Orthodontic Appliances

正畸矫治器
  • 文章类型: Journal Article
    背景:本文分析了三个患者组之间的微生物参数和牙周健康状况的差异:那些使用固定矫治器进行常规正畸治疗的患者,使用清晰的矫正器进行正畸治疗的患者,对照组不接受治疗。
    方法:在本研究中,纳入60例患者。微生物分析采用细菌形态分析的定性和半定量方法。
    结果:分析显示,对于透明的口腔和牙周健康矫正器有显著差异。这可以归因于更好的细菌生物膜去除和减少对牙周膜的机械应力,容易清除矫正器的促进因素。观察到全口斑块评分的显著差异(p值<0.05),全口出血评分,斑块指数,和牙周健康评估测量。
    结论:尽管与使用传统正畸矫治器治疗的患者相比,矫治器组患者的整体卫生似乎有所改善,关于斑块组成没有统计学意义的结果。在这项研究的后续行动中,将使用更具体的技术进一步解决微生物学方面的问题。
    BACKGROUND: This article analyzes differences in microbiological parameters and periodontal health conditions among three patient groups: those undergoing conventional orthodontic treatment with fixed appliances, patients undergoing orthodontic treatment with clear aligners, and a control group receiving no treatment.
    METHODS: In this study, 60 patients were enrolled. The microbiological analysis employed a qualitative and semi-quantitative methodology of bacterial morphotype analysis.
    RESULTS: The analyses revealed a significant difference in favor of clear oral and periodontal health aligners. This could be attributed to better bacterial biofilm removal and reduced mechanical stress on the periodontal ligament, factors facilitated by the ease of clear aligner removal. Significant differences (p-value < 0.05) were observed for the Full-Mouth Plaque Score, Full-Mouth Bleeding Score, Plaque Index, and periodontal health assessment measurements.
    CONCLUSIONS: Although overall hygiene appears to be improved in patients in the aligners group compared to those treated with conventional orthodontic appliances, there are no statistically significant results regarding plaque composition. Microbiological aspects will be further addressed using more specific techniques in the follow-up of this research.
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  • 文章类型: Journal Article
    阻塞性睡眠呼吸暂停(OSA)可影响儿童和成人,and,如果不及时治疗,可能会对患者的总体和整体健康产生重大影响。牙科保健提供者和正畸医生在筛查有OSA风险的患者中具有跨学科的作用,并由睡眠医生进行转诊以建立明确的诊断。诊断测试的黄金标准是多导睡眠图。腺扁桃体肥大是儿童睡眠呼吸暂停的主要原因;因此,腺扁桃体切除术必须是一线治疗。腺体扁桃体切除术后,如果由于潜在的骨骼差异而存在残留的OSA,病人可以转介给正畸医生进行适当的管理。目前,文献中关于儿童预防性生长修饰以预防OSA的证据很少。在成年人中,管理OSA的黄金标准是气道正压(PAP)治疗;然而,对这种治疗的依从性相当低。口腔矫治器(OA)疗法是PAP不耐受患者和轻度至中度OSA患者的替代疗法。在仔细检查牙齿和牙周健康以及任何预先存在的关节状况后,必须由合格的牙医或正畸医生进行OA治疗。OA治疗可能导致OA相关的咬合不正,并且在开始治疗之前必须使患者意识到。重度OSA患者,手术上颌下颌前移(MMA)是非常有效的。
    Obstructive sleep apnea (OSA) can affect children and adults, and, if left untreated, could have a major impact on the general and overall well-being of the patient. Dental health care providers and orthodontists have an interdisciplinary role in screening patients at risk for OSA and make a referral to establish a definitive diagnosis by a sleep physician. The gold standard of diagnostic testing is polysomnography. The adeno-tonsillar hypertrophy is the primary cause of sleep apnea in children; therefore, adeno-tonsillectomy must be the first line of treatment. Post adeno-tonsillectomy, if there is residual OSA due to underlying skeletal discrepancy, the patient may be referred to an orthodontist for appropriate management. Currently the evidence in the literature for prophylactic growth modification in children to prevent OSA is weak. In adults, the gold standard for managing OSA is Positive Airway Pressure (PAP) therapy; however, adherence to this treatment is rather low. The oral appliance (OA) therapy is an alternate for PAP intolerant patients and for mild to moderate OSA patients. The OA therapy has to be administered by a qualified dentist or orthodontist after careful examination of dental and periodontal health as well as any pre-existing joint conditions. The OA therapy could cause OA-associated malocclusion and patients have to be made aware of prior to initiating treatment. In patients with severe OSA, surgical maxilla-mandibular advancement (MMA) is highly effective.
