclusion – a pilot study

Published Online: 20 Jul 2021
Page range: 3 - 10

Abstract

AbstractBackground

The use of Twin Block therapy is a well-accepted functional treatment option for the correction of a Class II malocclusion. In addition to skeletal and dental changes, its use may also promote changes in airway structure and dimension, including the size of the posterior airway space (PAS). This may be of importance in reducing the risk of developing obstructive sleep apnoea syndrome (OSAS).

Materials and methods

Sixteen (16) subjects (eight females and eight males) underwent treatment of a Class II division 1 malocclusion via the use of a Sydney Bonded Twin Block (SBTB) appliance followed by full fixed orthodontic therapy (FFOA). Pretreatment (T1), post-twin block (T2) and post-fixed appliance (T3) lateral cephalograms were taken and skeletal and soft tissue landmarks were hand traced. A pairwise comparison was used to assess whether there were any significant differences in the cephalometric variables between each phase of treatment (T1, T2, T3).

Results

The skeletal variables SNB and ANB revealed a significant change between T1-T2 (p < 0.01). The sagittal size of the nasopharynx (RPAS) also recorded a significant change between T1-T3 (p < 0.05). There was no significant change in the PAS at any stage of treatment. There was an average reduction in the ANB angle of 2° (p < 0.01) between T1-T3.

Conclusions

There was no significant change in the size of the PAS following SBTB treatment. However, an increase in RPAS was recorded following SBTB treatment which continued to improve during FFOA therapy.

Open Access

Accuracy of orthognathic surgery using 3D computer-assisted surgical simulation

Published Online: 20 Jul 2021
Page range: 17 - 26

Abstract

AbstractObjective

To evaluate the accuracy of maxilla and mandibular repositioning during two-jaw orthognathic surgery using computerassisted surgical simulation (CASS)

Materials and methods

Fifteen patients who underwent two-jaw orthognathic surgery using CASS (VSP,® Orthognathics by 3D Systems) were evaluated to assess the accuracy of the simulation. Translational and rotational discrepancies of the centroids of the maxilla and mandible and the translational discrepancy of the dental midline between the planned and actual outcomes were reported using the root mean square error (RMSE). The number of cases that exceeded limits set for clinical significance, the direction of the error in relation to the direction of planned movement and the differences between segmental and non-segmental procedures were evaluated as secondary outcomes

Results

The largest translational RMSE was 1.53 mm along the y-axis in the maxilla and 1.34 mm along the y-axis in the mandible. The largest rotational RMSE was 1.9° about the x-axis in the maxilla and 1.16° about the x- and y-axes in the mandible. The largest RMSE for the dental midline was 1.6 mm along the y-axis in the maxilla and 1.34 mm along the y-axis in the mandible. A tendency for insufficient advancement of the maxilla was noted

Conclusions

CASS is an efficient and accurate way to develop the surgical plan and transfer the plan to the patient intraoperatively. While CASS is accurate on a population level, there remains the potential for clinically significant errors to occur on an individual basis

Conclusion

The present case indicated that the timely extraction of palatally-placed maxillary lateral incisors facilitated functional appliance therapy in the management of a skeletal Class II problem. The crowding of the lower anterior teeth was relieved and alignment of the upper arch was achieved with full fixed appliance therapy, resulting in improved aesthetics and a stable occlusion at one year review

Open Access

Do combined glucosamine sulfate and chondroitin sulfate supplements affect condylar remodelling during functional appliance therapy?

Published Online: 20 Jul 2021
Page range: 27 - 35

Abstract

AbstractObjectives

The purpose of this study was to qualitatively and quantitatively analyse the effect of glucosamine sulfate and chondroitin sulfate supplements on condylar remodelling in conjunction with bite-jumping functional appliance therapy in rats.

Materials and methods

The study involved 140 three-week-old, female rats which were divided into a control group (CG), a supplementation group (SG), a functional appliance (bite-jumping) group (FG) and a bite-jumping appliance and supplement recipient group (FSG). The animals were sacrificed at Day 0, Day 7 and at Day 21 after appliance placement, as well as seven days following appliance removal. The condylar head from each animal was blindly scanned using micro-computed tomography (μCT). Qualitative evaluation and volumetric measurements of the condyles, including total condylar volume (TCoV), posterior condylar volume (PCoV), total cartilage volume (TCaV) and posterior cartilage volume (PCaV), were undertaken using VGStudioMax software.

