A randomized clinical trial to compare the Goshgarian and Nance palatal arch.
ABSTRACT The aim of this trial was to evaluate whether a Nance or Goshgarian palatal arch was most effective for prevention of mesial drift, distal tipping, prevention of mesio-palatal rotation of the upper first permanent molars, and patient comfort and ease of removal. Patients were recruited from a district general hospital and a specialist orthodontic practice and randomly allocated to a Goshgarian (n = 29) or a Nance (n = 28) group. Pre-treatment study models (T1) were taken followed by the placement of the palatal arch, premolar extractions, and upper and lower fixed appliances. The clinical end point was 6 months (T2), at which time, an impression for an upper study model was taken. The amount of upper first permanent molar mesial movement, distal tipping, and mesio-palatal rotation was measured by scanning T1 and T2 study models and then using a software program to calculate molar changes. In addition, the patients recorded their discomfort scores using a seven-point Likert scale at each recall visit. Forty-nine patients (86 per cent) completed the trial. t-tests were used to compare molar movements between the Goshgarian and Nance palatal arch groups. There were no statistically significant differences between the palatal arches in terms of prevention of mesial drift or distal tipping (P > 0.05). There was a statistically significant difference in the amount of molar rotation between the arch types, with both exhibiting some disto-palatal rotation even though they were not activated for this movement. The Goshgarian palatal arch produced marginally more disto-palatal rotation than the Nance arch (P = 0.02), although this may not be considered clinically significant. A Mann-Whitney test revealed that there was also a statistically significant difference in pain scores between the Goshgarian and the Nance arch, with the latter being associated with more discomfort (P = 0.001). This trial did not support any preference in the use of the Goshgarian or Nance palatal arch, unless the slightly reduced patient discomfort with the Goshgarian arch is considered significant.
- SourceAvailable from: Luiz Guilherme Martins Maia[Show abstract] [Hide abstract]
ABSTRACT: The aim of this study was to identify the procedures adopted by Brazilian orthodontists in the following situations: extraction space closure, anchorage control in case of necessary anchorage for group A and frequency of skeletal anchorage use, especially in the upper jaw. A questionnaire was sent to the e-mail address of all dentists registered in the Brazilian Federal Council of Dentistry. The results showed that most Brazilian orthodontists usually perform extraction space closure by means of sliding mechanics. The use of palatal bar, inclusion of second molars in the archwire and space closure performed in two phases are the most used techniques for anchorage control in the upper jaw. The skeletal anchorage is referenced by 36.5% of specialists as a routine practice for the upper arch anchorage. There is a wide variety of procedures adopted by Brazilian orthodontists for orthodontic space closure and anchorage control.Dental press journal of orthodontics. 12/2013; 18(6):86-92.