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  • 文章类型: Journal Article
    颈椎姿势与颅面形态有关,气道,步态和身体姿势。这种姿势可能会受到功能矫治器疗法带来的下颌位置变化的影响。因此,本系统综述旨在评估在骨骼II类受试者中使用功能矫治器治疗时颈椎姿势的变化.
    在六个电子数据库中搜索研究-Medline(通过Pubmed),Cochrane图书馆,OVID,LILACS,Scopus和WebofScience进行到2024年1月18日,没有任何日期或出版语言的限制。资格筛选,研究选择,数据提取由两名评审员独立进行.采用纽卡斯尔渥太华量表和CochraneRoB2.0对纳入研究的偏倚风险进行评估。使用随机效应模型进行Meta分析,以评估可移动和固定功能矫治器的颈椎变化。
    12篇满足资格标准的文章被纳入系统评价,9篇文章被纳入荟萃分析。五项研究显示偏见的风险较低,一个是中度的,六个是高风险的。等级评估显示了低质量的证据。荟萃分析显示,上颈椎倾斜度降低了1.16°(95%CI为-2.68至0.35,I2=6%),中颈椎倾斜增加2.20°(95%CI为0.46-3.94,I2=49%),颈椎曲角增加1.60°(95%CI为0.12-3.09,I2=89%),颈椎前凸角减少1.54°(95%CI为-4.16-1.08,I2=0%)。
    使用功能性矫治器注意到颈椎的最小直立。固定功能电器比可移动功能电器发挥更大的作用。通过可移除的功能性矫治器治疗可减少宫颈高前凸。虽然这些变化很小,临床正畸医生应该意识到功能疗法也会影响颈椎姿势。由于证据的异质性和低质量,结果将被批判性地考虑。
    UNASSIGNED: Cervical spine posture is related to craniofacial morphology, airway, gait and body posture. This posture may be influenced by the changes in the mandibular position brought about by functional appliance therapy. Therefore, this systematic review aimed to assess the changes in the cervical spine posture with functional appliance treatment in Skeletal Class II subjects.
    UNASSIGNED: A search of studies in six electronic databases - Medline (via Pubmed), the Cochrane Library, OVID, LILACS, Scopus and Web of Science were performed until January 18, 2024 without any restriction in date or language of publication. Eligibility screening, study selection, and data extraction were performed by two reviewers independently. The risk of bias assessment of the included studies was performed with the Newcastle Ottawa scale and Cochrane RoB 2.0. Meta-analysis was performed using random effects model for assessment of changes in the cervical spine with removable and fixed functional appliances.
    UNASSIGNED: Twelve articles that satisfied the eligibility criteria were included for systematic review and nine articles for meta-analysis. Five studies showed a low risk of bias, one as moderate and six as high risk of bias. GRADE assessment revealed a low quality evidence. Meta-analysis revealed a decrease of the upper cervical inclination by 1.16° (95 % CI of -2.68 to 0.35, I2 = 6 %), an increase of the middle cervical inclination by 2.20° (95 % CI of 0.46-3.94, I2 = 49 %), an increase in cervical curvature angle by 1.60° (95 % CI of 0.12-3.09, I2 = 89 %) and a decrease in cervical lordosis angle by 1.54° (95 % CI of -4.16 to 1.08, I2 = 0 %).