Results

One hundred and thirty-five rats were analysed, some of which responded to the intervention with a protruded bite (Class III response) while others responded with a retruded bite (Class II response). The TCoV and PCoV of the CG decreased during the experimental period. The functional appliance alone and the combination of the functional appliance with the supplement had a significant effect on TCoV and PCoV over the intervention period (p < 0.01), peaking at Day 7. There was no statistically significant difference in TCaV between animals that experienced Class II and Class III bite responses at Days 21 and 28 (p > 0.05). However, at Day 21, the PCaV increased significantly in those animals which displayed a Class II bite response (p < 0.05). The shape of the condyles in FG and FSG varied significantly from that of the condyles in CG and SG.

Conclusion

Supplement therapy was found to enhance the normal biological response to functional appliance therapy in a rat model, particularly after the functional appliance was removed. Further research using an immuno-histochemical analysis of a modified bite-jumping appliance and improved food delivery is recommended.

Open Access

Sexual dimorphism related to occlusal traits in Australian children

Published Online: 20 Jul 2021
Page range: 36 - 44

Abstract

AbstractBackground

The aim of the present study was to assess sexual dimorphism related to occlusal variables recorded from dental casts of Australian twins and to compare trends across primary (T1), mixed (T2) and permanent (T3) dentitions in the same individuals.

Methods

The sample comprised 22 males and 25 females selected at random from monozygotic pairs and 19 males and 19 females from dizygotic pairs. Overjet, overbite, midline deviation, midline diastema, primary and permanent molar relationship, and primary and permanent canine relationships were measured in millimetres using a digital calliper

Results

The mean values for overjet in males in the permanent dentition and for overbite in the mixed and permanent dentitions were significantly greater than those for females. The other occlusal traits showed no sexual dimorphism. Midline diastemata were most prevalent in the primary dentition while coincident midlines were most prevalent at all stages for both genders. In addition, a mesial step deciduous molar relationship was more prevalent on the right side and a flush terminal plane present on the left. Furthermore, a Class II permanent molar relationship was predominant in T1/T2, while a Class I relationship was most prevalent in the permanent dentition. Class II primary and permanent canine relationships were most common at all stages

Conclusions

Significant sexual dimorphism was found for overjet and overbite at several occlusal developmental stages but sexual dimorphism was not found for the other occlusal traits studied

Open Access

Clinical evidence in the treatment of white spot lesions following fixed orthodontic therapy: a meta-analysis

Published Online: 20 Jul 2021
Page range: 45 - 60

Abstract

AbstractObjective

This systematic review aims to determine the most effective method of treatment to remineralise post-orthodontic white spot lesions (WSLs).

Method

Six databases were accessed and searched for articles. Screening and selection were conducted according to the PRISMA guidelines using predetermined inclusion and exclusion criteria. Two reviewers independently assessed and extracted identified studies and relevance disagreement was resolved through consensus. Experimental studies were included that involved (i) patients of any age who had WSLs after the removal of fixed appliances, (ii) any treatment to remineralise the WSLs compared with no treatment or a placebo, and (iii) measurement of the changes in enamel mineralisation status after treatment. Eligible articles were assessed for internal bias and underwent narrative synthesis. A meta-analysis using random-effects modelling was performed to calculate a pooled estimate and assess between-study variability using Cochran’s Q and I2.

Results

The nine articles included in this review were found to have a medium or high risk of bias. The qualitative assessment provided contrasting results between studies. The meta-analysis showed both CPP-ACP – pooled d of -0.28 (N = 5 studies; 95% CI = -0.48- -0.07) – and fluoride – pooled d of -0.25 (N = 4 studies; 95% CI = -0.48- -0.02) – to generate improvement in the enamel mineralisation status, with CPP-ACP producing more consistent results compared with fluoride.

