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.12/2013; 18(6):86-92. DOI:10.1590/S2176-94512013000600013
- [Show abstract] [Hide abstract]
ABSTRACT: Alkaline phosphatase (ALP), tartrate-resistant acid phosphatase (TRAP) and aspartate aminotransferase (AST) activities were studied as biomarkers of canine movement. Root resorption was also evaluated in canines subjected to the orthodontic forces. Nineteen subjects randomly received 100 and 150 g force using self-ligating brackets (SLB) either on the right or left site of maxillary arch. Gingival crevicular fluid samples were collected at distal sites of canines for five consecutive weeks. The activities of ALP, TRAP and AST were assayed and measured spectrophotometrically. Canine movement was measured for five consecutive weeks while root resorption was monitored at baseline, week 0 and week 5 using periapical radiographs. In 100 g group, TRAP activity significantly increased in week 3-5 when compared to TRAP baseline activity. However, ALP and AST activities slightly increased. In 150 g group, ALP and TRAP activities slightly increased when compared with their baseline activities. However, AST significantly increased in week 5. Canine movement and root resorption were not significantly different (p<0.05) in both groups. A force of 100 and 150 g slightly increased the bone modeling process and resulted in similar canine movement and root resorption. Therefore, 100 g force could be an optimum force for canine retraction and is preferable (compared with 150 g force) in canine retraction using SLB. ABSTRAK Aktiviti alkalin fosfatase (ALP), asid fosfatase rintang tartarat (TRAP) dan aspartat aminotransferase (AST) telah dikaji sebagai penanda biologi bagi pergerakan gigi kanin. Penyerapan akar juga dinilai pada gigi kanin yang dikenakan daya ortodontik. Sembilan belas subjek secara rawak menerima daya 100 dan 150 g menggunakan braket swa-peligaturan (SLB) samada pada kanan atau kiri lengkung rahang atas. Sampel cecair krevis gingiva (GCF) dikumpul daripada tapak distal gigi kanin selama 5 minggu berturut-turut. Aktiviti ALP, TRAP dan AST diasai dan diukur menggunakan spektrofotometer. Pergerakan gigi kanin diukur setiap minggu selama 5 minggu, manakala penyerapan akar diperhatikan pada sebelum rawatan, minggu 0 dan minggu 5 menggunakan radiograf periapikal. Bagi kumpulan 100 g, aktiviti TRAP meningkat secara signifikan pada minggu 3-5 apabila dibandingkan dengan aktiviti TRAP sebelum rawatan. Namun, aktiviti ALP dan AST hanya mengalami sedikit peningkatan. Bagi kumpulan 150 g pula, aktiviti ALP dan TRAP meningkat sedikit apabila dibandingkan dengan aktiviti masing-masing sebelum rawatan. Walau bagaimanapun, aktiviti AST didapati meningkat secara signifikan pada minggu ke-5. Pergerakan dan penyerapan akar gigi kanin didapati tidak berbeza secara signifikan (p<0.005) bagi kedua-kedua kumpulan. Daya 100 dan 150 g hanya menyebabkan sedikit peningkatan dalam proses pembentukan tulang dan seterusnya menghasilkan pergerakan dan penyerapan akar gigi kanin yang sama. Oleh itu, daya 100 g boleh menjadi daya optimum untuk retraksi gigi kanin dan lebih menjadi pilihan (berbanding daya 150 g) dalam retraksi gigi kanin menggunakan SLB. Kata kunci: Alkalin fosfatase; asid fosfatase rintang tartarat; aspartat aminotransferase; braket swa-peligaturan; penanda biologi; pergerakan gigiSains Malaysiana 01/2015; 44(2):249-256. · 0.48 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The Nance appliance is widely considered to be an efficient method of anchorage reinforcement; however, much of the perceived advantage is based on clinical judgment. The aim of this study was to assess the amounts of anchorage loss and desired tooth movement associated with the Nance appliance. The mandibular arches of 7 beagle dogs were used. The first and third premolars were extracted. Reference miniscrews were placed at the first premolar sites as stable references to measure the amounts of anchorage loss and desired tooth movement. Four beagles were fitted with custom-made Nance appliances on the fourth premolars and orthodontic bands on the second premolars (Nance group). Three beagles were fitted with orthodontic bands on the second and fourth premolars with no anchorage reinforcement (control group). The second premolars were retracted over 15 weeks in both groups. The amounts of second premolar movement (desired tooth movement) and fourth premolar movement (anchorage loss) were recorded at 5, 10, and 15 weeks. The percentages of desired tooth movement and anchorage loss to the total space closure were calculated. The mean desired tooth movement was significantly more in the Nance group than in the control group at 10 weeks (P <0.05) but was not significantly different at 5 and 15 weeks. The mean percentages of anchorage loss to the total space closure at 15 weeks were 45.7% in the control group and 28.8% in the Nance group. The Nance group had 16.9% less anchorage loss and 16.6% more desired tooth movement than did the control group at 15 weeks (P <0.05). Most of the anchorage loss (80%) in the Nance group occurred during the first 10 weeks. The Nance appliance did not provide absolute anchorage, but there was significantly less anchorage loss with it than in the control group. The majority of anchorage loss occurred during the first 10 weeks in the Nance group. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.American Journal of Orthodontics and Dentofacial Orthopedics 03/2015; 147(3). DOI:10.1016/j.ajodo.2014.11.014 · 1.44 Impact Factor