    UNASSIGNED: Minimal uprighting of the cervical spine was noted with functional appliances. Fixed functional appliances exerted a greater effect than removable functional appliances. Cervical hyperlordosis was reduced with removable functional appliance treatment. Though these changes are minimal, the clinical orthodontist should be aware that functional therapy also influences cervical spine posture. Due to the heterogeneity and low quality of evidence, the results are to be considered critically.
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  • 文章类型: Case Reports
    暂无摘要。
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  • 文章类型: Journal Article
    这项初步研究涉及对接受治疗矫正器治疗的I类错牙合畸形患者的预测牙齿变化的成功评估,使用叠加。
    将数字模型叠加并使用3DSlicer5.0软件进行分析。关于水平和垂直线性位移的治疗和预测变化,中远端旋转,和门牙颊舌倾翻进行量化。通过将平均治疗变化量除以预测的变化量来计算成功率。
    下切牙侵入是预测的垂直位移中最准确的(86.96%),上犬齿的颊扩张(99.32%)和下切牙的内侧平移(98.57%)是最准确的水平线性位移。下切牙的预测旋转精度最高(75.69%)。切牙颊舌翻倒成功率在45.78%至69.31%之间。发现上摩尔挤压(10.23%)和收缩(8.91%)的预测变化精度较低。然而,计划在这些方向上进行最小的校正。
    可以评估上颌和下颌弓所有区域的牙齿变化。对于计划用于ClearCorrect对准器治疗的大多数运动,观察到了很高的成功率。
    UNASSIGNED: This pilot study concerned evaluation of the success of predicted dental changes in patients presenting with Class I malocclusions who were submitted to treatment aligners, using the superimposition.
    UNASSIGNED: The digital models were superimposed and analyzed using 3DSlicer 5.0 software. Treatment and predicted changes regarding horizontal and vertical linear displacements, mesiodistal rotations, and incisor buccolingual tipping were quantified. The success rates were calculated by dividing the mean treatment change amount by the predicted change amount.
    UNASSIGNED: Lower-incisor intrusion was the most accurate of the predicted vertical displacements (86.96 %), and buccal expansion of upper canines (99.32 %) and mesial translation of the lower incisors (98.57 %) were the most accurate horizontal linear displacements. The predicted rotation was achieved with the highest accuracy for lower incisors (75.69 %). Incisor buccolingual tipping success rates ranged between 45.78 % and 69.31 %. Low accuracy of predicted changes was found for upper-molar extrusion (10.23 %) and constriction (8.91 %). However, minimal corrections in these directions were planned.
    UNASSIGNED: Dental changes for all regions of maxillary and mandibular arches could be evaluated. High success rates were observed for most of the movements planned for ClearCorrect aligner therapy.
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    文章类型: Journal Article
    Linguoverted mandibular canine teeth (LMC) is a common malocclusion in dogs. Several inclined bite-plane techniques using acrylic resin have been introduced to correct LMC in dogs. Although these techniques have suggested modifications to overcome shortcomings, there are still limitations; e.g., high technical sensitivity, as the viscous acrylic resin must still be fabricated in the oral cavity. The authors developed a novel method for small-breed dogs that uses a doughy acrylic resin form to achieve an easy intraoral design and extraoral fabrication. Eight small-breed dogs were presented to evaluate and treat malocclusion causing palatal trauma. First, a Class-1 malocclusion with linguoversion of the mandibular canine teeth (6 dogs with unilateral LMC and 2 dogs with bilateral) was diagnosed based on oral examination. Dogs were treated with the new method using a doughy acrylic resin form for 6 to 7 wk and had posttreatment follow-up 1 y after the procedure. All treated canine teeth were in correct positions 1 y after the appliances were removed. Key clinical message: The authors believe that the new method using a doughy acrylic resin form could be a good alternative for veterinarians to use when treating LMC.