Conclusions

The meta-analysis found that CPP-ACP and fluoride were effective in reducing post-orthodontic WSLs. Due to the heterogeneity of the included studies with regard to the fluoride concentrations and mode of delivery, the current meta-analysis could not accurately establish which remineralising agent, CPP-APP or fluoride, is more effective. Further high quality studies of long-term duration are required to determine best clinical practice.

Open Access

Craniofacial growth studies in orthodontic research — lessons, considerations and controversies

Published Online: 20 Jul 2021
Page range: 61 - 69

Abstract

Abstract

The distinguishing features of Class I, Class II and Class III craniofacial growth have been subjects of orthodontic research since the middle of the 20th century. However, the moral and practical issues related to studying craniofacial growth in modern times have presented unresolved challenges to researchers. While previous longitudinal growth investigations are typically based on historical data sets, the cephalometric growth studies of contemporary populations must now rely on cross-sectional data. Furthermore, clinical orthodontic research has faced similar ethical challenges in which therapeutic outcomes are analysed using historical control data. These limitations, amongst others, have obscured the conclusions that can be drawn from both types of studies. This article begins with a review of the defining characteristics of Class I, Class II and Class III growth and then explores the limitations of growth studies and the use of historical control groups in orthodontic research.

Open Access

Multidisciplinary treatment of a severe facial asymmetry

Published Online: 20 Jul 2021
Page range: 70 - 77

Abstract

Abstract

This case report presents the multidisciplinary treatment of an adult female who presented with a previously repaired right unilateral cleft lip and palate. The patient had been referred with a complaint of facial asymmetry, eating difficulties and a missing right central incisor. A clinical evaluation revealed severe facial asymmetry created by a mandibular deviation to the right side and a compensatory transverse cant of the maxillary occlusal plane. After pre-surgical orthodontic treatment, a Le Fort I osteotomy and a bilateral sagittal split osteotomy were performed. During post-surgical orthodontic treatment and, as a result of the rotational surgery, the maxillary left central incisor became the right central incisor. The left lateral incisor was subsequently moved toward the midline and reshaped with a composite buildup to serve as a new left central incisor. The combination of orthodontic, orthognathic and restorative treatment established a favourable occlusal and aesthetic result.

Open Access

Management of multiple adjacent asymmetric intruded teeth by differential curve of Spee mechanics: a case report

Published Online: 20 Jul 2021
Page range: 78 - 84

Abstract

AbstractIntroduction

Of the types of dental trauma, intrusive luxation is considered to have the worst prognosis. When forceful intrusion affects multiple adjacent teeth, orthodontic repositioning may be required; however, orthodontic treatment can be complicated by the development of a cant in the occlusal plane, especially when the affected teeth are not symmetrically located from the midline and corrective forces and anchorage are unbalanced. Designing an appropriate mechanism to overcome this problem is essential.

Case presentation

The present case report describes a 28-year-old male who suffered the traumatic intrusion of multiple teeth, with accompanying alveolar bone fractures, following a road traffic accident. The intruded teeth were repositioned using orthodontic traction, following which, endodontic treatment was performed. After initial alignment, differential curve of Spee mechanics were applied to correct the occlusal plane and an acceptable result was achieved. The overall outcome was maintained at a 24-months review.

Conclusion

This report demonstrates the importance of the early repositioning of intruded teeth to avoid dento-alveolar ankylosis, as well as the use of differential curve of Spee mechanics which provides effective force application in the management of a canted occlusal plane.

Open Access

Skeletal Class II open-bite malocclusion with idiopathic condylar resorption: a case report

Published Online: 20 Jul 2021
Page range: 85 - 93

Abstract

AbstractBackground

The orthodontic treatment of patients with idiopathic condylar resorption (ICR) remains controversial. The effect of molar intrusion using temporary anchorage devices (TADs) and the consequential gradual counterclockwise rotation of the mandible in patients with ICR remains unclear.

Aims

To present the long-term treatment result of an adult skeletal Class II open-bite malocclusion with a history of ICR corrected by the combination of orthognathic surgery and TADs.

Methods

After six months of occlusal splint therapy, a surgically-assisted intrusion of the maxillary molars was performed using TADs, followed by a bilateral sagittal split osteotomy (BSSO) and genioplasty.

Results

The five-year post-treatment records showed a good facial appearance, occlusion and mandibular/condylar position with no progress in the condylar resorption.

Conclusion

Based on a single case, this treatment option is an effective alternative to a bimaxillary osteotomy for patients presenting with ICR.

Open Access

A skeletal Class III malocclusion with agenesis and canine-bicuspid transposition: a non-surgical approach

Published Online: 20 Jul 2021
Page range: 94 - 102

Abstract

AbstractBackground

The present case report describes the orthodontic management of a patient who presented with a skeletal Class III malocclusion combined with other dental anomalies. The malocclusion was complicated by agenic maxillary lateral incisors and a lower right second premolar, in company with the transposition of the maxillary canines and premolars.

Methods

Dentoalveolar compensation of the anteroposterior jaw relationship was performed. The upper deciduous lateral incisors were extracted and the spaces closed, so that the first premolars replaced the missing lateral incisors while the canine transposition was maintained

Results

Satisfactory results were obtained which provided an improvement in function and occlusal stability, as well as smile and profile aesthetics.

Conclusion

This case demonstrates the importance of an accurate diagnosis when many treatment options are available and clearly addressed.

Open Access

Congenitally absent maxillary lateral incisors. A case report illustrating the use of a Mesialslider and a customised lingual appliance

Published Online: 20 Jul 2021
Page range: 103 - 116

Abstract

AbstractBackground

A young adolescent female, aged 17 years and one month, presented seeking orthodontic treatment to address the congenital absence of her maxillary lateral incisors.

Aims

The therapeutic aims were to provide an adequate aesthetic and functional occlusion, coupled with sound adjunctive periodontal tissue relationships and a favourable long-term prognosis.

Methods

The malocclusion was managed by customised lingual orthodontic appliances and the adjunctive use of direct skeletal anchorage derived from two palatal mini-implants.

Results

The treatment objectives of good aesthetics, a functional occlusion, normal function, a healthy periodontium and a balanced profile were readily achieved. The retention records demonstrate the stability of the correction. The treatment duration was approximately 41 months, which encompassed the use of full fixed customised lingual appliances over a period of 24 months.

Open Access

Orthodontic treatment in conjunction with distraction osteogenesis and orthognathic surgery for severe facial asymmetry

Published Online: 20 Jul 2021
Page range: 117 - 125

Abstract

Abstract

The present case report describes the combination of orthodontic treatment and two-stage surgery used to treat a 16-year-old female with a severe maxillary occlusal cant and a mandibular deviation. The patient was diagnosed with right temporomandibular joint ankylosis six months after suffering a facial injury at five years of age. A unilateral condylectomy was performed 12 months later. A hybrid functional appliance was used between nine and 16 years of age to prevent deterioration of the maxillary occlusal cant. At 16 years and six months, it was determined that the patient required a combination of surgical and orthodontic treatment, the pre-surgical orthodontic phase of which was completed at 19 years. The surgery was performed in two stages, which involved a Le-Fort 1 procedure to intrude the maxilla in the left molar region and to extrude in the right molar region. Distraction osteogenesis was performed to achieve a lengthening of the right mandibular ramus. The second operation was a unilateral sagittal split ramus osteotomy to achieve a forward and upward rotation of the left hemimandible. As a result, the patient’s facial asymmetry and occlusion significantly improved. The improvements were well maintained and the patient remained stable after one year of retention.

Open Access

Two-phase treatment of iatrogenic periodontitis: an eight-year follow-up

Published Online: 20 Jul 2021
Page range: 126 - 132

Abstract

Abstract

The mixed dentition is often accompanied by transient malocclusions, such as a midline diastema. The general principle is to monitor development to ascertain the appropriate timing of possible intervention. The present clinical article reports the case of a seven-year-old boy who suffered from severe iatrogenic periodontitis of the maxillary incisors due to direct closure of a diastema by a rubber band. The incisors survived and exhibited periodontal and pulpal health at an eight-year review. Carefully-sequenced interdisciplinary management and co-operation, appropriate biomechanics aided by temporary anchorage devices, and a longterm follow-up are noted as key factors determining success when clinicians encounter such challenges.

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