    Un nouveau dispositif orthodontique en acrylique pour le traitement des canines mandibulaires linguoverties chez les petits chiens. Les canines mandibulaires linguoverties (LMC) sont une malocclusion courante chez le chien. Plusieurs techniques de plan de morsure incliné utilisant de la résine acrylique ont été introduites pour corriger la LMC chez le chien. Bien que ces techniques aient suggéré des modifications pour surmonter les lacunes, elles présentent encore des limites; par exemple, une sensibilité technique élevée, car la résine acrylique visqueuse doit encore être fabriquée dans la cavité buccale. Les auteurs ont développé une nouvelle méthode pour les chiens de petite race qui utilise une forme pâteuse de résine acrylique pour obtenir une conception intra-orale et une fabrication extra-orale faciles. Huit chiens de petite race ont été présentés pour évaluer et traiter une malocclusion provoquant un traumatisme palatin. Tout d’abord, une malocclusion de classe 1 avec linguoversion des canines mandibulaires (6 chiens avec LMC unilatérale et 2 chiens avec bilatérale) a été diagnostiquée sur la base d’un examen oral. Les chiens ont été traités avec la nouvelle méthode en utilisant une forme pâteuse de résine acrylique pendant 6 à 7 semaines et ont fait l’objet d’un suivi post-traitement 1 an après la procédure. Toutes les canines traitées étaient dans la bonne position un an après le retrait des appareils.Message clinique clé:Les auteurs estiment que la nouvelle méthode utilisant une forme pâteuse de résine acrylique pourrait être une bonne alternative que les vétérinaires pourraient utiliser lors du traitement du LMC.(Traduit par Dr Serge Messier).
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  • 文章类型: Journal Article
    背景:本研究旨在比较使用矫正器治疗期间疼痛对生活质量和患者满意度的影响。
    方法:邀请94名积极治疗的受试者回答关于疼痛严重程度和持续时间的自我报告问题,其他体征和症状的发生,以及他们对治疗的满意程度。此外,OHIP-14问卷用于评估患者OHRQoL.
    结果:94名患者(49名女性和45名男性)回答了调查。69.1%的患者报告疼痛持续时间为1-3天(n=60)。对于那些报告疼痛的人(n=84),它被认为是轻度的42.9%和中度的52.4%。几乎64%的样本对矫正器的美学非常满意(n=60),而49%的样本对总体治疗满意(n=46)。平均OHIP-14评分为3.36±2.54。OHRQoL与疼痛严重程度显著相关,而报告经历中度疼痛的患者的平均OHIP-14评分明显高于报告经历轻度疼痛的患者(分别为3.92±1.93和2.69±2.83;p=0.036).OHIP-14的“心理不适”领域受疼痛程度的影响最大。
    结论:疼痛严重程度显著影响OHRQoL,在使用清晰对齐器治疗的成年患者中。然而,报告了高水平的患者满意度,无论疼痛持续时间或严重程度。
    BACKGROUND: This study aims to compare the impact of pain on quality of life and patient satisfaction during treatment with aligners.
    METHODS: Ninety-four subjects in active treatment were invited to answer self-reported questions concerning pain severity and duration, occurrence of other signs and symptoms, and level of satisfaction with their treatment. Also, the OHIP-14 questionnaire was applied to assess patients\' OHRQoL.
    RESULTS: Ninety-four patients (49 women and 45 men) answered the survey. Pain duration of 1-3 days was reported by 69.1% of patients (n = 60). For those who reported pain (n = 84), it was considered mild severity by 42.9% and moderate by 52.4%. Almost sixty-four percent of the sample were very satisfied with the aligner\'s aesthetics (n = 60) and forty-nine percent were satisfied with treatment in general (n = 46). Mean OHIP-14 score was 3.36 ± 2.54. OHRQoL was significantly associated with pain severity, whereas patients who reported having experienced moderate pain presented a significantly higher mean OHIP-14 score than those who reported having experienced mild pain (3.92 ± 1.93 and 2.69 ± 2.83, respectively; p = 0.036). The \"psychological discomfort\" OHIP-14\'s domain was the most influenced by the level of pain.
    CONCLUSIONS: Pain severity significantly influenced OHRQoL, in adult patients under treatment with clear aligners. However, high levels of patient satisfaction were reported, regardless of pain duration or severity.
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  • 文章类型: Journal Article
    背景:外部根尖吸收(EARR)是在接受固定矫治器治疗的患者中经常观察到的不良事件。在治疗期间评估患者的风险很重要,因为某些因素被认为与发生的可能性增加有关。然而,它们的预测价值仍然有限,使基于证据的临床决策对正畸医生具有挑战性。为了解决这个问题,荷兰正畸医师协会(NvVO)于2018年根据AGREEII工具(评估研究和评估指南II)制定了EARR临床实践指南(CPG).这项研究的目的是了解正畸医生对指南的实际利用和实际实施情况。要检验的假设是,在引入之后,EARR的临床实践已转向CPG中的建议。
    目的:调查2018年EARR临床实践指南在口腔正畸医师中的使用情况。
    方法:针对指南中描述的EARR的四个领域,开发了使用7点Likert量表的问卷。问卷是试行的,定稿,然后在荷兰的正畸医生中以数字方式分发。REDCap用于数据收集,从2021年6月的邀请电子邮件开始,然后是两个提醒。效果由曼-惠特尼U检验检验,并分析了人口统计学变量的影响。
    结果:向所有275人发送了问卷,并由133人完成(回应率48%);包括N=59名女性和N=73名男性;81%的人在荷兰接受过培训,89%有≥6年的工作经验,89%的人在私人正畸诊所工作。一百三十名正畸医生(98.5%)报告了临床实践的变化。如果在治疗期间诊断出EARR,则有关EARR的临床行为发生了最大的积极变化。性,临床经验,专业培训国家,受访者的工作环境并不影响EARR的临床实践。
    结论:这份问卷表明,指南出台3年后,正畸医生改进了他们自我报告的临床实践,以更标准化地管理牙根吸收。没有一个人口统计学预测因子对结果有显著影响。
    BACKGROUND: External apical root resorption (EARR) is a frequently observed adverse event in patients undergoing fixed appliance therapy. Assessing the patients\' risk during treatment is important, as certain factors are assumed to be associated with an increased likelihood of occurrence. However, their predictive value remains limited, making evidence-based clinical decision-making challenging for orthodontists. To address this issue, the Dutch Association of Orthodontists (NvVO) developed a clinical practice guideline (CPG) for EARR in accordance with the AGREE II instrument (Appraisal of Guidelines for Research and Evaluation II) in 2018. The aim of this study is to get insight into the actual utilization and the practical implementation of the guideline among orthodontists. The hypothesis to be tested was that after its introduction, clinical practice for EARR has changed towards the recommendations in the CPG.
    OBJECTIVE: To investigate the use of the 2018 clinical practice guidelines for EARR among orthodontists 3 years after its introduction.
    METHODS: A questionnaire using a 7-point Likert scale was developed concerning four domains of EARR described in the guideline. The questionnaire was piloted, finalised, and then distributed digitally among Dutch orthodontists. REDCap was used for data collection, starting with an invitation email in June 2021, followed by two reminders. Effect was tested by the Mann-Whitney U test, and the influence of demographic variables was analysed.
    RESULTS: Questionnaires were sent out to all 275 and completed by 133 (response rate 48%); N = 59 females and N = 73 males were included; 81% had their training in the Netherlands, 89% had ≥ 6 years of work experience, and 89% worked in private orthodontic practice. One hundred thirty orthodontists (98.5%) reported changes in clinical practice. The biggest positive change in clinical behaviour regarding EARR occurred if EARR was diagnosed during treatment. Sex, clinical experience, country of specialist training, and working environment of the respondents did not affect clinical practices regarding EARR.
    CONCLUSIONS: This questionnaire demonstrated that, 3 years after introduction of the guideline, orthodontists improved their self-reported clinical practices to a more standardised management of root resorption. None of the demographic predictors had a significant effect on the results.
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  • 文章类型: Journal Article
    目的:评估市售正畸产品提供商网站中包含的信息的质量和准确性。
    方法:确定了21个正畸矫治器和辅助(产品)提供商的网站。网站内容通过两种经过验证的信息质量工具(DISCERN和《美国医学会杂志》[JAMA]基准)和一种信息准确性工具进行评估。对网站内容进行了主题和子主题的定性分析。
    结果:超过一半(n=11;52.3%)的评估网站包含临床医生的证词。平均(SD)DISCERN评分为33.14(5.44)。没有网站记录表明可靠性所需的至少三个JAMA基准。最常见的内容主题与生活质量影响和治疗持续时间有关。网站内只有8%的陈述是客观真实的。Pearson相关系数表明DISCERN评分与信息准确度评分相关(r=.83;P<.001)。
    结论:市售正畸产品提供商网站中包含的信息质量和准确性较差。DISCERN和信息准确性工具的结合使用可能有助于克服各自的缺点。临床医生在自己的网站上添加链接到这些网站之前,应检查正畸产品提供商网站上信息的准确性。
    OBJECTIVE: To assess the quality and accuracy of information contained within the websites of providers of marketed orthodontic products.
    METHODS: Twenty-one websites of orthodontic appliance and adjunct (product) providers were identified. The website content was assessed via two validated quality-of-information instruments (DISCERN and the Journal of the American Medical Association [JAMA] benchmarks) and an accuracy-of-information instrument. Website content was qualitatively analyzed for themes and subthemes.
    RESULTS: More than half (n = 11; 52.3%) of the assessed websites contained clinician testimonials. The mean (SD) DISCERN score was 33.14 (5.44). No website recorded the minimum of three JAMA benchmarks required to indicate reliability. The most common content themes related to quality-of-life impact and treatment duration. Just 8% of the statements within the websites were objectively true. The Pearson correlation coefficient indicated that the DISCERN scores were correlated with the accuracy-of-information scores (r = .83; P < .001).
    CONCLUSIONS: The quality and accuracy of information contained within the websites of the providers of marketed orthodontic products was poor. The combined use of DISCERN and the accuracy-of-information instrument may help overcome the shortcomings of each. Clinicians should check the accuracy of information on orthodontic product provider websites before adding links to those websites on their own sites.
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  • 文章类型: Journal Article
    探索了使用具有双半圆形缺口配置的标本进行正畸热塑性矫正器材料拉伸测试的潜力。用万能试验机对无缺口和双半圆形缺口试样进行拉伸加载,测定其拉伸强度,而有限元分析(FEA)和数字图像相关(DIC)用于估计应力和应变,分别。形状确实影响了抗拉强度,证明了统一标本形式的重要性。在拉伸下的弹性阶段,双半圆形缺口标本表现出与无缺口标本相似的行为。然而,在无缺口标本的应变模式中观察到很大的差异,表现出更大的最终失败的可能性,而双半圆形缺口标本的应变模式显示出均匀性。理论模型(FEA)和实际模型(DIC)之间的相当大的一致性进一步证实了双半圆形缺口模型的有效性。
    The potential of using specimens with a double-semicircular-notched configuration for performing tensile tests of orthodontic thermoplastic aligner materials was explored. Unnotched and double-semicircular-notched specimens were loaded in tension using a universal testing machine to determine their tensile strength, while finite element analysis (FEA) and digital image correlation (DIC) were used to estimate stress and strain, respectively. The shape did affect the tensile strength, demonstrating the importance of unifying the form of the specimen. During the elastic phase under tension, double-semicircular-notched specimens showed similar behavior to unnotched specimens. However, great variance was observed in the strain patterns of the unnotched specimens, which exhibited greater chance of end-failure, while the strain patterns of the double-semicircular-notched specimens showed uniformity. Considerable agreement between the theoretical (FEA) and practical models (DIC) further confirmed the validity of the double-semicircular-notched models.
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